Prediction of ambulatory performance based on motor scores derived from standards of the American Spinal Injury Association

Abstract

Assessment of strength using motor scores derived from the standards of the American Spinal Injury Association (ASIA) was compared with assessment using motor scores based on biomechanical aspects of walking in the prediction of ambulatory performance. Measurements of strength, gait performance, and the energy expenditure were performed in 36 spinal cord injured patients. The ASIA scoring system compared favorably with the biomechanical scoring system. The ASIA score strongly correlated with the percent increase in the rate of O2 consumption above normal (p < .0005), O2 cost per meter (p < .0006), peak axial load exerted by the arms on crutches (p < .0001), velocity (p < .0001), and cadence (p < .0001).Patients with lower extremity ASIA scores ≤ 20 were limited ambulators with slower average velocities at higher heart rates, greater energy expenditure, and greater peak axial load exerted on assistive devices than patients with lower extremity ASIA scores ≥ 30 who were community ambulators. We conclude the ASIA motor score is a simple clinical measure that strongly correlates with walking ability.