Spinal Cord Functional Outcomes Flashcards
High Tetraplegia (C1-C4)
Mobility, Transfers, ADLs
Mobility: sipping or blowing to independently control a POWER w/c, power tilt mechanism and environmental controls
Transfers: Dependent for all
ADLs: Dependent for dressing, bathing, bowel and bladder mgmt
Requires 24 hr personal care
C1-C3: capable of talking, mastication, sipping and blowing d/t mms of face and neck (will need mechanical vent)
C4: Capable of respiration, scapular elevation d/t diaphragm and traps (may not need vent)
C5
Mobility, Transfers, ADLs
addition of what muscles?
Addition of biceps and deltoids
capable of elbow flx and sup, shldr ER and abd to 90, limited shldr flx
Mobility: can propel manual w/c with hand rims for short distance on level surface, power w/c for long distance
Transfers: able to assist with transfers and bed mobility
(max assist sliding board transfer)
ADLs: able to assist with feeding and grooming w/ adaptive equipment and setup, dependent for: dressing and bathing, bowel/bladder
needs assistance for manual cough
C6
Mobility, Transfers, ADLs
addition of what muscles?
Addition of pectorals
capable of shldr flx, ext, IR, add, scap abd and upward rot, forearm pron, wrist ext, tenodesis grip
Mobility: able to independently use manual w/c projections on hand rims (on smooth surfaces)
Transfers: min assist to mod I with sliding board transfers and bed mobility
ADLs: Mod Ind feeding and grooming with equipment, Mod ind for UE dressing, Min assist LE dressing, mod assist with bowel, min assist with bladder
ind manual cough technique
can drive with a specially adapted van (hand controls)
can live without assistance if motivated
C7-T1
Mobility, Transfers, ADLs
addition of what muscles?
Triceps
capable of elbow ext, wrist flex, finger flex
Mobility: ind propel manual w/c w/ friction hand rims on level surfaces
Transfers: ind w/ sliding board, car transfers
ADLs: mod ind feeding, grooming, dressing, bathing, bowel/bladder with adaptive equipment
can drive car with hand controls
T4-T6
Mobility, Transfers, ADLs
addition of what muscles?
Upper abdominals
Mobility: independent with manual w/c, able to do curbs using wheelie techniques, can ambulate short distance with RGOs & walker
Transfers: Independent in all, including car transfers
ADLs: independent for feeding, grooming, dressing, bathing, bowel/bladder
may participate in w/c sports
T6-T8
Mobility, Transfers, ADLs
addition of what muscles?
Lower abdominals
Mobility: w/c for community, RGOs or HKAFOs w/ AD at home (ind in swing to gait in parallel bars with orthotics)
Tranfers: Independent in all, including car transfers
ADLs: independent for feeding, grooming, bowel, bladder, bathing
T9-T12
Mobility, Transfers, ADLs
addition of what muscles?
Lower abdominals, all intercostals
improved endurance and trunk control
Mobility: Ind swing to or swing through gait on level surfaces with KAFOs and walker or forearm crutches, use w/c for long distances
Transfers: Ind in floor to w/c and tub transfers
ADLs: independent for feeding, grooming, dressing, bathing, bowel/bladder
T12-L3
Mobility, Transfers, ADLs
addition of what muscles?
Gracilis, iliopsoas, QL, sartorius, rectus femoris, and sartorius
Capable of hip flexion and add, knee ext
Mobility: Ind swing to, swing through, or 4 point gait, with KAFOs and forearm crutches, on level surfaces and small elevations, w/c may be used for energy conservation but can be community ambulators
Transfers: ind in all, including floor to w/c and tub
ADLs: ind feeding, grooming, dressing, bathing, bowel/bladder
L4-L5
Mobility, Transfers, ADLs
addition of what muscles?
low back muscles, medial hamstring, posterior tibias, quad, and tibialis ant
capable of strong hip flx and knee ext, weak knee flx, improved trunk control
Mobility: ind home and can be community ambulators, usually with AFO. may use w/c for energy conservation
Transfers: ind in all
ADLs: ind feeding, grooming, dressing, bathing, bowel/bladder