3B: LOI Functional Outcomes Flashcards
What muscles are innervated with a C1-C4 SCI?
- Cranial nerve
- Diaphragm (C3-C5)
- Traps, levator scap, some rhomboid (C4)
What movements can C1-C4 SCI patients perform?
- Head rotation
- Mastication, talking
- Sip and blow
- Scap elevation
What nerve roots innervate the diaphragm?
C3-C5
What nerve roots innervate the traps levator scap, and some of the rhomboid?
C4
What assist is needed for C1-C4 SCI mobility and ALDs?
Dependent, requires full time care, may require ventilator
How does a pt with a C1-C4 SCI perform weight shifts?
Able to be independent in a power wheelchair
What type of wheelchair is indicated for a C1-C4 SCI?
Can be independent with a power chair using sip and puff, head, tongue, or chin control
What muscles are innervated by C5?
- Biceps
- Brachialis
- Brachioradialis
- Deltoid
- Supra/infraspinatus
- Rhomboids
- Some supination
What are transfers expected to look like with a C5 LOI?
Dependent with mechanical lift, some can use transfer board and assist
Describe bed mobility at C5
Dependent or with significant assist
What type of care does someone with a C5 injury likely require?
Part time, but the patient is able to direct them and advocate for themself
How can a pt with C5 LOI perform ADLs?
Able to assist with ADL or with set up with the use of adaptive equipment. Will still be dependent for bathing and dressing
What type of wheelchair is common for patients with C5 LOI?
- Independent with a power chair with joystick controls with hand support
- Can be independent with manual chair on level indoor surfaces
How does a pt with a C5 LOI perform pressure relief?
Independent in their wheelchair
What modifications may be required for a manual chair for a pt with a C5 LOI?
- Plastic coated rims
- Rim extensions
- Power assist
- Assist with pressure relief
Can a patient with a C5 LOI drive?
Yes - can be independent with adaptive controls
What muscles are innervated with a C6 LOI?
- Extensor carpi radialis
- Infraspinatus
- Lats
- Pec major
- Pronator teres
- Serratus anterior
- Teres minor
What is the expectation for transfers with a C6 LOI?
Min assist to independent - use of a transfer board will increase their independence
How does a pt with a C6 LOI perform bed mobility?
Min assist or independent with the use of loops and rails
What is the expected outcome for a C6 LOI in regards to bowel and bladder?
May be independent with adaptive equipment, but likely needs assist
What type of care will someone with a C6 LOI require?
Part time - but able to direct and advocate
How does a pt with a C6 LOI perform ADLs?
- Adaptive equipment for eating
- Independent for UE dressing
What type of wheelchair will someone with a C6 LOI use?
- Independent with a power chair with joystick and hand support
- Independent with manual on level indoor surfaces
If a pt with a C6 LOI has a manual chair, what modifications are needed?
- Plastic coated rims
- Rim extensions
- Power assist
- Assist with pressure relief
Can a pt with a C6 LOI drive?
Can drive independently with adaptive controls
What muscles does a pt with a C7 LOI have?
- Extensor pollicis longus and brevis
- Extrinsic finger extensors
- Flexor carpi radialis
- Triceps
- Full serratus
How does a pt with a C7 LOI perform bed mobility and transfers?
Independent, may use loops and rails or require assistance on uneven surfaces
What type of wheelchair will a pt with a C7 LOI most likely have?
- Independent with manual, plastic rims
- Need assist for uneven terrain or ramps
What is expected for a pt with a C7 LOI in regards to ADLs and bowel and bladder management?
Independent with adaptive equipment
What muscles will a pt with a C8 LOI have?
- Extensor finger flexors
- Flexor carpi ulnaris
- Flexor pollicis longus
- Intrinsic finger flexor
- Pecs
- Lats
Describe transfers for a pt with a C8 LOI
- Occasional assist on uneven surfaces
- Can do floor to chair transfers
What type of wheelchair is indicated for a C8 LOI?
Independent with manual chair
Describe ADLs and bowel and bladder management with C8 LOI
Mostly independent, can still use adaptive equipment
What muscles are innervated with T1-T12 LOI?
- Intercostals
- Abdominals (T7)
What is the nerve root for abdominal muscles?
T7
Describe general functional outcomes for someone with a thoracic LOI
Primarily independent
Describe ambulation with a C8 LOI
- Physiologic standing and gait
- Independent or some assist for household distances with AD and orthotics
What muscles are innervated with a L1-L3 LOI?
- Gracilis
- Iliopsoas
- QL
- Rectus femoris
- Sartorius
Describe ambulation with a L1-L3 LOI
- Independent with AD and orthotics for short distances
- High energy expenditure
What is the likely gait pattern for someone with a L1-L3 LOI and why?
Potential for 4 point due to hip flexion compensation for weight shift
What orthotic is indicated for a L1-L2 LOI?
KAFO
What orthotic is indicated for a L3 LOI?
AFO
What muscles are innervated by the L4 nerve root?
Quads
What muscles are innervated by the L5 nerve root?
Anterior tibialis and some hamstrings
What muscles are innervated by S1 nerve root?
Hamstrings and gastroc
What muscles are innervated with L4-S1 LOI?
- Quads
- Anterior tibialis
- Hamstrings
- Gastroc
- Glute med
How will a person with a L4-S1 LOI ambulate?
Independent with AD and orthotics for community ambulation
What type of AD will someone with a L4-S1 LOI use?
Forearm crutches
At what age can children start to use powered wheelchairs?
18-24 months
At what age are children more likely to have ambulation goals?
< 5 years
Why do older children tend to abandon their ambulation goals?
Use their wheelchair instead to keep up with their peers
