Functional Expectations depending on levels of lesions

Question 1

What type of wheelchair would a patient with a high cervical lesion need (C1-C4)

Answer 1

Electric wheelchair with tilt-in space seating or reclining seat back; microswitch or puff and sip controls

Question 2

What kind of wheel chair would a patient with a C5 lesion need>

Answer 2

Can use manual chair with propulsion aids. Independent for short distances on smooth flat surfaces; may choose electric chair for energy conservation

Question 3

C6 lesions may use what type of wheelchair

Answer 3

Manual wheelchair with friction surface hand rims; pretty independent

Question 4

What type of wheelchair would a patient with a C8-T1 lesion use?

Answer 4

Manual wheelchair with standard rims

Question 5

What are the functional exceptions for a patient with a mid thoracic lesion (T6-T9)?

Answer 5

Supervised ambulation for short distances; requires KAFO and crates, swing-to gait pattern; requires assistance; may prefer standing devices/standing wheelchairs

Question 6

What are the functional exceptions for a patient with a high lumbar lesion (T12-L3)?

Answer 6

Can be independent in ambulation on all surfaces and stairs; using a swing-through or 4-point gait pattern and bilateral KAFO’s and crutches.
May also use a RGO with walker.
Typically independent household ambulatory; wheelchair use for community ambulation

Question 7

What are the functional exceptions for a patient with a low lumbar lesion (L4-L5)?

Answer 7

Can be independent with AFO’s and crutches or canes. Typically independent community abulators