RIGHT

RIGHT

Light Touch (LTR) Pin Prick (PPR) C2 C3 C4 C3 Elbow flexors C5 Wrist extensors UER C6 (Upper Extremity Right) Elbow extensors C7 Finger flexors C8 Finger abductors (little finger) T1 T2 Comments (Non-key Muscle? Reason for NT? Pain? C6 Non-SCI condition?): T3 Dorsum T4 T5 T6 T7 T8 S3 T9 T10 T11 2 T12 L S2 3 L1 Hip flexors L2 Knee extensors L3 LER Ankle dorsiflexors L4 (Lower Extremity Right) L Long toe extensors L5 4 S1 Ankle plantar flexors S1 L5 S2 S3 (VAC) Voluntary Anal Contraction S4-5 (Yes/No) RIGHT TOTALS (MAXIMUM) (50) (56) (56) MOTOR SUBSCORES LER +UEL = UEMS TOTAL + LEL = LEMS TOTAL UER MAX MAX (25) (25) (50) (25) (25) R L NEUROLOGICAL 3. NEUROLOGICAL LEVELS 1. SENSORY LEVEL OF INJURY Steps 1- 6 for classification 2. MOTOR (NLI) as on reverse Page 1/2 This form may be copied freely but should not be altered without permission from the American Spinal Injury Association.

Figure 30.13 American Spinal Injury Association neurological evaluation. (Reproduced with permission from American Spinal Injury Association: International standards for neurological classi /f_i cation of spinal cord injury

RIGHT

Light Touch (LTR) Pin Prick (PPR) C2 C3 C4 C3 Elbow flexors C5 Wrist extensors UER C6 (Upper Extremity Right) Elbow extensors C7 Finger flexors C8 Finger abductors (little finger) T1 T2 Comments (Non-key Muscle? Reason for NT? Pain? C6 Non-SCI condition?): T3 Dorsum T4 T5 T6 T7 T8 S3 T9 T10 T11 2 T12 L S2 3 L1 Hip flexors L2 Knee extensors L3 LER Ankle dorsiflexors L4 (Lower Extremity Right) L Long toe extensors L5 4 S1 Ankle plantar flexors S1 L5 S2 S3 (VAC) Voluntary Anal Contraction S4-5 (Yes/No) RIGHT TOTALS (MAXIMUM) (50) (56) (56) MOTOR SUBSCORES LER +UEL = UEMS TOTAL + LEL = LEMS TOTAL UER MAX MAX (25) (25) (50) (25) (25) R L NEUROLOGICAL 3. NEUROLOGICAL LEVELS 1. SENSORY LEVEL OF INJURY Steps 1- 6 for classification 2. MOTOR (NLI) as on reverse Page 1/2 This form may be copied freely but should not be altered without permission from the American Spinal Injury Association.

Figure 30.13 American Spinal Injury Association neurological evaluation. (Reproduced with permission from American Spinal Injury Association: International standards for neurological classi /f_i cation of spinal cord injury

RIGHT

Light Touch (LTR) Pin Prick (PPR) C2 C3 C4 C3 Elbow flexors C5 Wrist extensors UER C6 (Upper Extremity Right) Elbow extensors C7 Finger flexors C8 Finger abductors (little finger) T1 T2 Comments (Non-key Muscle? Reason for NT? Pain? C6 Non-SCI condition?): T3 Dorsum T4 T5 T6 T7 T8 S3 T9 T10 T11 2 T12 L S2 3 L1 Hip flexors L2 Knee extensors L3 LER Ankle dorsiflexors L4 (Lower Extremity Right) L Long toe extensors L5 4 S1 Ankle plantar flexors S1 L5 S2 S3 (VAC) Voluntary Anal Contraction S4-5 (Yes/No) RIGHT TOTALS (MAXIMUM) (50) (56) (56) MOTOR SUBSCORES LER +UEL = UEMS TOTAL + LEL = LEMS TOTAL UER MAX MAX (25) (25) (50) (25) (25) R L NEUROLOGICAL 3. NEUROLOGICAL LEVELS 1. SENSORY LEVEL OF INJURY Steps 1- 6 for classification 2. MOTOR (NLI) as on reverse Page 1/2 This form may be copied freely but should not be altered without permission from the American Spinal Injury Association.

Figure 30.13 American Spinal Injury Association neurological evaluation. (Reproduced with permission from American Spinal Injury Association: International standards for neurological classi /f_i cation of spinal cord injury