…and that's what coming out of it
A complete
There is no sensory or motor function in the sacral segments S4-S5 and the anal sphincter cannot be voluntarily innervated (intentionally contracted). Sensory and motor innervation below the neurological level is usually absent. However, zones with partial sensation or muscle activity can occur on both sides of the body.
B incomplete
Only sensory, but no motor functions are preserved below the neurological level and extend into the sacral segments (S3-S4).
In the case of unilateral perianal (around the anus) sensitivity, zones with partial sensitivity may be found on the other side. Zones with partial motor function can occur on both sides.
C incomplete
Sensible and motor functions are preserved below the neurological level and extend into the sacral segments. The majority of the characteristic muscles below the neurological level have a muscle grade of less than 3, which does not allow any functions that can be used in everyday life.
In the case of unilateral perianal (around the anus) sensitivity, zones with partial sensitivity may be found on the other side. Zones with partial motor function can occur on both sides.
Muscle-Grades are divided in 1-5 -below you can find a more precise explanation.
D incomplete
Sensory and motor functions are preserved below the neurological level (paralysis level) and extend into the sacral segments. The majority of the core muscles below the neurological level have a muscle strength grade of 3 or more. This enables usable functions for everyday life.
In the case of unilateral perianal (around the anus) sensitivity, zones with partial sensitivity may be found on the other side. Zones with partial motor function can occur on both sides.
E normal
Sensory and motor functions have normalized after a temporary disturbance. There are no more deficits to be found. [2]
Muscle-Grades (strength levels of the muscles)
- 0 complete paralysis
- 1 palpable (palpable) or visible contraction
- 2 active movement without gravity
- 3 active movement against gravity
- 4 active movement against resistance
- 5 active movement against maximum resistance
- NT not testable [2]
→ We want to point out that the muscle test is very helpful to define the current state of your muscle but tells nothing about your possibilities to regain innervation. Additional fact: There are hundreds of muscles in your body and just few of them can even be tested - so be hopefully, there might be more potential you think.
So now we know what the AIS-Score is - but what’s the “problem” with that?
We would like to point out - That categorizing people with spinal cord injuries into different groups is a useful tool, but it simply does not do justice to the severity of the event and the individuality of the people affected by these injuries. It is a definition of the system to facilitate the allocation of resources to those affected, but is not very meaningful in the medium to long-term recovery perspective and, to be honest, is not terribly helpful, or rather destructive.
We fully understand that there needs to be a measurement tool for determining each individual's degree of disability - our simple question here: Is this still the right way to do it according to modern standards and technology? And we know from dozens of conversations with longtime professionals that some of them share these thoughts.
