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Muscle Testing & Functional Goals for SCI

Spinal Cord Injury - Functional Goals for Specific Levels of Complete Injury

Level Action/Muscles

Tested

Abilities Functional Goals

C1-C3 C3-limited

movement ofhead and neck

Breathing: Depends on a ventilator for breathing.

Communication: Talking is sometimes difficult, verylimited or impossible. If ability to talk is limited,communication can be accomplished independentlywith a mouth stick and assistive technologies like acomputer for speech or typing.

Effective verbal communication for the individual withSCI to direct caregivers in the person's dailyactivities, like bathing, dressing, personal hygiene,transferring as well as bladder and bowelmanagement.

Daily tasks: Assistive technology allows forindependence in tasks such as turning pages, usinga telephone and operating lights and appliances.

Mobility: Can operate an electric wheelchair byusing a head control, mouth stick, or chin control. Apower tilt wheelchair also for independent pressurerelief.

C3-C4 Usually has head

and neck control.Individuals at C4level may shrugtheir shoulders.

Breathing: May initially require a ventilator for

breathing, usually adjust to breathing full-timewithout ventilatory assistance.

Communication: Normal.

Daily tasks: With specialized equipment, some mayhave limited independence in feeding andindependently operate an adjustable bed with anadapted controller.

C5 Elbow flexors

(biceps brachii)

Typically hashead and neck

control, can shrugshoulder and hasshoulder control.Can bend his/her

Daily tasks: Independence with eating, drinking,face washing, brushing of teeth, face shaving and

hair care after assistance in setting up specializedequipment.

Health care: Can manage their own health care by

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elbows and turnpalms face up.

doing self-assist coughs and pressure reliefs byleaning forward or side -to-side.

Mobility: May have strength to push a manualwheelchair for short distances over smooth surfaces.A power wheelchair with hand controls is typicallyused for daily activities.

Driving may be possible after being evaluated by aqualified professional to determine specialequipment needs.

C6 Wristextensors

(extensor carpiulnaris,extensor carpiradialis longusand radialisbrevis)

Has movement inhead, neckshoulders, armsand wrists. Canshrug shoulders,bend elbows, turnpalms up anddown and extendwrists.

Daily tasks: With help of some specializedequipment, can perform with greater ease andindependence daily tasks of feeding, bathing,grooming, personal hygiene and dressing. Mayindependently perform light housekeeping duties.

Health care: Can independently do pressure reliefs,skin checks and turn in bed.

Mobility: Can independently do transfers but oftenrequire a sliding board. Can use a manualwheelchair for daily activities but may use powerwheelchair for greater independence.

C7 Elbowextensors

(triceps

brachii)

Has similarmovement as anindividual with C6,with added ability

to straightenhis/her elbows.

Daily tasks: Able to perform household duties. Needfewer adaptive aids in independent living.

Health care: Able to do wheelchair pushups for

pressure reliefs.

Mobility: Daily use of manual wheelchair. Cantransfer with greater ease.

C8 Finger flexors

(Flexordigitorumprofundus-distal phalanxof the middle

finger)

Has addedstrength andprecision offingers that resultin limited ornatural handfunction.

Daily tasks: Can live independently withoutassistive devices in feeding, bathing, grooming, oraland facial hygiene, dressing, bladder managementand bowel management.

T1 Fingerabductors(Abductor digitiminimi)

T2-T6 Has normal motorfunction in head,neck, shoulders,arms, hands andfingers. Has

increased use ofrib and chestmuscles, or trunk

Mobility: Has increased ability to do someunsupported seated activities.

A few individuals capable of limited walking withorthodic aids. This requires extremely high energy

and puts stress on the upper body, offering nofunctional advantage. Can lead to damage of upperoints.

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control.

T7-L1 Has added motorfunction fromincreasedabdominalcontrol.

Daily tasks: Able to perform unsupported seatedactivities.

Health care: Has improved cough effectiveness.

L2 Hip flexors

(Iliopsoas)

Has additionalreturn of motormovement in thehips and knees.

Mobility: Walking can be a viable function, with thehelp of specialized leg and ankle braces. Lowerlevels walk with greater ease with the help ofassistive devices.

L3 Kneeextensors

(Quadricepsfemoris)

L4 Ankledorsiflexors

(Tibialisanterior)

L5 Long toeextensor(Hallicuslongus)

S1-S5 Ankle plantar

flexors

(Gastrocnemius)

Depending on

level of injury,there are variousdegrees of returnof voluntarybladder, boweland sexualfunctions.

Mobility: Increased ability to walk with fewer or no

supportive devices.

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