The third presentation on Friday was by Elizabeth Ardolino and called The Neuromuscular Recovery Scale: A New Classification and Measurement Tool. In this talk, Elizabeth introduced her new outcome measure that is meant to measure functional recovery in spinal cord injury.
Most anyone that is familiar with spinal cord injury is familiar with the AISA. Elizabeth said that, “A ‘D’ is not a ‘D’ is not a ‘D,'” meaning that not all levels in the AISA perform the same functionally even though they are in the same label. Her Neuromuscular Recovery Scale is meant to further define and track functional recovery after SCI. It could also be used to set goals.
The Neuromuscular Recovery Scale has 4 “phases” and within each phase 3 “subphases” of recovery on 14 tasks: 3 body weight supported treadmill tasks/BWSTT (stand adaptability, step retraining, step adaptability) (although she said the most recent study stated these weren’t 100% necessary to maintain validity, reliability), 4 upper extremity tasks (forward reach and grasp, overhead press, opening a door handle) performed in typical clinical environment and 7 trunk and lower extremity tasks (sitting, sit-up, lying back (reverse sit-up), trunk extension, sit to stand, standing, walking) performed in the typical clinical environment. Here’s a link to the latest article on this measurement which lo-and-behold is FREE! Woopie! Coming out of The Journal of Neurotrauma as a collaboration with Susan Harkema who did the previous lecture session. The instructions for how to specifically perform and score the test are in the supplemental data. (I feel the need for a scoring sheet coming on!)
They are currently in the process of making a pediatric version. Which is proving difficult as children grow, so differentiating between recovery and normal development of the neuromuscular system with an outcome measure is challenging. So far, it has 13 items on it including: supine to sit, sitting inside base of support, sitting outside base of support, object to mouth, overhead reach, sit to stand, static standing, dynamic standing, walking, stand adaptability (BWSTT for the remainder), step retraining, step adaptability.
Happy outcome measure scoring!