Importance of ASIA and Its Role in SCI Treatment
The American Spinal Injury Association (ASIA) is a leading organization dedicated to improving the lives of individuals with spinal cord injuries (SCI). Founded in 1973, ASIA publishes the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), a comprehensive neurological exam widely used to document sensory and motor impairments following SCI. The ASIA assessment is regarded as the gold standard for evaluating SCI, playing a vital role in research, treatment, and rehabilitation globally.
The History of ASIA
Prior to the 1970s, there was no universally accepted method for classifying the severity of spinal cord injuries. This made it difficult to compare research findings and treatment outcomes across different institutions. The Rehabilitation Services Administration (under the then Department of Health, Education, and Welfare) recognised this gap. They launched the “model spinal cord injury systems” program in the early 1970s. This program aimed to establish a standardized approach to SCI care and rehabilitation. Out of this initiative emerged a group of dedicated professionals who formed the foundation for ASIA. In 1973, a group of 21 healthcare professionals with a passion for improving SCI care came together for the first official meeting of ASIA. From then on, annual Assemblies have been held for all those health professionals who work towards the benefit of patients with SCI.
The ASIA Annual Assembly 2024 in Puerto Rico
- Presenting groundbreaking research: This can lead to advancements in SCI treatment and rehabilitation.
- Setting new treatment standards: Sharing best practices helps improve care for SCI patients globally.
This year, the meeting was held from May 20 to May 23 in San Juan, Puerto Rico, where over 280 abstracts of professionals around the world were submitted, only 25 were accepted for oral presentations. Along with the scientific presenters and doctors from all over the world, representatives of Neuralink, Miami Project to Cure Paralysis, Rancho Los Amigos, and many other leaders in spinal cord injury investigations participate.
Verita Neuro’s Participation at ASIA 2024
Neuromodulation is a new and very fast-growing topic as a therapeutic option nowadays, and one complete segment of the meeting was intended for the leading heads on this field.
Presentation on Neuromodulation-Enhanced Rehabilitation
Dr. Beatriz Perez and Dr. Rodrigo Vilches, our Medical Directors at Verita Neuro Mexico, were one of few to have their abstract accepted for oral presentation at this prestigious event. Their presentation, titled “Neuromodulation-Enhanced Rehabilitation through Epidural Stimulation in Patients with Subacute and Chronic Spinal Cord Injury,” highlighted the innovative treatments being developed by Verita Neuro.
Study Highlights and Outcomes
The study presented by Verita Neuro included 28 cases of patients treated with an epidural stimulation program in Mexico. Key outcomes from the study included:
- Functional Independence Measure improved by 13% in the overall population.
- Trunk Control Test improved by 87% across all patients.
- Knee blocking was achieved in 23 out of 28 cases.
- All patients with double location gained bilateral grip control.
These findings underscore the effectiveness of neuromodulation-enhanced rehabilitation through epidural stimulation for SCI patients. You can read more about our patient case studies here.
Collaborative Efforts
Throughout the event, Dr. Beatriz and Dr. Rodrigo engaged in one-on-one interactions with top investigators and representatives from renowned institutions, sharing ideas and learning about new research that enhances Verita Neuro’s expertise and keeps them at the forefront of SCI treatment.
Establishment of the Latin Americas Committee
Given the increasing interest and active participation of Latin American SCI attendees, ASIA established a Latin Americas committee, with Dr. Beatriz and Dr. Rodrigo serving on the board. This committee aims to foster new investigative and educational projects within the region, furthering the global impact of ASIA’s work.
During the assembly, several sessions with the LatAm committee were held to discuss new and exciting projects of investigation and educational matters. It was enlightening for us to be a part of this annual assembly sharing our preliminary results and learning from the other professionals in SCI. We look forward to actively participating in the ASIA Annual Assemblies in the future.
Additional Information about ASIA and ISNCSCI Scoring
ASIA and ISNCSCI Scoring
The ISNCSCI, published by ASIA, is a standardized neurological exam used globally to document sensory and motor impairments in SCI patients. This scoring system evaluates the extent and severity of SCI, providing essential data for developing personalized treatment plans and conducting research. The exam includes assessments of muscle strength, sensory function, and other neurological functions, forming the foundation for determining the injury’s impact and guiding rehabilitation efforts.
Sensory Examination: This part of the exam assesses light touch and pinprick sensations at key dermatomes (specific areas of skin) on both sides of the body. Each dermatome is scored from 0 (absent) to 2 (normal).
Motor Examination: This involves testing the strength of key muscles (myotomes) on both sides of the body, ranging from the upper limbs to the lower limbs. Each muscle group is scored from 0 (total paralysis) to 5 (normal strength).
Neurological Level of Injury (NLI): This is determined by the lowest segment of the spinal cord with normal sensory and motor function on both sides of the body.
ASIA Impairment Scale (AIS): This scale classifies the degree of impairment and completeness of the injury, ranging from AIS A (complete injury, no motor or sensory function preserved) to AIS E (normal motor and sensory function).
Zone of Partial Preservation (ZPP): For patients with complete injuries, the ZPP refers to the dermatomes and myotomes below the neurological level of injury that still retain some function.
ASIA Impairment Scale (AIS)
| Grade | Type of injury | Description of injury |
|---|---|---|
|
A |
Complete |
No muscle movement, light touch, pinprick, or pressure feelings are present in or around your anus |
|
B |
Sensory Incomplete |
The feeling is present in or around your anus. There might be a few muscle movements preserved below your neurological level of injury but only in the first adjacent segments. |
|
C |
Motor Incomplete |
Motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade of less than 3 |
|
D |
Motor Incomplete |
Muscle strength in most muscles below your neurological level of injury is strong enough to lift against gravity |
|
E |
Normal |
The tested sensation and muscle movements have returned to normal. Impaired feelings or movements might still be present, but cannot be detected with the exam. |
*As per ASIA 2022 brochure update
References
- ASIA 2024 event photo album: https://photos.app.goo.gl/5ZngqPtGVcQXpzhDA
- ASIA agenda: https://asia-spinalinjury.org/wp-content/uploads/2024/02/2024-ASIA-PROGRAM_-Abstracts-Links_2.12.24.pdf
- ASIA scoring* https://asia-spinalinjury.org/wp-content/uploads/2022/12/11.18.22-ISNCSCI-Patient-Brochure.pdf
- American Spinal Injury Association (ASIA) – Official Website
