AIS C Walking Recovery Prediction

Clinical Prediction Rule for One-Year Walking Outcomes

Motor Examination Findings

Select each myotome with strength ≥3/5 on either side:

Patient Age
Score Calculation
0
Total Score
L2 — Hip Flexion 0
L3 — Quadriceps 0
L4 — Dorsiflexion 0
S1 — Plantarflexion 0
Age Adjustment 0
−3 +3
−5 (Likely No Walk) Uncertain +5 (Likely Walk)
Prediction Result
?
Uncertain
Score falls within the uncertain range (−3 to +3). Additional clinical factors may help refine the prediction.
—
Accuracy
—
Sensitivity
—
Specificity
—
PPV
—
NPV
Study Cohort Distribution (Training Set)
7%
84%
9%
About This Prediction Rule

Background

This clinical prediction rule (CPR) predicts one-year walking recovery in AIS C spinal cord injury. Walking recovery is defined as walking 150 ft indoors, one street block outdoors, and one flight of stairs—with or without aids.

How It Works

Points are assigned for lower extremity motor function (L2, L3, L4, S1 with ≥3/5 strength on either side) and subtracted for older age. Scores >+3 predict "Likely Walk," <−3 predict "Likely No Walk," otherwise "Uncertain."

Study Cohort

Developed using 1,414 adults from the SCIMS database (2000–2019) across 12 centers. Among classified cases: 81% accuracy, 92% sensitivity, 72% specificity.

Smith AC, Kepple J, Weber KA II, Thornton WA, Connor JR, Villines J, Tefertiller C, Park A, Berliner J, Draganich C. A bedside score predicts one-year walking recovery in AIS C spinal cord injury: a multisite cohort study. Accepted for publication in Topics in Spinal Cord Injury Rehabilitation, 2026.
Clinical Disclaimer: For educational and research purposes only. Not a substitute for clinical judgment. The rule has not undergone prospective validation.