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SC function levels

COTA exam

spinal levelbody FunctionsAssistance requiredKey musclesPossible movements
Dx involving upper motor neuron lesions SCI, MS, Parkinsonism, CVA, TBI
Dx involving lower motor neuron lesions MD, Polio, Myasthenia gravis, Peripheral nerve injuries
C1-C3 Respiratory-vent dependent. Unable to clear secretions. Total A- bowel & bladder Total A w/ mobility, eating, dressing, bathing, needs 24hr care, TA to I for communication dep on tech/set up sternocleidomastoid, levator scapulae, Upper traps, diaphragm neck flex/ext/rotate; chew, swallow, talk, sip, puff, some scapular elevation
C4 Function: breathe independently, shoulder girdle elevation 24 hr attendant care including homemaking Trapezius (upper, mid,low) diaphragm, cervical & paraspinal muscles respiration, scapula elevation, neck movements
C5 Elbow flexion. Can be independent in feeding & grooming. OT: prevent contractors due to unopposed biceps. Assistive tech key Personal care 10 hours/day. Homecare 6 hrs/day deltoid, biceps brachialis, brachioradialis, rhomboids, s. anterior, teres maj, Elbow flexions & supination, shoulder abduct, flex, ext, H abduc, H adduct, Int/ext rotation, scapular protraction/retraction
C6 W/assistive devices can achieve functional independence, but not common. Trnsfr w/sliding board Personal care 6 hrs/day. Homecare 4 hrs/day Ext carpi radialis longus & brevis, serratus anterior, pronator teres, coracobrach, pec maj, lat dorsi Wrist extension, tenodesis possible.
C7 Elbow extension. Highest level of injury allowing for independent living w/adaptations. Bowel/bladder program key. More difficult for women I in ADLs, Txf, bed mob, ManW/C, bowel/bladder - Indep Triceps, pec maj, lat dorsi, flex digitorum superfic, ext digitorum FCR, ECU, EP longus & brevis, Ab pollic longus elbow ext, ulnar/wrist ext & flex, finger flex/ext, thumb ext/flex/abdu, full strength shoulder movement
C8,T1 Finger flexion - helps with independence with hand grasp/release Indep in ADL w/ txf & bed mob All UE muscles fully innervated full control of UE, fine coordination and grasp
Created by: sherryama