{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:52:51Z","timestamp":1791453171747,"version":"4.3.3"},"reference-count":33,"publisher":"American Spinal Injury Association","issue":"4","funder":[{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health","award":["K01HD106928"],"award-info":[{"award-number":["K01HD106928"]}],"id":[{"id":"https:\/\/ror.org\/04byxyr05","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"\n Background:<\/jats:title>\n Walking recovery after American Spinal Injury Association Impairment Scale (AIS) C spinal cord injury (SCI) remains difficult to predict.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n This study aimed to validate the prognostic value of quadriceps strength for future walking and to develop and test a simplified bedside clinical prediction rule (CPR) for walking recovery in AIS C SCI.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We conducted a retrospective cohort study using Spinal Cord Injury Model Systems data. Neurological examinations were performed at rehabilitation admission. Predictors included binary indicators of \u22653\/5 muscle strength for key myotomes (L2, L3, L4, S1) and age cutoffs (\u226550, \u226565 years). Logistic regression coefficients were scaled into an integer-based bedside score with 3 categories: likely walk, likely no walk, and uncertain. Model performance was evaluated using a random 20% holdout test set. A total of 1414 adults initially classified as AIS C were included; 40% achieved walking recovery at 1 year.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Quadriceps strength \u22653\/5 was significantly associated with walking recovery (\n P<\/jats:italic>\n < .0001) but demonstrated modest diagnostic accuracy when considered alone. In the CPR training set, 9% were categorized as likely walk and 7% as likely no walk, with accuracy 81%, sensitivity 92%, specificity 72%, positive predictive value 72%, and negative predictive value 92%, with similar performance in the test set. A large proportion of patients remained uncertain.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n A simple bedside score combining lower extremity strength and age offers clinically useful early risk stratification for individuals with AIS C SCI. Prospective validation and refinement are needed to improve classification of indeterminate cases. The CPR is available at:\n aiscwalkingcpr.org<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.46292\/sci26-00004","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:24:05Z","timestamp":1791451445000},"page":"91-97","source":"Crossref","is-referenced-by-count":0,"title":["A Bedside Score Predicts One-Year Walking Recovery in AIS C Spinal Cord Injury: A Multisite Cohort Study"],"prefix":"10.46292","volume":"32","author":[{"given":"Andrew C.","family":"Smith","sequence":"first","affiliation":[{"name":"University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Kepple","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth A.","family":"Weber","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley A.","family":"Thornton","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, Colorado"},{"name":"Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan R.","family":"Connor","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, Colorado"},{"name":"Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Villines","sequence":"additional","affiliation":[{"name":"Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace","family":"Tefertiller","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, Colorado"},{"name":"Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Park","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, Colorado"},{"name":"Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Berliner","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, Colorado"},{"name":"Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Draganich","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, Colorado"},{"name":"Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"issue":"22","key":"b1","series-title":"JAMA","first-page":"2236","article-title":"Traumatic spinal cord injury in the United States, 1993-2012","volume":"313","author":"Jain NB","year":"2015","unstructured":"Jain NB, Ayers GD, Peterson EN, et al. 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