Functional independence in quadriplegia: critical levels

The purpose of this study was to examine the self-care abilities of individuals with quadriplegia at two critical functional levels, once they resumed community living. Twenty-nine individuals with quadriplegia (17 with wrist extensors as the lowest functional muscle and 12 with triceps), were surveyed three months to four years after discharge, to determine self-care independence and change in ability since discharge in ten self-care areas. Personal care assistance, use of equipment, and present living situation also were surveyed. Results indicated that subjects with triceps as the lowest functioning muscle had significantly greater independence levels in self-care activities than those with wrist extensors. Changes in abilities from discharge to follow-up were noted for both groups, especially in the areas of bowel and bladder care, dressing, and mobility activities. Most subjects lived at home with their family and used personal care assistance to accomplish part of their self-care. Equipment use was decreased upon community living for both groups. It is concluded that the functioning of triceps is a significant determinant for functional independence in self-care tasks.