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Abstract
Nerve lesions caused by traumatic events to the lower extremity's peripheral nerves are rated using Section 16.4 of the sixth edition of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). Results from sensory and motor nerve tests are used to assign the impairment class within Table 16-12, Peripheral Nerve Impairment (6th ed, 534). The default rating may be modified with the functional history and clinical studies modifiers, but not the physical examination modifier, because it is used to assign the impairment class and define the degree of neurologic severity. Impairment for both sensory and motor deficits are assigned and then combined at the lower extremity level.
Contributor Notes
This article is modified with permission from the authors of the same article published in the Winter 2021 issue of the AdMIRable Review Journal
- Abstract
- Introduction
- Overview
- Lower Extremity Peripheral Nerve Rating Process
- Step 1: Identify the Injured Nerve
- Step 2: Grade Sensory and Motor Deficits
- Step 3: Start with the Default Impairment Rating
- Step 4: Assign the Functional History and Clinical Studies Grade Modifiers
- Step 5: Modify the Impairment Rating from Its Default Value
- Step 6: Combine the Motor and Sensory Impairment Ratings
- References
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1.
Nolan, MF. Limits of two-point discrimination ability in the lower limb in young adult men and women. Phys Ther. 1983 Sep;63(9): 1424–1428.
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2.
Wang, F, Zhang, J, Yu, J, et al.Diagnostic accuracy of monofilament tests for detecting diabetic peripheral neuropathy: a systematic review and meta-analysis. J Diabetes Res. 2017;2017:8787261.
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3.
Finnerup, NB, Haroutounian, S, Kamerman, P, et al.Neuropathic pain: an updated grading system for research and clinical practice. Pain. 2016 Aug;157(8): 1599–1606.
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4.
Naqvi, U, Sherman, A. Muscle strength grading. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020. Accessed Feb 2, 2021. https://www.ncbi.nlm.nih.gov/books/NBK436008.
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