title: The 72-hour examination as a predictor of recovery in motor complete quadriplegia.
abstract: Twenty-nine C4 to C7 motor-complete spinal cord injured subjects were evaluated to determine whether the manual muscle test (MMT) performed within 24 hours of injury or at 72 hours after injury better predicts short-term functional muscle recovery. A single muscle in the zone of injury that had a muscle grade between 1 and 3, inclusive, was evaluated serially in each patient from admission to three months. Increase in muscle strength to grade 4 or better was defined as success. Outcomes were evaluated by the Fisher exact test. Using the less-than-24-hour MMT, 12 of 17 subjects with grade 3 muscle strength vs four of 12 subjects with grade 1 or 2 muscle strength achieved success (p greater than .05). Using the 72-hour MMT, all 11 subjects with grade 3 muscle strength vs five of the 18 subjects with less than grade 3 muscle strength achieved success (p less than .001). Short-term functional muscle recovery in the zone of injury in cervical motor-complete quadriplegia is better predicted by the 72-hour MMT than by the less-than-24-hour MMT.
authors.affiliation: Department of Rehabilitation Medicine, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
authors.forename: P J
authors.initials: PJ
authors.lastname: Brown
authors.forename: R J
authors.initials: RJ
authors.lastname: Marino
authors.forename: G J
authors.initials: GJ
authors.lastname: Herbison
authors.forename: J F
authors.initials: JF
authors.lastname: Ditunno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D011237:Predictive Value of Tests; D011379:Prognosis; D011782:Quadriplegia / Q000175:diagnosis* / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications*; D013997:Time Factors