Multi-select

Click on two cells to highlight the range of cells between them, then enter the value which will populate all highlighted cells. This feature can be used to both bulk enter and bulk clear a group of cells. You clear values entered in a group of cells by highlighting the cell range and then clicking on the purple highlighted button.

Remove Values

Select a cell or range, then click 1 (purple button) to clear them.

Data Input

Click on any grid cell to select it. Possible values will enable depending on the type of cell selected. Click any of the enabled buttons to enter the value in the selected cell or range of cells. If you click on an asterisk *, the value to its left will be entered.

The first value entered for each column (e.g. right motor) will auto-populate down through all cells below. After this, values will not auto-populate and you can use the Multi-select button to enter the same value for multiple cells at the same time.

If your device allows, once you have selected a cell, you can also use the keyboard to enter data. You can enter values in a selected cell by pressing the 0, 1, 2, 3, 4, 5, n and * keys. To enter a value with an asterisk (e.g., 0* - 5* or NT*), hold Shift and press the corresponding number or n.

The drawing of the person ("Dermatome Chart") will change colour, indicating the minimum value entered for the sensory score at each dermatome.

When to use an asterisk (*) while entering motor and sensory scores

If a key muscle or dermatome does not test normally for a reason other than SCI (e.g., peripheral neuropathy, plexopathy, etc.), enter the motor or sensory score obtained during testing and flag that value with an asterisk to indicate that the weakness or sensory change is all or partly due to something other than the SCI. The resulting score will be displayed as 0*, 1*, 2*, etc. to indicate both the score obtained during bedside examination, and the fact that this score represents a weakness or sensory change due to something other than the SCI.

In the instance that a key muscle or dermatome is not able to be tested, but is believed to have weakness or sensory change due to something other than the SCI (e.g. brachial plexus injury with an arm cast), enter NT and flag that value with an asterisk (*).

To ensure accurate classification of the spinal cord injury, after flagging a value with an asterisk, an input box will become available for you to specify if the score should be considered 'normal' or 'not normal' for classification. You are required to choose a value for this box (* flagged scores without this information will display with a ! above the score). The algorithm will then use the 'normal' or 'not normal' score option(s) chosen when determining the sensory levels, motor levels, NLI, AIS and ZPP. For this purpose, consider 'normal' will result in a normal value of 5 (for motor) or 2 (for sensory) being used. Consider 'not normal' will result in all possible abnormal values for motor or sensory being used. Information entered here will automatically display in the Comments section of the exam worksheet in the downloaded PDF version.

Note: the algorithm uses the examined and not assumed (i.e. 'normal' or 'not normal' values) for calculating the motor and sensory total and sub scores, and as such these will not be tagged with an asterisk.

Providing a reason for impairment values not due to a Spinal Cord Injury

After flagging a value with an asterisk to indicate an impairment not due to spinal cord injury, extra input boxes will become available for you to specify what the reason for the impairment is (e.g. plexopathy or pain) and any comments you may need to add (e.g. brachial plexus injury). The reason dropdown box contains a list of possible reasons for the impairment. The 'other (specify)' option can be chosen for any reason not specifically listed. You can enter any extra information into the specify text box. All information entered here will automatically display in the Comments section.

When to use NT (Not Testable)

If any value is unable to be tested, please enter NT, or not testable. This may be for a variety of reasons: if the key muscle is not available for testing (e.g. joint is casted or fused with less than 50% of the normal range of motion available, etc.) or if the dermatome is not available for testing (e.g. covered by a dressing, burn, etc.).

When entering a value as NT, please use the asterisk(*) flag if it applies per the instructions above in that section.

The algorithm will substitute all possible values to determine the resulting classification. If more than one classification option is possible, the algorithm will display 'ND' representing that it is Not Determinable as well as all possible values. In calculating motor and sensory total and subscores, the algorithm will display ND if any motor or sensory values are NT.

Lowest non-key muscles

If motor function in a non-key muscle below the level of injury is noted while performing the bedside exam, enter the lowest (i.e. most caudal) muscle group with any motor function from the drop-down lists provided. This information will be added to the Comments section and the algorithm will use this information if needed to determine the AIS.

Performing a calculation

After you have entered all values, use the Calculate button to obtain the calculated classification variables. If the form is missing information required to calculate an error box will pop up listing the missing fields. Please note, if any score has been flagged with an asterisk, entering information on how it should be considered during classification is required to calculate.

What is ND (Not Determinable)?

A calculated value of ND will be displayed when the value of that calculated field is not able to be determined conclusively. This may be due to the location or amount of Not Testable (NT) values entered, or values entered, flagged with an asterisk, and marked as consider 'not normal' for classification. In this case the calculated value will display ND followed by all possible values for that field. In the case of motor and sensory total and subscores, possible values are not displayed.

When should a classification variable be tagged with an asterisk (*)?

When determining if a classification variable requires an "*", the International Standards Committee recommends the following steps:

1. First, perform the classification by replacing the "*"-tagged scores with the assumed ones.
2. Record the classification results in the respective boxes at the bottom of the ISNCSCI worksheet.
3. Next, use the actual examined scores and re-classify.
4. All classification variables that are different between the examined score value and the assumed score value (i.e. what a clinician assumes is representative of the SCI itself, without the non-SCI condition) should receive an "*".

Reporting a form presenting an error

We are always trying to improve the algorithm and encourage you to report any errors you may encounter. If you find that a form is not being calculated correctly please follow these steps:

1. Complete an ISNCSCI form using the values that produce the error.
2. Press the Calculate button to generate the totals.
3. Press the Report button 13 at the top of the interface.
4. Please enter your contact information and add the details of the error in the message box. We will keep your contact information private and will only use it to contact you in case more details are required to fix the issue.
5. Make sure that the "Attach form data" option is checked.
6. Click the Send button.