Spinal Cord Level Functional Ability Flashcards
C4
Capable of respiration, scapular elevation
Key muscles: diaphragm, trapezius
Ventilator usually NOT needed
Glossy pharyngeal breathing used to cough
Chin control to adjust wheelchair
Limited feeding & ADLs may be possible with use if mobile arm supports, environmental controls, adapted eating equipment, head or mouth stick, & other adaptive equipment
C1-C3
Capable of talking, mastication, sipping, blowing
Key muscles: face and neck muscles
Dependent self-care
Requires:
portable ventilator or phrenic nerve stimulator
Power “tilt in space” wheelchair with mouth control
Seatbelt for trunk control
Can attain wheelchair independence on smooth, level surfaces
Assistive technology and devices make interaction or mastery of the environment feasible
C5
Capable of elbow flexion & supination, shoulder external rotation, abduction to 90 degrees & limited shoulder flexion
Key muscles: biceps, brachialis, brachioradialis, deltoid, infraspinatus, rhomboids, & supinator
Power chair with hand controls (joystick) for community
Manual wheelchair with rim projectors for 200-300 ft indoors
Driving possible with van lift
Dependent for transfers with aid of sliding board or swivel bar
Mobile arm supports assist upper extremity ADL performance
Min-mod assist for lower extremity dressing & rolling
Needs assistance for manual cough technique
C6
Capable of shoulder flexion, extension, internal rotation, adduction, scapular abduction & upward rotation, forearm pronation, wrist extension tenodesis grip
Key muscles: extensor carpi radialis, infraspinatus, latissimus dorsi, pectoralis major, serratus anterior, & teres minor
Can become independent in self-care with equipment
Manual wheelchair with projections or friction hand rims for household mobility.
Power wheelchair for community integration
Locks on casters positioned sideways provide increased stability
Can drive with hand controls
Long term goals: independence with rolling & unsupported sitting
C7
Capable of elbow extension, wrist flexion, finger extension
Key muscles: extensor pollicis longus & brevis, extrinsic finger extensors, flexor carpi radialis, & triceps
Manual wheelchair with friction hand rims for community integration with some difficulty on rough terrain
Button hook for dressing
Independent in lower extremity self-ROM
Able to get wheelchair in & out of car.
C8
Capable of use of all upper extremity muscles except intrinsic muscles of the hand
Key muscles: extrinsic finger flexors, flexor carpi ulnaris, & flexor pollicis longus & brevis
May need tub seat, grab bars, etc for full independence at home
May be able to independently go up/down curbs in manual wheelchair
Able to work in building without environmental barriers
T1-T5
Capable of full use of upper extremities, improved trunk control, increased respiratory reserve
Key muscles: top half of intercostals, long muscles of back, intrinsic finger flexors
Standing table
Negotiate curbs in manual wheelchair using wheelie technique
If dependent in all areas including cart transfers
Wheelchair sports
T6-T8
Capable of improved trunk control, increased respiratory reserve
Key muscles: long muscles of the back including sacrospinalis & semispinalis
Supervision with walker and KAFOs in home
Manual wheelchair for community ambulation
Independent swing-to gait in parallel bars with bilateral KAFOs for short distances
T9-T12
Capable of increased endurance, improved trunk control
Key muscles: lower abdominals, all intercostals
Independent swing-to or swing-through gait on level surfaces with bilateral KAFOs & a walker or forearm crutches
Independent floor to wheelchair and tub transfers
May be independent household ambulators
Usually use manual wheelchair for outdoor locomotion & energy conservation
T12-L3
Capable of hip flexion & adduction, knee extension
Key muscles: gracious, iliopsoas, quadratus lumborum, rectus femoris, & sartorius
Independent swing-to, swing-through, or four point gait with bilateral KAFOs & forearm crutches on level surfaces and small elevations
Independent home ambulators
Can be community ambulators
May use manual wheelchair for energy conservation or convenience
L4-L5
Capable of strong hip flexion & knee extension, weak knee flexion, improved trunk control
Key muscles: low back muscles, medial hamstring (weak), posterior tibial is, quadriceps, & tibialis anterior
Independent home ambulators
Can be community ambulators
Mayes manual wheelchair for energy conservation or convenience
