American Spinal Injury Association Impairment Scale

The extent of injury is defined by the American Spinal Injury Association (ASIA) Impairment Scale using the following categories:

Essentially, without learning a lot about Physical Medicine and Rehabilitation (PM&R), this gives you a ranking of the degree of impairment.  A person with a D-level impairment is much higher functioning than a person with a B-level impairment.  This is common terminology used in PM&R, and may be referenced in conversation when discussing degree of disability.  As well, it is important to know the current nomenclature of SCI, which includes the ASIA scale.  A person is no longer diagnosed simply with C6 quadriplegia.  Rather, the diagnosis will be referenced as, for example, tetraplegia C6 ASIA A.

In addition, to assist your understanding of the above scale, muscle grading is a scale that ranks muscle strength.  Zero is the lowest, representing complete absence of muscle movement.  Five is the highest, which represents normal muscle function and strength.  The grade is determined by the muscle’s ability to withstand force.  Sometimes force is gravity, and others it is applied by the examiner.  A grade 3 muscle is able to fight gravity, but unable to tolerate applied force.

 Now let’s take a closer look at psychosocial factors related to SCI.