CHOP INTEND
Children’s Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND)
A 64-point motor assessment that captures neck, trunk, proximal, and distal limb strength in 14 elicited and 2 observational items, and is designed to evaluate muscle strength and function in infants with SMA. Each item is graded on a scale of 0 to 41,2:
0 = no response
4 = complete response
Total score ranges from 0 to 64. Higher scores indicate improved ability
CHOP INTEND items and graded response ranges2
| Item | Graded response range (0-4) | ||
|---|---|---|---|
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1 | Spontaneous upper extremity movement | No movement of limbs (0): moving elbow off surface in supine position (4) |
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2 | Spontaneous lower extremity movement | No movement of limbs (0): moving feet/knees off surface in supine position (4) |
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3 | Hand grip | No attempt io maintain grasp (0): maintains hand grip with shoulder off bed (4) |
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4 | Head movement | Head falls to side; no attempts to regain midline (0): rotates from maximum rotation to midline (4) |
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5 | Hip adductors | No attempt to maintain knees off surface (0): keeps knee off surface of bed >5 seconds or lifts foot off surface (4) |
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6 | Rolling from legs | Pelvis lifted passively off support surface (0): when traction is applied at the end of maneuver, rolls to prone with lateral head righting (4) |
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7 | Rolling from arms | Head turns to side; body remains limp or shoulder lifts passively (0): rolls to prone with lateral head righting (4) |
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8 | Shoulder and elbow flexion and horizontal abduction | No attempt (0): clears hand from surface with antigravity arm movement (4) |
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9 | Shoulder and elbow flexion | No attempt to lift arm (0): abducts or flexes shoulder to 60° (4) |
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10 | Knee extension | No visible knee extension (0): extends knee to >45° (4) |
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11 | Hip flexion and foot dorsiflexion | No active hip, knee, or ankle motion (0): hip flexion or knee flexion >30° (4) |
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12 | Head control | No response; head hangs (0): attains head upright from flexion and turns head side to side (4) |
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13 | Elbow flexion score with item 14 | No visible contraction (0): flexes elbow (4) |
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14 | Neck flexion score with item 13 | No muscle contraction (0): lifts head off bed (4) |
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15 | Head/neck extension, Landau reflex | No head extension (0): extends head to horizontal plane or above (4) |
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16 | Spinal incurvation, Galant reflex | No response (0): twists pelvis toward stimulus off axis (4) |