ASIA Exam Frequency

[FasterNow]

Not sure if these questions should be in the cure section. Are ASIA exams only typically done in the first weeks after injury? Do 'Model SCI System Centers' have a desired frequency for conducting ASIA exams?

My experience has been that I received ASIA exams at approximately two weeks and eight weeks post injury. Both exams were during inpatient rehab at a model center. Initial exams post injury and post decompression surgery did not seem to be standard ASIA exams though the surgery was done at a (different) model center.

I requested an ASIA exam from my neurosurgeon during an office visit last week but he declined. I am at approximately 2.5 years post injury.

I see statistics about conversion from one ASIA rating to another but wonder where these statistics come from and whether there is any desire by the model centers to do follow ups to support or change methods of treatment of spinal cord injury.

[IMC67]

I'm about a year behind you. Right after my injury, I asked my neurosurgen about my asia rating, he avoided the question saying that stuff was for a rehab doctor. Never did get a reply. Could be neuro thing. Personnally I think he didn't wanna be the bearer of bad news. The only asia exams I've had were inpatient.

[new dimension]

My son one year out today has had three....and his rating has changed. He had one at the initial phase of his inpatient stay at the Shepherd Center another when we were discharges and another last week at a new doctor that we have searched out here in southern California who is involved in SCI research at the Reeve Irvine Center. I personally think it should be done annually, so much changes as time passes...it would be great to keep track for research alone!!!!!!!!!!!!!!!!!

[cmoore]

Since the ASIA exam requires the doctor to check anal sensation and tone be certain in advance of your appointment that there are accessible exam tables.

[conrad]

IMO, you should try to get them to do an ASIA every year in your first 5 to 7 after injury, but so far I've only been examined by rehab Dr's, don't know if a Neuro even cares about ASIA?
If you do get it once a year, you will know definitively about any progress or, heaven forbid loss in sensation/ strength. It gives you a baseline to compare against.

[FasterNow]

Originally Posted by new dimension

...I personally think it should be done annually, so much changes as time passes...it would be great to keep track for research alone!!!!!!!!!!!!!!!!!

It sure does seem some good information could come from regular ASIA exams. If not annually, at least have some frequency recommendation.

[FasterNow]

Originally Posted by cmoore

Since the ASIA exam requires the doctor to check anal sensation and tone be certain in advance of your appointment that there are accessible exam tables.

Very good point cmoore. This last visit is the first scheduled Dr. appointment that I've been to that actually had an accessible exam table. I've been somewhat shocked to find that the few visits I have had the examinations had to take place from my chair.

[FasterNow]

Originally Posted by conrad

IMO, you should try to get them to do an ASIA every year in your first 5 to 7 after injury, but so far I've only been examined by rehab Dr's, don't know if a Neuro even cares about ASIA?
If you do get it once a year, you will know definitively about any progress or, heaven forbid loss in sensation/ strength. It gives you a baseline to compare against.

My neurosurgeon at least knew about the ASIA. But I think you are right, a neurosurgeon probably isn't interested. He is/was my closest link with the model system and that's why I asked him for the ASIA exam.

Other than randomly, I have no idea how information on recovery after spinal cord injury is gathered. I had a notion that being involved in a model center system would highlight accurate and consistent data gathering to improve the system.

[jhope]

it's like after inpatient rehab, no one cares how you're doing. recovery stats are based on small studies not the sci population.

[SCI-Nurse]

We include these in the annual exam in the VA SCI Centers, as well as doing them upon admission to rehab, discharge, and at 3 months post-discharge from the rehab program. No only can this show improvement and possible change in AIS, but it can be used to detect negative changes associated with root impingement or development of a syrinx.

Neurosurgeons and neurologist often have not been sufficiently trained in the proper way to do the ASIA, so do it wrong, and don't want to admit they are not competent in doing it. In addition, they are not trained in rehab or in RECOVERY from SCI, but much more in diagnosis and the acute management. If you want a good ASIA exam, see a physiatrist or a neurologist or neurosurgeon who also is board certified in Spinal Cord Medicine.

Both the Model SCI System Centers and the VA SCI System of Care maintain large databases of information from both the initial injury and follow-up data for many years after injury (if you stay in touch with them and get the required exams and assessments as recommended). All CARF accredited SCSC (Spinal Cord System of Care) facilities must also collect outcome data, including the ASIA, at admission and discharge and an acceptable follow up period, usually at least 3 and 12 months after discharge.

(KLD)