Cohen M E, Ditunno J F, Donovan W H, Maynard F M
Department of Rehabilitation Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Spinal Cord. 1998 Aug;36(8):554-60. doi: 10.1038/sj.sc.3100602.
This study was designed to test the 1992 International Standards for Neurological and Functional Classification of Spinal Cord Injury. One hundred and six professionals in the field of spinal cord injury attending an instructional course at the 1994 ASIA Meeting participated in the test. Participants completed a pretest and posttest in which they classified two patients who had a spinal cord injury (one with complete tetraplegia and one with incomplete paraplegia) by sensory and motor levels, zone of partial preservation (ZPP), ASIA Impairment Scale and completeness of injury. Between tests, three members of the ASIA Standards Executive Committee gave presentations on the neurological assessment, scoring, scaling and classification of spinal cord injury and a video of the actual examinations of the two cases was viewed. Percent 'correct' (as defined by the ASIA Standards Committee) was calculated for sensory and motor levels, ZPP, ASIA Impairment and completeness. Overall, the analyses showed that participants had very little difficulty in correctly classifying the patient with complete tetraplegia. Pretests scores ranged from 72% (left motor level) to 96% (complete injury), posttest scores from 73% (left motor level) to 100% correct (complete injury). For the patient with incomplete paraplegia (Case 2), scores were considerably lower. Pretest scores ranged from 16% (right motor level) to 95% correct (incomplete injury); posttest scores from 21% (right motor level) to 97% correct (incomplete injury). The results showed that further revisions of the 1992 Standards and more training is needed to ensure accurate classification of spinal cord injury.
本研究旨在测试1992年脊髓损伤神经学与功能分类国际标准。106名参加1994年亚洲脊髓损伤学会会议培训课程的脊髓损伤领域专业人员参与了此次测试。参与者完成了一项前测和后测，在测试中他们根据感觉和运动平面、部分保留区（ZPP）、ASIA损伤分级和损伤的完整性对两名脊髓损伤患者（一名完全性四肢瘫患者和一名不完全性截瘫患者）进行分类。在两次测试之间，ASIA标准执行委员会的三名成员就脊髓损伤的神经学评估、评分、分级和分类进行了讲座，并观看了这两例病例实际检查的视频。计算了感觉和运动平面、ZPP、ASIA损伤分级和损伤完整性的“正确”百分比（由ASIA标准委员会定义）。总体而言，分析表明参与者对完全性四肢瘫患者进行正确分类几乎没有困难。前测分数从72%（左侧运动平面）到96%（完全损伤）不等，后测分数从73%（左侧运动平面）到100%正确（完全损伤）。对于不完全性截瘫患者（病例2），分数要低得多。前测分数从16%（右侧运动平面）到95%正确（不完全损伤）；后测分数从21%（右侧运动平面）到97%正确（不完全损伤）。结果表明，需要对1992年标准进行进一步修订并提供更多培训，以确保脊髓损伤的准确分类。
