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SCI Lvls& Func Capab

Spinal Cord Movement Levels and Functional Capabilities

LevelMovement PossiblePatterns of WeaknessKey Innervated MusclesFunctional CapabilitiesAE/AD Equipment
T1-T9 (All Arms) Upper extremities fully intact; limited upper trunk stability; endurance increased secondary to innervations of intercostals Lower trunk paralysis; total paralysis of LE Intrinsics of the hands incl thumbs; inter, exter intercostals, erector spinae; lumbricals; flex/ext/abd pollicis Eating, grooming, dressing, bathing, bowel and bladder management (I); (I) bed mobility, standing (I) Hand mirror for skin checks; Manual rigid/ light weight w/c; hand controlled driving
T10-L1 (Pull it up!) Good trunk stability Paralysis of LE Fully intact intercostals; external obliques; rectus abdominis Functional ambulation some assist to (I) KAFOs; Manual rigid/ light weight w/c; hand controlled driving
L2-S5 (Can you moonwalk?) Good trunk stability; partial to full control of LE Partial paralysis of LE incl hips, knees, ankle, foot Fully intact trunk abdominals & all other trunk muscles; depend on level some hip flex, ext, abd; knee flex, ext, ankle dorsiflexors, plantar flexors Functional ambulation some assist to (I); walking with AD/AE KAFOs and AFOs; Manual rigid/ light weight w/c; hand controlled driving
C1-C3 (Lean on me) Neck flexion, extension and rotation Complete paralysis of trunk, UE & LE; limited head and neck control; no motor innervations to diaphram; ventilator dependent Sternocledomastoid, neck accessories Talking, chewing, swallowing, blowing Respirator!! Head, chin, mouth controlled power w/c
C4 (Breathing Free) Neck flexion, extension, rotation; scapular elevation; Inspiration (inhalation) Paralysis of trunk, UE & LE; inability to cough; Low endurance/ respiratory reserves Diaphragm, upper trapezius, cervical paraspinal muscles Shoulder shrug, respiration Respirator maybe; head, breath, vox controlled power w/c
C5 (Winnie the Pooh eating hunny out of hunny pot) Shoulder flexion, abduction, extension; elbow flexion, supination; scapular ab/adduction Absent: elbow extension, pronation; all wrist, hand movement; complete paralysis of lower trunk, LE; no trunk control for side bending Deltoid, biceps (elbow flexion, forearm supinator), brachialis (prime mover for elbow flexion), brachioradialis (elbow flexion, supin/pro); serratus anterior (partial) Head and neck control, elbow flexion, palmar supination Universal cuff; splints: wrist cock-up (day), instrinsic plus (night); hand controlled power w/c; driving with specialized equip
C6 (Snow White eating apple) Scapular protraction, some horizontal adduction, forearm supination, radial wrist extension (tenodesis) Absent: wrist flexion, elbow extension, hand movement; complete paralysis of trunk, LE Clavicular pectoralis; supinator; extensor carpi radialis longus, brevis; serratus anterior; latissimus dorsi Palmar pronation, wrist extensions, tenodesis grasp Tenodesis splint; modified long handled sponge, bath mitts; hand controlled power w/c ; limited manual w/c use; hand controlled driving
C7-C8 (Ariel the Mermaid push up off rock) Elbow extension (I-Depression transfers); ulnar wrist extension; wrist flexion; finger flexion & extension; thumb flexion, extension, abduction Paralysis of trunk, LE; limited grasp, dexterity, secondary to partial intrinsic muscles of the hand Latissimus dorsi; sternal pectoralis, triceps (C7); Finger intrinsics (C8); ext carpi ulnaris; flex carpi radialis; flex digit profundus, superficialis; ext communis; pronator, flex, ext, & abd pollicis; lumbricals (part) Depression transfers (I); w/c push -ups (pressure relief) Button hook, sock assist, zip assist; manual rigid/light weight w/c w modified rims; hand controlled driving
Created by: Catf