2009 Review and Revisions of the International Standards for the Neurological Classification of Spinal Cord Injury

J Spinal Cord Med, 2010 · DOI: · Published: October 1, 2010

Simple Explanation

The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) were reviewed by experts from ASIA and the International Spinal Cord Society. The review aimed to update the standards, create educational materials, and establish a process for future revisions. The updated standards include clarifications and revisions to the sensory and motor exams, as well as specific instructions for the anorectal examination.

Study Duration

3 years (2006 to 2009) for InSTeP development

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
The ISNCSCI's primary purpose is to serve as an internationally adopted standardized clinical neurological examination and classification for SCI.
2
Revisions were made to the sensory and motor exams, including alternate tests for the T3 sensory exam and clarifications for muscle/joint contractures.
3
Specific directions were added for the anorectal examination to improve accuracy and avoid misinterpretations.

Research Summary

The International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) were reviewed by the ASIA’s Education and Standards Committees, in collaboration with the International Spinal Cord Society’s Education Committee. The Standards Committee recommended that the numerous items that were revised should be published and a precedent established for a routine published review of the ISNCSCI. ASIA’s International Standards Committee has adopted a process for thorough and transparent review of requests to revise the ISNCSCI, or a regular periodic review of the entire standards, to keep them up-to-date with current knowledge.

Practical Implications

Improved Accuracy

The revisions and clarifications to the ISNCSCI enhance the accuracy and reliability of neurological assessments for spinal cord injuries.

Standardized Practice

The updated standards promote consistency in clinical practice and research, facilitating better data collection and analysis.

Enhanced Education

The development of InSTeP and WeeSTeP provides comprehensive educational resources for healthcare professionals involved in spinal cord injury care.

Study Limitations

1
The earliest a revised Reference Manual will be available will be in 2013.
2
The change made to L4—Ankle Dorsiflexors was not intentional and requires correction in a future version of InSTeP.
3
The non–key muscle concept requires further research and consensus before being fully integrated into the ISNCSCI.

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