ASIA Motor Score

[vederosa]

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I was having a discussion on my clinical about the ASIA Motor score today and thought I would put it up here and see what the response was...

Anyway... Do you think using the ASIA motor score is a good/reliable tool for helping to predict patient prognosis/outcome? (ie 20/50 = moderate outcome)

Why or why not?

 

[fozzy40]

I think that the ASIA scoring system is a good system to describe patients for the immediate acute and subacute period. From an inpatient rehabilitation aspect, the score allows the team to set appropriate goals for equipment needed, type of family and patient education, ADL evaluation, and length of stay. The word "outcome" is tricky word. The outcome of SCI patients is multifactorial and I find that the ASIA score is not as big of a factor as what type of insurance they have, what state they live in (i.e. how much funding is allocated), environmental barriers, and there social support system.

It's not perfect (like any other system) but it gets the job done from my perspective.

 

[Akiramay]

ASIA scores are helpful in determining the potential for neurological improvement:

A retrospective analysis was conducted on 150 patients w/ SCI b/w T4-S5 over a 10 yr period.
92.9% of pts w/ lumbar SCI improved 1 ASIA level or more compared to 22.4% of pts w/ thoracic or thoracolumbar SCI in 1 year. No correlation with age, gender, or race.

Improvement by ASIA level:

ASIA A: 7.7%
ASIA B: 66.7%
ASIA C: 84.6%
ASIA D: 95.2%

(Harrop et. al, 2011)

From the SCI Locomotor Trial:

Able to walk 150' at supervised or better level of function at discharge:
15% ASIA B
40% ASIA C
75% ASIA D

So if someone is ASIA A, it's not likely that they will regain strength and be ambulatory. You can use evidence so that if someone with an SCI asks you if they will be able to walk again, you won't tell them anything misleading. It also lets you know the prognosis for your patient.