FUNCTIONAL EVALUATION  classification of injury (neurologically complete or

International Standards incomplete)

 widely accepted instrument of impairment
 interrater reliability is very good overall
The Modified Benzel Scale
 7-grade scale
 expands the AIS D category into 3 separate grades
International Classification for Surgery of the Hand in
Tetraplegia
 most commonly used when dealing with upper limb
reconstruction procedures#
Grasp and Release Test
 measure functional limitation in SCI
 evaluates the impact of implanted upper limb
prosthesis/capabilities of UE instrument
Timed Get Up and Go test
 To measure walking in a standardized environment as
it relates to walking, the
Walking Scale for SCI (WISCI)
 a valid scale that ranks walking based on various
combinations of braces, assistive devices, and level of
personal assistance
 perform neurological physical examination
using the International Standards
 72 hours post injury
initial strength of muscle immediately below motor level
 most significant predictor of achieving antigravity
strength by 1-year postinjury
Presence of sensation (dermatome ~ motor level)
 improves the chances of recovery
with incomplete tetraplegia
 better prognosis for recovery
 best prognosis for LE motor recovery and ambulation
Ambulation
 can be predicted by having pin prick sensation
sparing in 50% or more of the dermatomes in the LE
(L2-S1)
motor recovery
 within 1st 6 months after injury
 early return of motor function = better functional
outcome
 in the UEs and Les: occurs concurrently

Activity performance
 what an individual can do in his/her environment
 measured
 Functional Independence Measure (FIM) -
generic instrument
 Canadian Occupational Performance
Measure
 Quadriplegic Index of Function (QIF) - use to
persons with tetraplegia
 spinal cord independence measure (SCIM) -
addresses indoor and outdoor activities

**QIF & SCIM are more sensitive & a better

indicator of motor recovery (reflect small
gains in function = small strength gains

 same SCI level and severity ≠ levels of activity

performance
 differences:
o adaptive equipment
o personal assistance
o accessibility of environment

CHART: most commonly used measure of community

functioning (participation) for persons with SCI
 QOL
 is not related to impairment
 highly associated
o social support
o community integration
o resumption of life and family roles

PROGNOSTICATING NEUROLOGICAL
RECOVERY
 to provide accurate information to patients & their
families#
 to guide the rehabilitation course

Major factors in predicting recovery:

 initial NLI
 initial motor strength