脊髓損傷之神經檢查與功能評估

Neurological Examination and Functional Assessment after Spinal Cord Injury

王顔和(Yen-Ho Wang) ； 林光華(Kwan-Hwa Lin)

《中華民國物理治療學會雜誌》 19卷1期 (1994/03) Pp. 78-87

https://doi.org/10.29616/JPTAROC.199403.0009

摘要

爲分類與量化脊髓損傷患者之神經損傷與功能障礙，促成評估量表不斷發展改進。新的「脊髓損傷之神經與功能分類標準」，已於1992年底由美國脊傷協會發表。在新版手册中，除對相關名詞予以明確定義外，在神經學檢查方面，則包括感覺與運動機能兩部分。感覺機能檢查，係有系統地檢查身體左右兩側各28皮節感覺機能，每一皮節之關鍵檢查點必須施行針刺與輕觸兩種檢查；運動機能檢查係評估身體左右兩側各十對關鍵肌之肌力。根據計分，可以決定感覺、運動與神經機能部位。新的「ASIA機能損傷等級法」仍分五級，但損傷之完全性，則以薦髓機能保留之有無來判定。至於以「功能自主量表」來評估患者之功能障礙，則是新版添加的項目。這新的分類標準，能客觀、完整地記錄脊髓損傷患者機能損傷與功能障礙的程度，實爲目前最佳的脊髓損傷評估量表。

關鍵字

脊髓損傷 ； 機能損傷 ； 功能障礙 ； 分類

並列摘要

Attempts to categorize and quantify the neurological impairment and functional disability of spinal cord injury (SCI) have led to the development and use of scales of neurological and functional capacity. Revised ”Standards for Neurological and Functional Classification of Spinal Cord Injury” have been published in 1992. The neurological level of injury in SCI patients is defined as the most caudal segment that both sensory and motor function are normal. Dermatomes are examined, by pin prick and light touch, on the basis of the 28 key sensory points, and myotomes are examined by the 10 key muscles. The sensory or motor score is a numeric scoring system used to document changes in sensory or motor function. The ASIA Impairment Scale, modified from Frankel Classification, is used to grading degree of neurological impairment. This new scale emphasizes the preservation of sacral sparing as the indication of incomplete injuries. In the new edition, Functional Independence Measure is adopted to qualify functional disability on SCI. Generally, the revised ASIA standards, assessing and classifying SCI neurologically and functionally, will achieve widespread use and is gaining acceptance internationally.

並列關鍵字

Spinal cord injury ； Impairment ； Disability ； Classification