How is ambulatory capability predicted in cauda equina and conus medullaris syndromes?

Updated: Jun 14, 2018
  • Author: Segun Toyin Dawodu, JD, MD, MS, MBA, LLM, FAAPMR, FAANEM; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Ambulatory motor index also is used to predict ambulatory capability. It is calculated by scoring hip flexion, hip abduction, hip extension, knee extension, and knee flexion on both sides, using a 4-point scale (0=absent, 1=trace/poor, 2=fair, 3=good or normal); the score is expressed as a percentage of the maximum score of 30. Prognostic significance is as follows:

  • A patient with a score of 60% or more has a good chance for community ambulation with no more than one knee-ankle-foot orthosis (KAFO)

  • A patient with a score of 79% or higher may not need an orthosis

  • A patient with a score of 40% or less may require 2 KAFOs for community ambulation


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