1 Additional functional assessment scales are as follows Quadriplegic Index of

1 additional functional assessment scales are as

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[1] Additional functional assessment scales are as follows: Quadriplegic Index of Function (QIF) - Designed to detect small, but clinically relevant, changes in individuals with tetraplegia, in 9 categories of activities of daily living (ADL) Modified Barthel Index (MBI) - A 15-item assessment of self-care and mobility skills Walking Index for SCI (WISCI and WISCI II) - A scale that has demonstrated validity and responsiveness to change in neurologic/walking function after SCI [10] Capabilities of Upper Extremity Instrument (CUE) - A 32-item measure for assessing upper extremity function with tetraplegia Spinal Cord Independence Measure (SCIM) - Designed as an alternative to the FIM to assess 16 categories of self-care, mobility, and respiratory and sphincteric function [11] Canadian Occupational Performance Measure (COPM) - Used to assess outcomes in the area of self-care, productivity, and leisure Grasp and Release Test (GRT) - Designed to assess hand function in people with C6-7 level injuries Six-Minute Walk Test (6MWT) - Measures the distance a patient can walk on a flat, hard surface in 6 minutes Ten-Meter Walking Test (10MWT) - Assesses short duration walking speed C1-C4 Tetraplegia (High Tetraplegia) Individuals with complete C1-C4 (high) tetraplegia have little or no movement of upper and lower extremity muscles. They have movement of the head and neck, as well as, possibly, shoulder elevation (shrug). Persons with an injury at the C4 level have innervation of the diaphragm (the primary muscle for respiratory inspiration). They should not require long-term ventilatory assistance, although it is not uncommon to require ventilation initially after injury. Patients with C1-C3 injuries are likely to require long-term mechanical ventilatory support because of the loss of innervation to the diaphragm. These individuals may be candidates for FES of the phrenic nerve (or diaphragm) to reduce their need for mechanical ventilation, if their lower motor innervation to the diaphragm remains intact. [12] Swallowing and phonation functions are preserved. Individuals with injuries at the C1-C4 level will likely depend on others for help with almost all of their mobility and self-care needs, although they may be able to use a power wheelchair with chin or pneumatic (sip and puff) controls. If their elbow flexion and shoulder movement are suboptimal (muscle grade 2 or 3), a balanced forearm orthosis (BFO) or mobile arm support (MAS) may assist them with feeding and grooming activities. The use of a long bottle or straw can allow these individuals to drink independently. Patients should be able to communicate with caregivers (and provide direction) about their mobility needs, as well as about self-care and bladder and/or bowel care. Assistive technologies, such as electronic aids to daily activities (EADLs, previously referred to as environmental control units), may
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9/13/2017 Functional Outcomes per Level of Spinal Cord Injury: Overview, Neurologic Level and Completeness of Injury, C1-C4 Tetraplegia (High Tetraple… 5/13 be accessed by using a mouth stick or switch or by employing voice activation. Assistive devices
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  • Spring '08
  • Herzog,A

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