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Hi Sarah and Kathleen,

If the patient has deep anal pressure OR voluntary anal contraction OR a score of at least 1 on any S4-5 sensory test, the injury is incomplete. Because deep anal pressure is intact and more than 50% of key muscles below the level of injury are graded as at least 3/5, the patient’s injury is classified as AIS D.

Here is an example ISNCSCI matching this patient’s characteristics: http://rehabknowledge.com/exam-3-isncsci/

Hope this helps!