Spinal
level
Functional mm.
Movement possible
Patterns of
weakness
AE
ADLs
C1-C3
SCM, cervical
paraspinal, neck
accessories
Neck flexion,
extension, rotation
Total paralysis of
trunk, UE, LE
Dependent on
ventilator, suction,
padded chair
Cannot perform any
ADLs I, dependent
on others for all,
C4
Upper trap, diaphragm,
cervical paraspinal mm
Neck flexion,
extension rotation,
elevation, inspiration
Paralysis of the
trunk, UE, LE,
inability to cough,
endurance and
respiratory reserve
low to secondary
paralysis of
intercostals
Ventilator, suction,
reclining shower
chair
Cannot not cough I,
requires assistance
with suction to
remove mucus, at
risk for HO
C5
Deltoid, biceps,
brachialis,
brachioradialis,
rhomboids, serratus
anterior
Shoulder flex, abd,
ext, elbow flex, and
supination, scapular
add, abd
Loss of elbow ext,
pronation, all wrist
and hand
movements, total
paralysis of trunk
and LE
Padded
shower/commode,
electric leg bag for
bladder
C6
Clavicular pectoralis,
supinator, ext. carpi
radialis longus, and
brevis, serratus ant, latts
Scapular protractor,
some horizontal add,
forearm sup, radial
wrist ext
Absence of wrist
flex, elbow ext,
hand movement,
total paralysis of
trunk and LE, can
do shoulder
depression
Padded tub bench
with commode
cutout
Unable to lock
Maintain PROM
elbows- no tenodesis Strengthen remaining
grasp
mm.
Appropriate hand splint
w/c selection- power
assistance for pressure
relief
assist with bed mobility
assistance with ADLs
community mobility
Weak tenodesis
w/c selection
grasp, would require pressure relief
bed mobility technique
assist with ADLs
C7-C8
Latts, sternal pec,
triceps, pronator
quadratus, ext carpi
ulnaris, flex carpi
radialis, flex digitorum
Elbow ext, ulnar/wrist
ext, wrist flex, finger
flex/ext, thumb
flex/ext/abd
Paralysis of trunk
and LE, limited
grasp and dexterity
secondary to partial
intrinsic mm of the
Padded tub bench
with commode
cutout
Can transfer self if
they lock their
elbows,
What to do to help them
Maintain PROM
Prevent contractures
Foot drop splints,
resting hand splint,
pressure relief, AE to
control the environ, w/c
seating system, train
caregivers
Maintain PROM
Prevent contractures
Foot drop splints,
resting hand splint,
pressure relief, AE to
control the environ, w/c
seating system, train
caregivers
Most will be I in ADLs
Community
mobilization
May need assist with
bowel mgmt.
Spinal
level
Functional mm.
Movement possible
profundus, and
superficilis, ext
communis,
pronator/flex/ext/abd
pollicis, lumbricals
Patterns of
weakness
AE
ADLs
What to do to help them
hand
T1-T9
Intrinsics of the hand,
internal and external
instercostals, erector
spinae, lumbricals,
flex/ext/abd pollicis
UE fully intact,
limited trunk stability,
endurance increased
Lower trunk
paralysis, total
paralysis of LE
Elevated padded
toilet seat or
padded tub bench
Can transfer self to
bed, toilet, seat, can
do pressure relief,
no tenodesis
required
Need assist with
strengthening of
remaining mm.
Manual w/c
Adapted bed mobility
Transfer training
ADL training
Floor to chair transfer
Vocation/leisure
T10-L1
Fully intact intercostals,
ext obliques, rectus
abdominis
Good stunk stability
Partial paralysis of
LE, hips, knees,
ankle, foot
Elevated padded
toilet seat or
padded tub bench
Can transfer self, do
pressure relief,
tenodesis intact, can
perform ADLs
L2-L5
Fully intact abdominals,
and all trunk mm.,
depending on level:
some degree of hip flex,
ext, abd, knee flex, ext,
ankle dorsiflex, and
plantar flex
Good trunk stability,
partial to full control
of LE
Partial paralysis of
LE, hips, knees,
ankle, and foot
Elevated padded
toilet seat or
padded tub bench
Need AE for ADLs,
mostly I for them
Need assist with bed
mobility
Strengthen remaining
mm.
Manual chair and
appropriate seating
system
Floor to chair transfer
Most mod I in ADL
and community
mobility
Ambulate with AE
Vocation/leisure
Strengthen remaining
mm.
Manual chair and
appropriate seating
Transfer training
ADL training
Ambulate and AE
Vocation and leisure
Floor to chair