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Clear exam
Calculate
(
VAC
) Voluntary anal contraction
Yes
No
NT
Yes
No
NT
(
DAP
) Deep anal pressure
Lowest non-key muscle with motor function
Right:
C5 - Shoulder: Flexion, extension, abduction, adduction, internal and external rotation - Elbow: Supination
C6 - Elbow: Pronation - Wrist: Flexion
C7 - Finger: Flexion at proximal joint, extension. Thumb: Flexion, extension and abduction in plane of thumb
C8 - Finger: Flexion at MCP joint Thumb: Opposition, adduction and abduction perpendicular to palm
T1 - Finger: Abduction of the index finger
L2 - Hip: Adduction
L3 - Hip: External rotation
L4 - Hip: Extension, abduction, internal rotation - Knee: Flexion - Ankle: Inversion and eversion - Toe: MP and IP extension
L5 - Hallux and Toe: DIP and PIP flexion and abduction
S1 - Hallux: Adduction
Left:
C5 - Shoulder: Flexion, extension, abduction, adduction, internal and external rotation - Elbow: Supination
C6 - Elbow: Pronation - Wrist: Flexion
C7 - Finger: Flexion at proximal joint, extension. Thumb: Flexion, extension and abduction in plane of thumb
C8 - Finger: Flexion at MCP joint Thumb: Opposition, adduction and abduction perpendicular to palm
T1 - Finger: Abduction of the index finger
L2 - Hip: Adduction
L3 - Hip: External rotation
L4 - Hip: Extension, abduction, internal rotation - Knee: Flexion - Ankle: Inversion and eversion - Toe: MP and IP extension
L5 - Hallux and Toe: DIP and PIP flexion and abduction
S1 - Hallux: Adduction
Comments:
Consider normal or not normal for classification:
Consider Normal
Consider Not Normal
If motor impairment not due to SCI, please indicate reason:
Plexopathy
Peripheral neuropathy
Pre-existing myoneural disease (e.g. Stroke, MS, etc.)
Other (specify:)
Specify:
Classification
Neurological levels
R
L
Sensory
Motor
Neurological Level of Injury
(NLI)
Asia Impairment Scale
(AIS)
Zone of partial preservation
R
L
Sensory
Motor
Sub-scores
R
L
Total
UEMS
LEMS
Light touch
Pin prick