EXAM 2: SCI expectations based on level of injury

HF

C1-C4 Mobility Expectations

Dependent for bed mobility and transfers; power mobility only; unable to use manual wheelchair

C1-C4 ADL Expectations

All dependent; can independently direct care

C1-C4 Equipment Needs

Power-adjustable bed, pressure-reducing mattress, mechanical lift, power wheelchair with adaptive controls, ventilator, ECU

C1-C4 Key Muscles

Face/neck muscles, cranial nerves, diaphragm (partial at C3/4)

C1-C4 Available Motions

Talking, mastication, sipping, blowing, scapular elevation

C5 Mobility Expectations

Assistance for bed mobility and transfers; independent power mobility; manual wheelchair with assist

C5 ADL Expectations

Some assistance/setup for feeding, grooming, dressing, bathing; dependent for bowel/bladder

C5 Equipment Needs

Power bed, mechanical lift, power wheelchair with joystick, manual wheelchair with assist, adapted utensils, mobile arm support

C5 Key Muscles

Biceps, brachialis, deltoid, infraspinatus, rhomboids, supinator

C5 Available Motions

Elbow flexion/supination, shoulder ER, abduction, flexion to 90°

C6 Mobility Expectations

Independent to some assist for bed mobility and transfers; independent power/manual wheelchair

C6 ADL Expectations

Assistance to independent with setup/equipment; may be independent with bowel/bladder using adaptive equipment

C6 Equipment Needs

Power/manual wheelchair, transfer board, universal cuff, adaptive utensils, hand splints

C6 Key Muscles

Extensor carpi radialis, latissimus dorsi, pectoralis major (clavicular), pronator teres, serratus anterior

C6 Available Motions

Shoulder flexion/extension/IR/adduction, scapular protraction/upward rotation, forearm pronation, wrist extension (tenodesis)

C7 Mobility Expectations

Independent bed mobility and transfers; manual wheelchair use in home/community

C7 ADL Expectations

Independent with adaptive equipment; assistance for heavy household tasks

C7 Equipment Needs

Manual wheelchair with coated rims, transfer board, hand splints, shower/commode chair, adaptive van

C7 Key Muscles

Extensor pollicis longus/brevis, finger extensors, flexor carpi radialis, triceps

C7 Available Motions

Elbow extension, wrist flexion, finger extension

C8 Mobility Expectations

Independent bed mobility and transfers; may do floor transfers; manual wheelchair

C8 ADL Expectations

Independent with adaptive equipment; less need for equipment due to improved hand function

C8 Equipment Needs

Manual wheelchair, transfer board, hand splints, shower/commode chair, adaptive van

C8 Key Muscles

Finger flexors, flexor carpi ulnaris, flexor pollicis longus/brevis, intrinsic hand muscles

C8 Available Motions

Finger flexion

T1-T12 Mobility Expectations

Independent bed mobility, transfers (including floor), manual wheelchair use

T1-T12 ADL Expectations

Independent in all ADLs; assistance for heavy household tasks

T1-T12 Equipment Needs

Manual wheelchair, assistive device for ambulation, orthotics (HKAFO, KAFO), adaptive van

T1-T12 Key Muscles

Intercostals, sacrospinalis, semispinalis, abdominal muscles (T7 and below)

T1-T12 Available Motions

Improved trunk control, increased respiratory reserve, pectoral girdle stabilization

L1-L3 Mobility Expectations

Independent bed mobility and transfers; may use wheelchair for long distances

L1-L3 ADL Expectations

Independent in all ADLs

L1-L3 Equipment Needs

Manual wheelchair, assistive device (walker, loftstrands, canes), orthotics (HKAFO, KAFO, AFO)

L1-L3 Key Muscles

Gracilis, iliopsoas, quadratus lumborum, rectus femoris, sartorius

L1-L3 Available Motions

Hip flexion, hip adduction, knee extension

L4-S1 Mobility Expectations

Independent bed mobility and transfers; may use wheelchair for long distances

L4-S1 ADL Expectations

Independent in all ADLs

L4-S1 Equipment Needs

Manual wheelchair, assistive device (loftstrands, canes), orthotics (AFO, SMO, foot insert)

L4-S1 Key Muscles

Quadriceps, anterior tibialis, hamstrings, gastrocnemius, gluteus medius/maximus, toe/ankle muscles

L4-S1 Available Motions

Hip flexion, knee extension/flexion, ankle dorsiflexion/plantarflexion/eversion, toe extension

Tenodesis Grip

Passive grasp using wrist extension to create finger flexion

Functional Grip Testing

Observe active finger flexion vs passive tenodesis grasp

C8 ISNCSCI Testing

Test finger flexors for motor function