SCI Equipment & Fct Outcomes

Question 1

what is the primary function of these bad boys - i.e. when would you use them

Answer 1

to prevent PF contracture

Question 2

in what level SCI would you consider a wrist splint

Answer 2

C5 b/c no wrist extension

Question 3

what is a classic wheelchair adaptation for C5 patients to use their UE for control

Answer 3

goal post joy stick

Question 4

when would you consider using a feeding “see-saw” adaptation

Answer 4

if you have C4 but not C5

Question 5

what are the two primary modalities used for SCI

Answer 5

biofeedback and e-stim

Question 6

what are the four likely e-stim techniques encountered for SCI

Answer 6

1. FES
2. FES bike
3. PENS - sensory e-stim
4. epidural stim

Question 7

what are the three criteria for tendon transfer surgery

Answer 7

• 1 year post SCI
• minimal spasticity
• good muscle strength in donor muscle

Question 8

what muscle may aid in elbow extension, where can donor tissue be found to facilitate this tendon transfer?

Answer 8

Deltoid C4,5 may require TFL to connect to elbow extension C7

Question 9

what muscle may aid in wrist extension? key pinch?

Answer 9

brachioradialis C5,6 can help wrist extension C6-8 and thumb flexion/adduction C8-T1

Question 10

For C1-4 complete injury, what are the important muscles and contributing myotomes?

Answer 10

• diaphragm (C3-5)
• Cx extensors (C1-8) and flexors (C1-5)
• Scap control
  
  • trap (CN XI and C3-4) and lev scap (C3-5)
• rhomboids (C4-5)

Question 11

For C1-4 complete injury, how do they perform ADLs, transfers, and bed mobility?

Answer 11

dependent but the pt must know how to direct care

Question 12

For C1-4 complete injury, how is WC mobility

Answer 12

independent with power chair for mobilty and pressure relief (with adaptations such as sip and puff and tilt in space)

Question 13

For C1-4 complete injury, how is respiratory function

Answer 13

ventilator dependent for C1 and C2 and potentially C3; C1-4 require assistance in airway clearance

Question 14

For C1-4 complete injury, do they need an attendant

Answer 14

require full time attendant and environmental control unit

Question 15

For C5 complete injury, what are the important muscles and contributing myotomes

Answer 15

• scap control
  
  • levator C3-5, rhomboids C4,5, and SA C5-7
• shoulder
  
  • delt C5/6, RTC and teres maj C4-7, lats C5-8, and pec major clavicle C5-6
• elbow flexion and supination
  
  • biceps, brachialis, and brachioradialis C5-6

Question 16

For C5 complete injury, how are ADLs, transfers, and bed mobility

Answer 16

requires assitance/dependent - must be able to direct care

Question 17

For a C5 complete injury, how is WC mobility

Answer 17

may push manual WC on level surface with adaptations, power assist option, independent with power WC

Question 18

For C5 complete injury how is pulm function

Answer 18

requires assitance with cough

Question 19

For C5 complete injury how is driving

Answer 19

C5 can drive

Question 20

For C5 complete, do they need an attendant

Answer 20

part-time attendant

Question 21

for C6 complete, what are the important muscles and contributing myotomes

Answer 21

• shoulder
  
  • same as C5 but improved
  • pec major sternal fibers C6-T1 and supinator C6-7
• radial wrist extensors ECRL C6-8
• pronator teres C6-7

Question 22

For C6 complete, how are ADLs, transfers, and bed mobility

Answer 22

will likely require some assitance, especially with set up, and will require adaptive equipment

Question 23

For C6 complete how is WC mobility

Answer 23

can push a manual WC, independent with power chair w joy stick

Question 24

For C6 complete, how is pulm function

Answer 24

independent with self-assisted cough

Question 25

For C6 complete, how is driving

Answer 25

can drive with adaptive controls

Question 26

For C6 complete, do they need an attendant

Answer 26

requires part-time attendant

Question 27

For C7 complete. what are the important muscles and contributing myotomes

Answer 27

Same as C5 and 6 but includes * scap and shoulder stability * strong wrist ext (ECRB and ECU) and pronation * triceps C6-8 * wrist flexion FCR C6-7 and FCU C7-T1

Question 28

For C7 complete, how are ADLs, transfers, bed mobility

Answer 28

likley independent but will require adaptive equipment

Question 29

For C7 complete, how is WC mobility

Answer 29

community manual WC, may benefit from power assist

Question 30

For C7 complete, how is pulm function

Answer 30

independent for self-assisted cough

Question 31

For C7 complete, how is driving

Answer 31

can drive with adaptive control

Question 32

For C7 complete, do they need an attendant

Answer 32

requires assist with heavy household tasks

Question 33

For C8 complete, what are the important muscles and contributing myotomes

Answer 33

* long finger and thumb extensors (C7/8) * long finger flexors C8-T1 * hand intrinsics C8-T1

Question 34

For C8 complete, how are ADLs, transfers, and bed mobility

Answer 34

independent, may require adapative equipment

Question 35

For C8 complete, how is WC mobility

Answer 35

can push manual chair in community, may benefit from power assist

Question 36

For C8 complete, how is pulm function

Answer 36

independent with self assisted cough

Question 37

For C8 complete, how is driving

Answer 37

can drive with adapted controls

Question 38

For C8 complete, do they need an attendant

Answer 38

may require assist for heavy household activities

Question 39

for T1-T12 complete, what are the important muscles and contributing myotomes

Answer 39

* Abs T6-T12 * extensors T1-T12 * QL T12 * intercostals T1-T11

Question 40

For T12 complete, how are ADL, transfers, bed mobility, WC mob, respiratory, and driving

Answer 40

independent

Question 41

For T1-T12 complete, how is ambulation

Answer 41

HKAFO or KAFO, physiological or exercise ambulation - full time WC users in the community

Question 42

For L1-3 complete, what are important muscles and contributing myotomes

Answer 42

* hip flexion (iliopsoas L2-4) (sartorius L2-3) * knee extension (quads L2-4)

Question 43

For L1-3 complete, how are ADL, transfers, bed mobility, WC mobility, pulm function, and driving?

Answer 43

independent

Question 44

For L1-3, how is ambulation

Answer 44

KAFO or AFO - exercise or household with possible short distance community

Question 45

is L1-3 likely to use a wheelchair or orthotics to community ambulate?

Answer 45

WC most likely

Question 46

hip extension uses which muscles/groups and their myotomes

Answer 46

glut max L5-S2 and hams L5-S2

Question 47

hip abduction requires what muscles and innervation

Answer 47

glute med, min, TFL L4-S1

Question 48

hip adduction requires which muscles and innervation

Answer 48

adductor group L2-4

Question 49

knee flexion requires which muscles and innervation

Answer 49

hams L5-S2

Question 50

Ankle DF requires which muscle and innervation

Answer 50

tib ant L4-S1

Question 51

PF requires which muscle and innervation

Answer 51

gastroc-soleus S1-2

Question 52

describe ambulation for L4-S1 complete

Answer 52

* AFO * household ambulation * short community ambulation * L4 may use WC for long distances in the community