Spinal Cord Injury

Level: C1-3

Functional Goals:

• Breathing requires a ventilator or nerve stimulator to the diaphragm.
• Dependent for bed mobility and transfers.
• Independent in wheelchair after assisted into it.
• Can do pressure relief in power reclining wheelchair with head, chin, or mouth controls.
• Communication devices and environmental controls generally needed.
• Dependent for feeding, dressing, bowel and bladder care.

Attendant Care

• Requires 24 hour care.

Level: C4

Functional Goals:

• Dependent for bed mobility and transfers.
• Independent wheelchair mobility and pressure relief in power reclining wheelchair.
• Communication devices and environmental controls generally needed.
• Dependent for feeding, dressing, bowel and bladder care.

Attendant Care

• Requires 8-12 hours of care.

Level: C5

Functional Goals:

• Moderate to maximal assist for bed mobility.
• Maximal assist for sliding board transfers, except for rare cases of independence.
• Able to perform side to side pressure relief in wheelchair.
• Independent with electric wheelchair with hand drive.
• Independent in manual wheelchair with quad pegs for indoor mobility.
• Able to complete self-feeding with set-up and use of adaptive equipment.
• Requires assistance with upper body dressing.
• Dependent for bowel and bladder care.

Attendant Care

• Requires 6-8 hours, generally in morning and evening.

Level: C6

Functional Goals:

• Independent bed mobility and level transfers realistic, minimal assist for uneven transfers.
• Independent side to side pressure relief.
• Independent with light weight manual wheelchair on level, gentle slopes, and 2 inch curbs.
• Removes arm rests and foot plates independently.
• Drives adapted van independently.
• Independent in self-feeding with use of adaptive equipment.
• Independent with upper body dressing.
• Requires assistance with lower body dressing.
• Dependent for bowel and bladder care.

Attendant Care

• May require 2-6 hours per day.

Level: C7

Functional Goals:

• Independent in uneven transfers over greater distances.
• Independent with wheelchair push-up.
• Possibly able to transfer floor to wheelchair.
• Independent in manual wheelchair on slightly uneven terrain, low curbs, and standard ramps.
• Independent with all self-cares with some assistance required for bowel care.
• May stand in parallel bars with braces.

Attendant Care

• Varies depending on bowel and bladder care. May require 2-6 hours per day.

Level: C8

Functional Goals:

• Essentially the same as C7, but with greater ease and improved hand use.
• Independent bladder function with intermittent catheterization.
• Independent bowel function with digital stimulation.
• Independent car transfers and may be able to get wheelchair loaded.

Attendant Care

• Varies from 2-6 hours per day or may not be required.

Level: T1-4

Functional Goals:

• Independent in all transfers and pressure relief.
• Independent with manual wheelchair on curbs, ramps, wheelies, and uneven terrain.
• Able to load wheelchair into car and drive with hand controls.
• Short distance level ambulation with leg braces locked straight and crutches or walker.

Attendant Care

• Independent

Level: T5-12

Functional Goals:

• Walking with leg braces and walker possible.
• Extended walking difficult and wheelchair use still needed due to high energy required.

Attendant Care

• Independent

Level: L1-2

Functional Goals:

• Independent transfers from bottom of tub.
• Walking with leg braces and crutches possible.
• Wheelchair use still needed due to high energy required.

Attendant Care

• Independent

Level: L3-5

Functional Goals:

• Walking with leg braces and straight canes.
• May use wheelchair for sports or long distances.

Attendant Care

• Independent

Level: S1-3

Functional Goals:

• Walking without leg braces possible, but may be required due to muscle imbalances.

Attendant Care

• Independent