Appendix II


Functional Ability By Level of 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

Publication of this educational booklet is made possible in part by the generous support of the following sponsors:

  • Metronic
  • Stryker
  • DePuy Spine
  • Fraternal Order of Eagles