Functional Expectations for Patients With Spinal Cord Injury Flashcards
key muscles available in a C1, C2, C3, C4 injury
- Face and neck muscles
- cranial nerve innervation
- diaphragm (partial innervation at C3 and C4)
available movements in a C1, C2, C3, C4 injury
- Talking
- Mastication
- Sipping
- Blowing
- Scapular elevation
key muscles available in a C5 injury
- Biceps
- Brachialis
- Brachioradialis
- Deltoid
- Infraspinatus
- Rhomboid (major and minor)
- Supinator
available movements in a C5 injury
- Elbow flexion and supination
- Shoulder external rotation
- Shoulder abduction and flexion to ~90°
Equipment and Assistance Required
C5 injury, bowel and bladder
Dependent, directs care provided by attendants
Equipment and Assistance Required
C5, transfers
- Dependent, attendants use mechanical lift
- Directs care provided by attendants
- May be able to perform with assistance and transfer board
available key muscles in C6 injury
- Extensor carpi radialis (tenodesis grasp)
- Infraspinatus (shoulder ER)
- Latissimus dorsi (shoulder IR, EXT, ADD)
- Pectoralis major (clavicular portion) (shoulder FLX, IR)
- Pronator teres
- Serratus anterior (protraction and superior rotation of the scapula)
- Teres minor (shoulder ER)
available movements in a C6 injury
- Shoulder flexion, extension, internal rotation, and adduction
- Scapular abduction, protraction, and upward rotation
- Forearm pronation
- Wrist extension (tenodesis grasp)
Equipment and Assistance Required
C6 injury, bowel and bladder care
May be able to be independent with adaptive equipment, likely to require assistance/dependent
Equipment and Assistance Required
C6 injury, transfers
- Independent to some assistance with transfer board
- Assistance with uneven transfers
C5 injury, driving
Independent with van with adaptive controls
available key muscles in C7 injury
- Extensor pollicus longus and brevis
- Extrinsic finger extensors
- Flexor carpi radialis Triceps
available movements in a C7 injury
- Elbow extension
- Wrist flexion
- Finger extension
Equipment and Assistance Required
C7 injury, ADL
Independent with most ADL with adaptive equipment
avalaible key muscles in a C8 injury
- Extrinsic finger flexors
- Flexor carpi ulnaris
- Flexor pollicis longus and brevis
- Intrinsic finger flexor
avalaible movements in a C8 injury
finger flexion
avalaible key muscles in a T1 to T12 injury
- Intercostals
- Long muscles of back (sacrospinalis and semispinalis)
- Abdominal musculature (~T7 and below)
avalaible movements in T1 to T12 injury
- Improved trunk control with more caudal SCI
- Increased respiratory reserve
- Pectoral girdle stabilized for lifting objects
Equipment and Assistance Required
T1 to T12 injury, ambulation
- Independent with physiological standing and ambulation for exercise over short distance in the home Assistive devices (e.g., forearm crutches)
- Orthoses: hip-knee-ankle-foot-ortho- sis (HKAFO), knee-ankle-foot orthosis (KAFO)
key avalable muscles in a L1, L2, L3 injury
- Gracilis (hip ADD and knee FLX)
- Iliopsoas (hip FLX)
- Quadratus lumborum
- Rectus femoris (hip FLX, knee EXT)
- Sartorius (hip FLX, ABD, ER, little knee FLX)
available movements in a L1, L2, L3 injury
- Hip flexion
- Hip adduction
- Knee extension
Equipment and Assistance Required
L1, L2, L3 injury, ambulation
- Independent short distances in home and possibly community
- Many choose to use wheelchair in the community due to high energy demands of community ambulation Assistive devices (e.g., forearm crutches)
- Orthoses: HKAFO, KAFO, AFO (depending on which muscles are innervated)
key avalable muscles in a L4, L5, SI injury
- Quadriceps (L4)
- Anterior tibialis (L5)
- Hamstrings (L5–S1)
- Gastrocnemius (S1)
- Gluteus medius and maximus (L5–S1)
- Extensor digitorum, posterior tibialis, peroneals, flexor digitorum (L5, S1)
avalaible movements in a L4, L5, SI injury
- Strong hip flexion
- Strong knee extension
- Knee flexion
- Ankle dorsiflexion
- Ankle plantarflexion
- Ankle eversion
- Toe extension
