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-Can speak and use diaphragm (breathing may be weakened)
-Little to no voluntary bowel and bladder control
C6 Quadriplegic
By: Ben Kelly & Ashley Tietgen
Examinations:
Interventions
**Always test above and below lesion**
Type 1 Diabetes & C6 Quad
SCI patients with diabetes have extra ADLs to conquer and precautions to take into account. A high spinal cord lesion such as a C6 causes diabetic patients to lack early warning signs of hypoglycemia or make them unreliable sources of low blood sugar (e.g. palpitations, tachycardia, sweating). With the use of tenodesis, patients should be able to administer a test of blood glucose as well open and fill an insulin pump. However, if a strong tenodesis is not present a tenodesis split would allow patience to complete this. Also, SCI patients should inject insulin below the level of the spinal cord lesion. Research shows greatest problems seem to stem from infection from an overused injection site or bad technique administering the insulin (Barlascini, et. al., 1989).
Innervated Muscles:
Movements not possible:
-complete paralysis of legs
and trunk
-no direct finger movement
-decreased to no elbow extension
-decreased to no wrist flexion
Resources
Barlascini, C., Schmitt, J., & Adler, R. (1989). Insulin pump treatment of Type I diabetes mellitus in a
patient with C6 quadriplegia. Archives of Physical Medicine & Rehabilitation, 70(1), 58-60.
E Learn SCI (2012, February 26). OT Functional Expectations C6 upper body dressing in chair [Videofile]. Retrieved from http://vimeo.com/37479481
Harvey, L., & Crosbie, J. (1999). Weight bearing through flexed upper limbs in quadriplegics with
paralyzed triceps brachii muscles. School of Physiotherapy, 37(11), 780-785.
Levels of Injury. (2014, January 1). Retrieved September 17, 2014, from
http://www.spinalinjury101.org/details/levels-of-injury
Pedretti, L. (2013). Spinal Cord Injury. In OccupationalThreapy Practie Skills for Physcial
Dysfunction (7th ed., pp. 954-982). St. Louis: Mosby.
Quadriplegia. (2009, January 1). Retrieved September 17, 2014, from http://www.spinal-
injury.net/quadriplegia.htm
Radomski, M., & Trombly Latham, C. (2008). Spinal Cord Injury. In Occupational therapy for physcial
dysfunction (6th ed., pp. 1171-1211). Baltimore: Lippincott Williams & Wilkins.
Spinal Cord Injury Levels - Functionality of C6 Spinal Cord Injury. (2013, January 1). Retrieved
September 17, 2014, from http://www.apparelyzed.com/support/functionality/c6.html
Whiteneck, G., Adler, C., Blackburn, S., Hendricks, R., Johnson, K., & Thomas, H. (2002). A Guide
for People with C6 Spinal Cord Injury . In Expected outcomes: What You Should Know. Washington, DC (801 18th St. NW, Washington, DC 20006-3517): Paralyzed Veterans of America.
Movements possible:
-Full Head and Neck movement
w/normal strength
-Normal shoulder strength
-Wrist extension
-Elbow flexion
Research on elbow stability in C6 Quad
A study by Harvey and Crosbie (1999) shows that the paralysis of the triceps brachii muscles in C5 and C6 quadriplegics does not limit them from bearing weight on a flexed elbow. This is possible because of strong shoulder flexion movements as well as some wrist flexor movements. Results showed the anterior deltoid and upper pectoralis major to be the main contributors to this (Harvey & Crosbie, 1999).
**Developing good shoulder strength in C6 quads can benefit their ability to weight bear on a bent elbow which will carry over to occupation based tasks such as ability to perform transfers independently**
Spinal Cord Injury