Neuro Rehab

Question 1

Complete injury

Answer 1

no sacral sensation & motor function (not same as ASIS which is lowest intact level)

Question 2

L4-5 complete injury

Answer 2

gait deviation through WB

Question 3

L3-5 complete injury

Answer 3

huge deficits

Question 4

Paraplegia L3

Answer 4

No hamstring, hip extensor, ankle, p. elements;
Have some quads, hip flexor;
Bowel & bladder: need assistant, may catheter themselves, bowel program
Parenting: can’t hold hands
Functional community ambulatory;
WC for sport, parenting, work, distances (Ability to maximize WC skill);
Self care: full I
Require bilateral AFOs and UE assistive devices for gait

Question 5

Paraplegia L2 up to C8 (similar)

Answer 5

Weak hip flexor only;
C8: not have full hand function, a little extrinsit hand
No need hand gadget for function
WC: I in manual WC, advance skills (curbs up/off, transfers off floors and over height, I sowing into vehicle
Self care: full I;
BR equipment includes raised toilet seat and bath seat

Question 6

C7 Quadriplegia

Answer 6

No power grip/sensation, no voluntary grip release, but have grip relase via tendothesis;
WC: I in manual WC; advanced skill but some difficulty up curbs (>4’’), transfer off floor and over height, some limitations 2o to lack of grip
Self care: all I
Bowel care: need adaptive equipment

Question 7

C6 Quadriplegia

Answer 7

Level of greatest variation in outcome;
No triceps and some power across wrist, no power wrist flexor; dull innervation around shoulder girdle, have rotator, deltoid, biceps
Need to learn triceps substitution
Strength/weight matters
Pre SCI arthritis: problem
Not want too much laxity
A little hamstring shortness is needed
High end:
 WC: I in manual WC; limited WC skill to manage curbs I
 Transfer s board including uneven surfaces;
 Self care: I c equipment and adapted clothing
 Jeniffer see 2 C5s do off-floor transfer (rare case)
Low end
 WC: I in manual WC indoor level
 Transfer c sliding board (no triceps) and assistance for car and BR transfers
 Dressing
 B&B: attendant (paid person)
C6
 Manual WC
 WC skills include wheelie, off curbs and up small cones
 Transfer s board
 Drive from a van-transfer to the captain seat
 Use attendant care for efficiency c care
 I dressing and all “survival skills:

Question 8

C5 Quadriplegia

Answer 8

No shoulder control, no arm ext
WC: I in power WC
Able to do pressure relief
Transfers: Assisted
B&B, self care (dressing, bathing): attendant care
Eating after set up : I
Drive from WC in an adapted van
Sitting in balance is huge

Question 9

C4 and above

Answer 9

Can only do breathe
No biceps, most time shrug, if in well-positioned via G can drop shoulder
WC: full time power WC;
Power recline system
Care needs: I in instructing and managing
Full-time attendant care: ability to go on planed I activity
Very fragile (SCI: thermal regulation issue)