Electric Wheelchair Propulsion Using a Hand Control in C4 Quadriplegia

Excerpt

Directing a patient toward achieving the highest level of functional independence is the goal of physical therapists in the rehabilitation setting. This article will focus on spinal cord injuries at the C4 level. A patient with quadriplegia at the C4 level has innervation of facial musculature and of the trapezius, upper cervical paraspinal, and sternocleidomastoid muscles. Very often, a patient with a C4–C5 fracture or dislocation will have Trace musculature at the C5 myotome noted in the biceps brachii or deltoid muscles. The anterior horn cells are arranged in longitudinal groups throughout the segments of the spinal cord.¹ Therefore, a patient injured low in the C4 segment may have some preservation of the neurological functions of C5. Usually, a person with such a high level spinal cord injury is restricted to bed or, at most, to propelling an electric wheelchair using a sip and puff, mouthstick, or chin-cup control.^2–4…