{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T20:24:30Z","timestamp":1791750270838,"version":"4.3.4"},"reference-count":64,"publisher":"American Spinal Injury Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To describe the performance of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination in individuals with traumatic spinal cord injury (TSCI) and nontraumatic spinal cord injury (NTSCI) across Canadian acute and rehabilitation facilities, evaluating timing, completeness, and classification accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Using the Rick Hansen Spinal Cord Injury Registry (2015-2022), participants were analyzed across 6 cohorts: (A) TSCI-acute-admission (\n                      <jats:italic>n<\/jats:italic>\n                      = 4461), (B) TSCI-acute-discharge (\n                      <jats:italic>n<\/jats:italic>\n                      = 972), (C) TSCI-rehabilitation-admission (\n                      <jats:italic>n<\/jats:italic>\n                      = 2673), (D) TSCI-rehabilitation-discharge\n                      <jats:italic>(n<\/jats:italic>\n                      = 2316), (E) NTSCI-rehabilitation-admission (\n                      <jats:italic>n<\/jats:italic>\n                      = 728), and (F) NTSCI-rehabilitation-discharge\n                      <jats:italic>(n<\/jats:italic>\n                      = 619). ISNCSCI data included performed (yes\/no), timing (\u226472 hours, \u22647 days, and &gt;7 days of admission\/discharge), completeness, missing items, and worksheet used (yes\/no). Classification accuracy between the clinician-determined and algorithm-generated ASIA Impairment Scale and neurological level of injury classification was evaluated. Descriptive and bivariate statistics were used to analyze cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Overall, 70% of participants had at least one examination performed, with 76% performed \u226472 hours, 91% \u22647 days, and 9% &gt;7 days. However, 45% were partially complete, primarily missing sensory scores and rectal components \u22647 days. Comparison of TSCI and NTSCI during rehabilitation showed that NTSCI cohorts had significantly more exams at admission and fewer at discharge, with more complete exams. Moreover, age at injury, injury type, mechanism, severity, length of stay, and pain influenced examination performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study highlights the need for greater consistency in ISNCSCI examination performance and identifies patient-level barriers to completion. Determining the most effective standardized approach for ISNCSCI use across SCI care, addressing modifiable human\/organizational factors, and ensuring comprehensive clinical training will improve the quality of this assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.46292\/sci25-00011","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T17:05:20Z","timestamp":1755882320000},"page":"15-36","source":"Crossref","is-referenced-by-count":1,"title":["An Evaluation of International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) Performance Within the Canadian SCI Network"],"prefix":"10.46292","volume":"31","author":[{"given":"Heather A.","family":"Hong","sequence":"first","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Parsons","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jijie","family":"Xu","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Walden","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Fallah","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada"},{"name":"Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiana L.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najmedden","family":"Attabib","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Horizon Health Network, Dalhousie University, Saint John, New Brunswick, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean D.","family":"Christie","sequence":"additional","affiliation":[{"name":"Department of Surgery (Neurosurgery), Dalhousie University, Nova Scotia Health, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. Catharine","family":"Craven","sequence":"additional","affiliation":[{"name":"KITE Research Institute, University Health Network. Toronto, Ontario, Canada"},{"name":"Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Kinesiology and Health Science, University of Waterloo, Waterloo, Ontario, Canada"},{"name":"Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Fehlings","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery and Spine Program, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"},{"name":"Division of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daryl R.","family":"Fourney","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chester","family":"Ho","sequence":"additional","affiliation":[{"name":"Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Julien","sequence":"additional","affiliation":[{"name":"NSHA Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian K.","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary A.","family":"Linassi","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Saskatchewan, Saskatoon, Saskatchewan, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adalberto","family":"Loyola-Sanchez","sequence":"additional","affiliation":[{"name":"Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Canada"},{"name":"Department of Clinical Neurosciences, Alberta Health Services, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saranjan","family":"Moganathas","sequence":"additional","affiliation":[{"name":"Sunnybrook Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Paquet","sequence":"additional","affiliation":[{"name":"Centre de Recherche CHU de Quebec, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidya","family":"Sreenivasan","sequence":"additional","affiliation":[{"name":"University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Marc","family":"Mac-Thiong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Centre-ville, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Research Center, CIUSSS Nord-de-l\u2019\u00cele-de-Montr\u00e9al, H\u00f4pital du Sacr\u00e9-C\u0153ur de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"H\u00f4pital du Sacr\u00e9-C\u0153ur de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Townson","sequence":"additional","affiliation":[{"name":"University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve C.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Neuroscience Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Urquhart","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Whelan","sequence":"additional","affiliation":[{"name":"Department of Medicine (Physical Medicine and Rehabilitation), Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa 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Int Immunopharmacol. 2024;137:112505. https:\/\/doi.org\/10.1016\/j.intimp.2024.112505."},{"issue":"9-10","key":"b28","series-title":"J Neurotrauma","first-page":"1223","article-title":"Advanced Magnetic resonance imaging biomarkers of the injured spinal cord: A comparative study of imaging and histology in human traumatic spinal cord injury","volume":"41","author":"Morris S","year":"2024","unstructured":"Morris S, Swift-LaPointe T, Yung A, et al. Advanced Magnetic resonance imaging biomarkers of the injured spinal cord: A comparative study of imaging and histology in human traumatic spinal cord injury. 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Spinal Cord. 2022;60(1):37-44. doi:10.1038\/s41393-021-00672-y."},{"issue":"3","key":"b32","series-title":"J Neurotrauma","first-page":"453","article-title":"Computer implementation of the International Standards for Neurological Classification of Spinal Cord Injury for consistent and efficient derivation of its subscores including handling of data from not testable segments","volume":"29","author":"Schuld C","year":"2011","unstructured":"Schuld C, Wiese J, Hug A, et al. Computer implementation of the International Standards for Neurological Classification of Spinal Cord Injury for consistent and efficient derivation of its subscores including handling of data from not testable segments. 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