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Anorectal examination can be crucial in classifying Spinal Cord Injuries, but there is much more to explore - It is one piece of the puzzle, but not the entire puzzle

dc.contributor.authorLopes, Alfredo Alexandre
dc.contributor.authorSilva, Augusta
dc.contributor.authorLuz, João
dc.contributor.authorLopes, Alfredo
dc.contributor.authorFerreira Silva, Maria Augusta
dc.date.accessioned2026-06-29T09:25:35Z
dc.date.available2026-06-29T09:25:35Z
dc.date.issued2026
dc.description.abstractThe International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) remain the reference framework for classifying spinal cord injury, with the absence of deep anal pressure and voluntary anal contraction defining complete injury (AIS A). Accumulating evidence, however, suggests that anorectal examination alone may not fully capture residual physiological connec-tivity in some individuals clinically classified as complete. Neurophysiological studies have reported preserved sensory, motor, or autonomic conduction despite the absence of sacral sparing on standard examination, challenging the conceptual boundaries between complete and incomplete injury. This commentary argues for a refined and integrative interpretation of neurological assessment that preserves the central role of ISNCSCI while incorporating complementary neurophysiological information and systematically collect-ed patient-reported manifestations. Rather than proposing reclassification or operational thresholds, the perspective presented is con-ceptual and hypothesis-generating. Emphasizing preserved connectivity and neuroplastic potential may enhance prognostic under-standing and support more individualized rehabilitation approaches. Future progress will depend on prospective validation studies, methodological standardization, and expert consensus to determine how multimodal information may responsibly inform classifica-tion without compromising clinical reliabilityeng
dc.identifier.citationLopes, A. A., Silva, A., & Luz, J. (2026). Anorectal examination can be crucial in classifying spinal cord injuries, but there is much more to explore—It is one piece of the puzzle, but not the entire puzzle. ADVANCEMENTS IN HEALTH RESEARCH, 3. (Worldwide). https://doi.org/10.4081/ahr.2026.141
dc.identifier.doi10.4081/ahr.2026.141
dc.identifier.eissn3035-1103
dc.identifier.urihttp://hdl.handle.net/10400.22/32522
dc.language.isoeng
dc.peerreviewedyes
dc.publisherPAGEPress
dc.relation.hasversionhttps://www.ahr-journal.org/site/article/view/141
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectAnorectal examination
dc.subjectDiscomplete spinal cord injury
dc.subjectNeurological classification
dc.subjectRehabilitation
dc.titleAnorectal examination can be crucial in classifying Spinal Cord Injuries, but there is much more to explore - It is one piece of the puzzle, but not the entire puzzleeng
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.titleAdvancements in Health Research (AHR)
oaire.citation.volume3
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameLopes
person.familyNameFerreira Silva
person.givenNameAlfredo
person.givenNameMaria Augusta
person.identifier1087589
person.identifier.ciencia-idCE18-7090-9C5E
person.identifier.orcid0000-0003-4908-1326
person.identifier.orcid0000-0001-5018-6905
person.identifier.ridB-1548-2016
person.identifier.scopus-author-id24482045400
relation.isAuthorOfPublicationafe64921-ca72-481b-8b98-6b0e217651a2
relation.isAuthorOfPublicationedfc4f79-82b7-4669-8fa1-220cc20aa495
relation.isAuthorOfPublication.latestForDiscoveryafe64921-ca72-481b-8b98-6b0e217651a2

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