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High cervical lesions (C1 - C4)

electric WC with tilt in space seating or reclining seat back. Microswitch or puff and sip controls. portable respirator may be attached.

Cervical Lesion with C5 - elbow flexion

manual WC with propulsion aid (hand control - hand rim projections) . Independent for short distances on smooth, flat surfaces.
Anti-tip tube (on posterior frame): prohibit WC from falling over backwards

Cervical Lesion with C6 - pronation, wrist extensors

Manual wheelchair with friction surface hand rims
Independent on sliding board tranfer

Cervical Lesion with C7 - triceps

Manual wheelchair with friction surface hand rims, independent, with increased propulsion

Patients with Hand function (C8 - T1) and below

manual wheelchair, standard hand rims

Midthoracic lesions (T6 - T9)

KAFOs and crutches.
Swing-to gait pattern, short distance).
May prefer standing devices/standing wheelchairs for physiological standing.

High lumbar lesions (T12 - L3)

KAFOs and crutches.
Can be independent in ambulation all surfaces and stairs. Swing through or four point gait pattern.
May use RGOs with walker with or without FES system. Independent household ambulators. Wheelchair use for community ambulation.

Low lumbar lesions (L4 - L5)

Independent with AFOs and crutches/cane.
Typically independent ambulators.

Spina Bifida- Thoracic

WC or RGO (Reciprocating gait orthose)

Spina Bifida - Upper lumbar (L1-L2) - hip FL

WC or RGO (Reciprocating gait orthose) - house

Spina Bifida - Mild lumbar (L3 - knee FL)

WC community
HKAFO, KAFO, AFO house

Spina Bifida - Lower Lumbar (L4-L5 - hip AB)

KAFO, AFO house, communinity

Spina Bifida - Lumbosacral (ankle plantiflex)

AFO/ none

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