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Functional recovery
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American Spinal Injury Association (ASIA) International Standards for Neurological Classification
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Analyzes the effect that the injury has on both motor and sensory systems
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Is based on the extent of injury and muscle strength
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Uses an alphabetical score from A (the most severe) to E (the least severe)
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Insensitive to small but significant changes in motor and sensory functions
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May not be sensitive enough to detect even several spinal levels of regeneration in thoracic injuries
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Does not specifically address functions that affect a patient’s quality of life
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Does not assess pain, bowel, bladder, or sexual function
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Functional Independence Measure (FIM)
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Is an 18-item, seven-level ordinal scale
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Is designed to assess areas of dysfunction in activities that commonly occur
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The scale has few cognitive, behavioral, and communication-related functional items
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Is not specific for spinal cord injuries but is designed to assess neurological, musculoskeletal, and other disorders
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Functional Assessment Measure (FAM)
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Was developed to augment the FIM
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Specifically addresses functional areas that are relatively less emphasized in FIM, including cognitive, behavioral, communication, and community functioning measures
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The scale has few cognitive, behavioral, and communication-related functional items
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Is not specific for spinal cord injuries but is designed to assess neurological, musculoskeletal, and other disorders
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Spinal Cord Independence Measure (SCIM)
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Is specifically designed to assess spinal cord injuries and to be sensitive to changes
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Analyzes self-care, respiration, and sphincter management and mobility
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Is more sensitive than FIM for spinal cord injuries
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Electrophysiology
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Assesses MEPs or SSEP
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Stimulates corresponding cortical areas of the brain and records the response in target nerves to see if connections are still functional
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Is correlated to impairment of locomotor activity
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Is noninvasive
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Electrical activity may not coordinate with function
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Hard to assess subtle but critical improvements to circuitry
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Does not assess pain, bowel, bladder, or sexual function
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