Influence of Age Alone, and Age Combined With Pinprick, on Recovery of Walking Function in Motor Complete, Sensory Incomplete Spinal Cord Injury.
OBJECTIVE
To determine if age, pinprick scores in the lower extremities, and neurologic severity of injury influence recovery of ambulation in persons with motor complete, sensory incomplete (American Spinal Injury Association Impairment Scale [AIS] grade B) spinal cord injury (SCI) 1 year after initial injury.


DESIGN
This retrospective analysis examined subjects with AIS grade B from the Spinal Cord Injury Model System (SCIMS) database from 2006 to 2015. The baseline neurologic examination at rehabilitation admission (2-4wk postinjury) was used for comparison with 1-year outcome measures of locomotion.


SETTING
Fifteen acute inpatient rehabilitation centers (participants in the SCIMS database).


PARTICIPANTS
Participants with AIS grade B SCI (N=249) were enrolled in the SCIMS database in 2 cycles (2006-2010 and 2011-2015).


INTERVENTIONS
Not applicable.


MAIN OUTCOME MEASURES
Household ambulation at 1 year by FONE-FIM and by direct interview, as part of the annual neurologic exam; change in American Spinal Injury Association score 1 year postinjury.


RESULTS
Findings demonstrate a statistically nonsignificant increase in likelihood of walking for those age <50 years compared with those age ≥50 years (relative risk [RR]=1.99; 95% confidence interval, 0.80-3.04). Presence of pinprick in at least one half of the lower-extremity dermatomes L2-S1 was associated with higher likelihood of walking (RR=5.57, P=.0023). Pinprick was significant for patients age <50 years (RR=4.58, P=.0090) but not for those age ≥50 years (P=.15).


CONCLUSIONS
Compared with younger individuals, participants age ≥50 years with AIS grade B SCI are less likely to achieve walking function 1 year postinjury. Likewise, preservation of pinprick sensation postinjury in the majority of lower-extremity dermatomes L2-S1 increases the chances of walking in individuals age <50 years.
['Oleson|Christina V|CV|', 'Marino|Ralph J|RJ|', 'Leiby|Benjamin E|BE|', 'Ditunno|John F|JF|']
D000328:Adult D000367:Age Factors D005260:Female D006801:Humans D035002:Lower Extremity D008297:Male D008875:Middle Aged D009460:Neurologic Examination D011379:Prognosis D020127:Recovery of Function D012047:Rehabilitation Centers D012189:Retrospective Studies D013119:Spinal Cord Injuries D015599:Trauma Severity Indices D016138:Walking
Spinal cord injuries Rehabilitation