AIM:
To assess motor impairment using the ASIA motor examination (example C5-elbow flexors)
Rationale:
The ASIA (American Spinal Injury Association) impairment scale is used to assess neurological level of motor impairment
Equipment:
- Height adjustable bed
Key Points:
General
- The patient is positioned in supine for the entire test
- The ASIA guidelines identify a muscle to represent the myotomes between C5- T1 and L2-S1 – http://www.asia spinalinjury.org/publications/2006_Classif_worksheet.pdf (Links to an external site.)
- Begin with C5 myotome and proceed caudally
- Test entire right side first, then left side.
- Score each muscle according to:
- 0 = no contraction
- 1 = contraction
- 2 = full range of motion, gravity eliminated
- 3 = full range of motion, against gravity
- 4 = full range of motion, against some resistance o 5 = full range of motion, against normal resistance
- Test for grade 3 first, if the patient is successful, then test for grade 4, and 5. If not successful, then test for grade 2, 1 and 0.
- Grade 3 is tested through full active range of motion
- Grades 4 and 5 are tested isometrically
Common Errors:
- Therapist moves patient out of the supine position
- Therapist fails to stabilize the proximal segment
- Therapist fails to support the distal segment
- Therapist fails to accurately palpate the muscle belly when testing for grade 1
Progression and Variety:
- Not applicable as these tests are performed in a standardized manner