Spinal Cord Injury and Function

Question 1

Functional Ability SCI - C1-C3

Answer 1

• -capable of talking, mastication, sipping, blowing Key muscles: face and neck
• Self care - dependent
• Requires portable ventilator or phrenic nerve stimulator, power “tilt in space” wheel chair w/ mouth control and seatbelt for trunk control
• *C3 = wheelchair independence w/ ^ equipment on smooth/level surfaces
• Assistive technology devices (ATD) and electronic aids to daily living EADLs make interaction with or mastery of environment feasible

Question 2

Functional Ability SCI - C4

Answer 2

• capable of respiration, scapular elevation
• KM: diaphragm and trapezius
• ventilator not needed
• glossopharyngeal breathing is used to cough
• chin control required to operate wheelchair
• limited feeding and ADLs may be possible with the use of mobile arm supports, environmental controls, adapted eating equipment, head or mouth stick, and other AD

Question 3

Functional Ability SCI - C5

Answer 3

• Capable of elbow flexion/supination, shoulder ER/ABD to 90/limited shoulder flex
• KM: biceps, brachialis, brachioradialis, deltoid, infraspinatous, rhomboids, and supinator
• Mobile arm supports assist UE ADLs
• Mod-min assist w/ LE dressing/rolling
• Dependent transfers with the aid of a sliding board or swivel bar
• Power chair w/ hand controls for community integration
• Manual wheel chair w/ rim projectors 200-300 feet indoors
• Driving possible w/ van lift
• may achieve pressure relief but prob depend
• Needs assist for manual cough technique

Question 4

Functional Ability SCI - C6

Answer 4

• Capable of shoulder flex/ext/IR/add/scap ABD/scap UR/FA pron/wrist ext (tenodesis)
• KM: ECR, Infraspinatus, lats, pec major, serratus and teres minor
• Self care: independent w/ equipment
• Independent w/ rolling and unsupporting sitting (long term goals)
• Power WC for community
• Manual wheel chair for household
• Locks on caster positioned sideways for transfers
• Independent: manual cough, living if motivated, driving w/ hand controls

Question 5

Functional Ability SCI - C7

Answer 5

• impaired cough and ability to clear secretions, altered breathing pattern and poor endurance
• Capable of elbow extension, wrist flexion and finger extension
• KM: EPL, EPB, Extrinsic extensors, FCR and TRICEPS
• Independent: LE self ROM exercises and getting in/out car
• Manual wheel chair w/ friction hand rims for community and some rough terrain
• Button hook required for dressing
• independent with driving and adapted automobile

Question 6

Functional Ability SCI - C8

Answer 6

• capable of full use of all UE muscles except intrinsics of hands
• KM: extrinsic finger flexors, FCU, FPL, FPB
• Independent in living at home w/ modification
• May be independent w/ going up/down curbs w/ manual WC
• able to work in building free from architechtual barriers

Question 7

Functional Ability SCI - T1-T5

Answer 7

• Capable of use of full UE, improved trunk control, increased respiratory reserve
• KM: top half of intercostals, long ms of back, intrinsic finger flexors,
• Independent in all areas including car transfers
• Standing table for physiologic standing
• able to negotiate curbs using a “wheelie”
• participates in WC sports

Question 8

Functional Ability SCI - T6-T8

Answer 8

• Capable of improved trunk control, increased respiratory reserve
• KM: long ms of back including sacrospinalis and semispinalis
• Independent in swing-to gait in // bars w/ bilateral KAFOs for short distances
• Supervision w/ walker and KAFOs at home
• WC for community ambulation

Question 9

Functional Ability SCI - T9-T12

Answer 9

• Capable of improved endurance and improved trunk control
• KM: lower abdominals, intercostals
• Independent w/ swing to/thru gait on level surfaces w/ bilat KAFOs and walker/FA crutch
• Independent floor to WC and tub transfers
• May be independent household ambulators
• will usually use WC for outdoor amb and energy conservation

Question 10

Functional Ability SCI - T12-L3

Answer 10

• Capable of hip flexion, adduction, knee ext
• KM: gracilis, iliopsoas, QL, rectus fem, sartorius
• Independent: swing to/thru/4 point gait with bilateral KAFOs and FA crutches on level surfaces and small elevations.
• Independent w/ home ambulation, WC for community, but CAN be community ambulator

Question 11

Functional Ability SCI - L4-L5

Answer 11

• Capable of strong hip flexion and knee extension, weak knee flexion and improved trunk control
• KM: low back ms, medial hams (weak), posterior tib, quads, TA
• Independent home ambulation
• can be community ambulators
• may use wheel chair for convenience or energy conservation