Background: For young children with spinal cord injury (SCI), the sensory exam of the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) is long and arduous, often making it impossible to complete. Objectives: In this study, we determine whether an abbreviated sensory exam provides comparable information to the full 56-dermatome exam. Method: A total of 726 56-dermatome sensory exams were completed with 190 children and youth with SCI ranging in age from 3 to 21 years. The cohort was randomly split into test and validation groups. For the test group, a principal component analysis (PCA) was carried out separately for pin prick (PP) and light touch (LT) scores. From the PCA, a hierarchical cluster analysis was performed to identify the most influential set of 4, 8, 12, and 16 dermatomes. From the sensory exam data obtained from the validation group, a linear regression was performed to compare the limited-dermatome composite scores to the total 56-dermatome scores. Results: For both LT and PP, the 16-dermatome test resulted in the best fit (0.86 and 0.87, respectively) with the 56-dermatome test and was comprised of dermatomes from both the left (7 dermatomes) and right (9 dermatomes) sides and at least 1 dermatome from each vertebral region bilaterally (cervical, thoracic, lumbar, sacral). Conclusion: A 16-dermatome sensory exam provided a good correlation to the 56-dermatome exam. The shortened exam may be useful for evaluating children with SCI who cannot tolerate the full examination.

neurologic evaluation, pediatrics, spinal cord injury
American Spinal Injury Association. Reference Manual for International Standards for Neurological Classification of Spinal Cord Injury. Chicago: Author; 2003.
,
Reference Manual for International Standards for Neurological Classification of Spinal Cord Injury.
American Spinal Injury Association. International Standards for Neurological Classification of Spinal Cord Injury, revised 2011. Atlanta, GA: Author; 2011.
,
International Standards for Neurological Classification of Spinal Cord Injury, revised 2011.
Marino RJ, Barros T, Biering-Sorensen F, et al. International Standards for Neurological Classification of Spinal Cord Injury. J Spinal Cord Med. 2003;26 (suppl 1):S50–56.
,
International Standards for Neurological Classification of Spinal Cord Injury
,
J Spinal Cord Med.
, vol.
26
(pg.
S50
-
56
)
Ditunno JF, Donovan WH, Maynard FM. Reference Manual for the International Standards for Neurological and Functional Classification of Spinal Cord Injury. Chicago: American Spinal Injury Association; 1994.
,
Reference Manual for the International Standards for Neurological and Functional Classification of Spinal Cord Injury.
Cohen ME, Sheehan TP, Herbison GJ. Content validity and reliability of the International Standards for Neurological Classification of Spinal Cord Injury. Top Spinal Cord Inj Rehabil. 1996;1(4):15–31.
,
Content validity and reliability of the International Standards for Neurological Classification of Spinal Cord Injury
,
Top Spinal Cord Inj Rehabil.
, vol.
1
(pg.
15
-
31
)
Cohen ME, Ditunno JF Jr, Donovan WH, Maynard FM Jr. A test of the 1992 International Standards for Neurological and Functional Classification of Spinal Cord Injury. Spinal Cord. 1998;36(8):554–560.
,
A test of the 1992 International Standards for Neurological and Functional Classification of Spinal Cord Injury
,
Spinal Cord.
, vol.
36
(pg.
554
-
560
)
Jonsson M, Tollback A, Gonzales H, Borg J. Inter-rater reliability of the 1992 International Standards for Neurological and Functional Classification of Incomplete Spinal Cord Injury. Spinal Cord. 2000;38(11):675–679.
,
Inter-rater reliability of the 1992 International Standards for Neurological and Functional Classification of Incomplete Spinal Cord Injury
,
Spinal Cord.
, vol.
38
(pg.
675
-
679
)
Mulcahey MJ, Gaughan J, Betz RR, Johansen KJ. The International Standards for Neurological Classification of Spinal Cord Injury: reliability of data when applied to children and youths. Spinal Cord. 2007;45(6):452–459.
,
The International Standards for Neurological Classification of Spinal Cord Injury: reliability of data when applied to children and youths
,
Spinal Cord.
, vol.
45
(pg.
452
-
459
)
Savic G, Bergstrom EM, Frankel HL, Jamous MA, Jones PW. Inter-rater reliability of motor and sensory examinations performed according to American Spinal Injury Association standards. Spinal Cord. 2007;45(6):444–451.
,
Inter-rater reliability of motor and sensory examinations performed according to American Spinal Injury Association standards
,
Spinal Cord.
, vol.
45
(pg.
444
-
451
)
Marino RJ, Graves .DE. Ten dermatomes are enough! Information in a 10-dermatome ASIA sensory score is comparable to the full (28-dermatome) score. In: 45th Annual Scientific Meeting of the International Spinal Cord Society and 32nd Annual Meeting of the American Spinal Injury Association; June 23-28, 2006; Westin Copley Place Hotel, Boston, MA.
,
Ten dermatomes are enough! Information in a 10-dermatome ASIA sensory score is comparable to the full (28-dermatome) score. In: 45th Annual Scientific Meeting of the International Spinal Cord Society and 32nd Annual Meeting of the American Spinal Injury Association; June 23-28, 2006;
Chafetz RS, Vogel LC, Betz RR, Gaughan JP, Mulcahey MJ. International Standards for Neurological Classification of Spinal Cord Injury: training effect on accurate classification. J Spinal Cord Med. 2008;31(5):538–542.
,
International Standards for Neurological Classification of Spinal Cord Injury: training effect on accurate classification
,
J Spinal Cord Med.
, vol.
31
(pg.
538
-
542
)
Mulcahey MJ, Gaughan J, Betz RR, Vogel LC. Rater agreement on the ISCSCI motor and sensory scores obtained before and after formal training in testing technique. J Spinal Cord Med. 2007;30(suppl 1):S146–149.
,
Rater agreement on the ISCSCI motor and sensory scores obtained before and after formal training in testing technique
,
J Spinal Cord Med.
, vol.
30
(pg.
S146
-
149
)
Mulcahey MJ, Gaughan J, Betz RR. Agreement of repeated motor and sensory scores at individual myotomes and dermatomes in young persons with complete spinal cord injury. Spinal Cord. 2009;47(1):56–61.
,
Agreement of repeated motor and sensory scores at individual myotomes and dermatomes in young persons with complete spinal cord injury
,
Spinal Cord.
, vol.
47
(pg.
56
-
61
)
Chafetz RS, Prak S, Mulcahey MJ. Computerized classification of neurologic injury based on the International Standards for Classification of Spinal Cord Injury. J Spinal Cord Med. 2009;32(5):532–537.
,
Computerized classification of neurologic injury based on the International Standards for Classification of Spinal Cord Injury
,
J Spinal Cord Med.
, vol.
32
(pg.
532
-
537
)
Guyton AC. Textbook of Medical Physiology. 7th ed. Philadelphia: Saunders; 1986.
,
Textbook of Medical Physiology.
DeVivo MJ, Vogel LC. Epidemiology of spinal cord injury in children and adolescents. J Spinal Cord Med. 2004;27(suppl 1):S4–10.
,
Epidemiology of spinal cord injury in children and adolescents
,
J Spinal Cord Med.
, vol.
27
(pg.
S4
-
10
)
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