Feasibility, Reliability and Long-Term Prognostic Capability of the International Standards to document Autonomic Function after SCI (ISAFSCI) during Acute Inpatient Rehabilitation

Currently there are no standard of care guidelines regarding the clinical management of autonomic nervous system (ANS) dysfunction in newly injured individuals with SCI, and as such, most clinicians spend a substantial amount of time addressing a multitude of autonomic issues during acute inpatient rehabilitation (AIR). The lack of clinical management guidelines stems in part from the inability to accurately assess the level of ANS dysfunction initially, and in response to treatment interventions. The International Standards for the Neurological Classification of SCI (ISNCSCI) exam was developed as a tool for clinical assessment of the neurological level and completeness of injury to the motor and sensory nervous systems, but the ISNCSCI does not directly assess ANS function. As such an international collaboration of scientists and clinicians developed the International Standards to document Autonomic Function following SCI (ISAFSCI). Routine use of the ISAFSCI should be considered a high priority given the adverse impact of ANS impairment on long-term health and quality of life. However, to date, use of the ISAFSCI to determine the level of ANS function during AIR following SCI has not been reported.