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In both of these cases, we have to refer to sensation scoring to determine motor level even though strength is 5/5 in all key muscles. Practice ISNCSCI 4 appears to follow “different rules” because there are key muscles for the most caudal segments with intact sensation. Even though the lowest level with intact sensation is C8, we know motor is intact to at least T1 as determined by muscle testing of the finger abductors. Sensation is impaired at T1 and in all distal segments, so the motor level is T1. You described the rationale for Practice ISNCSCI 5’s scoring well. If there is testable motor function available, then the motor scores will supersede sensory scores for determining motor level.

Here is a previous discussion forum chain regarding Practice ISNCSCI 4 that might also help: http://rehabknowledge.com/forums/topic/isncsci-practice-4/

Let me know if you have any other questions!