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Muscle Testing & Functional Goals for SCI

Spinal Cord Injury - Functional Goals for Specific Levels of Complete Injury

Level Action/Muscles Abilities Functional Goals

Tested

C1-C3 C3-limited Breathing: Depends on a ventilator for breathing.

movement of
head and neck Communication: Talking is sometimes difficult, very
limited or impossible. If ability to talk is limited,
communication can be accomplished independently
with a mouth stick and assistive technologies like a
computer for speech or typing.

Effective verbal communication for the individual with

SCI to direct caregivers in the person's daily
activities, like bathing, dressing, personal hygiene,
transferring as well as bladder and bowel
management.

Daily tasks: Assistive technology allows for

independence in tasks such as turning pages, using
a telephone and operating lights and appliances.

Mobility: Can operate an electric wheelchair by

using a head control, mouth stick, or chin control. A
power tilt wheelchair also for independent pressure
relief.

C3-C4 Usually has head Breathing: May initially require a ventilator for
and neck control. breathing, usually adjust to breathing full-time
Individuals at C4 without ventilatory assistance.
level may shrug
their shoulders. Communication: Normal.

Daily tasks: With specialized equipment, some may

have limited independence in feeding and
independently operate an adjustable bed with an
adapted controller.

C5 Elbow flexors Typically has Daily tasks: Independence with eating, drinking,
head and neck face washing, brushing of teeth, face shaving and
(biceps brachii) control, can shrug hair care after assistance in setting up specialized
shoulder and has equipment.
shoulder control.
Can bend his/her Health care: Can manage their own health care by

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elbows and turn doing self-assist coughs and pressure reliefs by

palms face up. leaning forward or side -to-side.

Mobility: May have strength to push a manual

wheelchair for short distances over smooth surfaces.
A power wheelchair with hand controls is typically
used for daily activities.

Driving may be possible after being evaluated by a

qualified professional to determine special
equipment needs.

C6 Wrist Has movement in Daily tasks: With help of some specialized

extensors head, neck equipment, can perform with greater ease and
shoulders, arms independence daily tasks of feeding, bathing,
(extensor carpi and wrists. Can grooming, personal hygiene and dressing. May
ulnaris, shrug shoulders, independently perform light housekeeping duties.
extensor carpi bend elbows, turn
radialis longus palms up and Health care: Can independently do pressure reliefs,
and radialis down and extend skin checks and turn in bed.
brevis) wrists.
Mobility: Can independently do transfers but often
require a sliding board. Can use a manual
wheelchair for daily activities but may use power
wheelchair for greater independence.

C7 Elbow Has similar Daily tasks: Able to perform household duties. Need
extensors movement as an fewer adaptive aids in independent living.
individual with C6,
(triceps with added ability Health care: Able to do wheelchair pushups for
brachii) to straighten pressure reliefs.
his/her elbows.
Mobility: Daily use of manual wheelchair. Can
transfer with greater ease.

C8 Finger flexors Has added Daily tasks: Can live independently without
strength and assistive devices in feeding, bathing, grooming, oral
(Flexor precision of and facial hygiene, dressing, bladder management
digitorum fingers that result and bowel management.
profundus- in limited or
distal phalanx natural hand
of the middle function.
finger)

T1 Finger
abductors
(Abductor digiti
minimi)

T2-T6 Has normal motor Mobility: Has increased ability to do some

function in head, unsupported seated activities.
neck, shoulders,
arms, hands and A few individuals capable of limited walking with
fingers. Has orthodic aids. This requires extremely high energy
increased use of and puts stress on the upper body, offering no
rib and chest functional advantage. Can lead to damage of upper
muscles, or trunk joints.

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control.

T7-L1 Has added motor Daily tasks: Able to perform unsupported seated
function from activities.
increased
abdominal Health care: Has improved cough effectiveness.
control.

L2 Hip flexors Has additional Mobility: Walking can be a viable function, with the
return of motor help of specialized leg and ankle braces. Lower
(Iliopsoas) movement in the levels walk with greater ease with the help of
hips and knees. assistive devices.

L3 Knee
extensors

(Quadriceps
femoris)

L4 Ankle
dorsiflexors

(Tibialis
anterior)

L5 Long toe
extensor
(Hallicus
longus)

S1-S5 Ankle plantar Depending on Mobility: Increased ability to walk with fewer or no
flexors level of injury, supportive devices.
there are various
(Gastrocnemius)degrees of return
of voluntary
bladder, bowel
and sexual
functions.

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