C1-C3
C4
Breathing
Ventilator Ⓓ
Initially
ventilator Ⓓ →
Ⓘ c̅ ⬇︎VC
BADL/IADL
Total physical Ⓐ
Total physical Ⓐ
C5
C6
Ⓘ c̅ ⬇︎VC
Ⓘ c̅ ⬇︎VC
Need Ⓐ: productive
cough
Need Ⓐ:
productive cough
Total Ⓐ: bathing
Able to direct
Able to direct
T2-T12
L1-L5
Ⓘ resp. fxn
Ⓘ resp. fxn
Ⓘ resp. fxn
Ⓘ self-feeding
c̅ adaptive devices
Care needs
C7-T1
Total Ⓐ: bowel and
bladder mgt
Min-Total Ⓐ: bowel
and bladder mgt c̅
adaptive devices
Ⓐ bowel and
bladder mgt
Some Ⓐ: BADL c̅
adaptive devices
Mod Ⓘ:
BADL
Ⓐ grooming c̅
adaptive devices
Ambulation
Power W/C c̅
adaptations for
Ⓘ
Mobility
Others
Total Ⓐ for bed
mob & transfers
Ultra lightweight
manual W/C
or power W/C
Mod Ⓘ:
bowel and
bladder mgt
Ⓘ: ADL
Mod Ⓘ to Ⓘ:
BADL
Ambulate c̅ assistive
devices
Some Ⓐ for
manual W/C in
outdoor propulsion
Ⓘ W/C mob
Some Ⓐ for bed
mob & transfers c̅
adaptive devices
Mod Ⓘ:
Mod Ⓘ:
bed mob &
transfers
bed mob &
transfers
Total Ⓐ: standing
Some Ⓐ:
standing
Mod Ⓘ:
standing
Driving:
Ⓘ c̅ mod.
May use W/C for
distance;
Ⓘ: loading &
unloading in veh.
Ⓘ: bed mob
Driving:
Ⓘ c̅ hand controls
Level
Medical Management
Movement
Nervous System
Mobility
C1-C4
● Respiratory assistance
● Complete assistance: personal and
domestic care
● Limited head and neck mvmt.
● Tetraplegia
● Sympathetic N.S. compromised
● Possible autonomic dysreflexia
● No bowel or bladder control
● Power WC c̅ sip and puff possible
C5
● Low stamina, breathing c̅ diaphragm
● Complete assistance: personal and
domestic care
● Full head and neck mvmt.
● Raise arms and flex elbows
(no extension)
● Sympathetic N.S. compromised
● Possible autonomic dysreflexia
● No bowel or bladder control
● Power WC c̅ hand controls
C6
● Low stamina, breathing c̅ diaphragm
● Moderate assistance: personal and
domestic care
● Full head and neck mvmt.
● Raise arms and flex elbows
(no extension)
● Some wrist extension
● Little bowel or bladder control
● Power WC c̅ hand controls
● Manual WC → short distances
● Drive c̅ hand controls
C7
● Low stamina, breathing c̅ diaphragm
● Limited assistance: personal care
● Partial assistance: heavy-duty domestic
care
● Full head and neck mvmt.
● Raise arms, flex & extend elbows
● Wrist flexion and extension
● Partial finger movement
● Little bowel or bladder control
● Independent transfers
● Power WC c̅ hand controls
● Manual WC → short distances
● Drive c̅ hand controls
C8
● Low stamina, breathing c̅ diaphragm
● Independent: personal care
● Partial assistance: heavy-duty domestic
care
● Full head and neck mvmt.
● Raise arms, flex & extend elbows
● Wrist flexion and extension
● Partial finger movement
● Little bowel or bladder control
● Independent transfers
● Power WC c̅ hand controls
● Manual WC → short distances
● Drive c̅ hand controls
T1-T5
● Respiration capacity and endurance may
be compromised
● Independent: personal care
● Partial assistance: heavy-duty domestic
care
● Normal UE ROM and strength
● Little bowel or bladder control
● Independent transfers
● Manual WC
● Drive c̅ hand controls
T6-T12
● Respiration capacity and endurance may
be compromised
● Independent: personal care
● Partial assistance: heavy-duty domestic
care
● Normal UE ROM and strength
● Little bowel or bladder control
● Independent transfers
● Manual WC, or
● Standing frame or walk with
braces
● Drive c̅ hand controls
L1-L5
● Normal respiratory system
● Independent: personal care
● Partial assistance: heavy-duty domestic
care
● Normal UE ROM and strength
● Partial paralysis: hips & legs
● Little bowel or bladder control
● Independent transfers
● Manual WC, or
● Walk with braces
● Drive c̅ hand controls
S1-S5
● Independent: personal care
● Partial assistance: heavy-duty domestic
care
● Normal UE ROM and strength
● Some loss of function: hips &
legs
● Little bowel or bladder control
● Independent transfers
● Walk c̅ assistance/aids
slow and with difficulty
● Drive c̅ hand controls and load
WC in car independently