SCI

Level C1-C3

• Limited head and neck movement depending on muscle strength.
• Complete paralysis of arms, body and legs.
• Sympathetic nervous system will be compromised, possibility of Autonomic Dysreflexia.
• Electric wheelchair may possibly be controlled by either a chin or "sip and puff" controller, this will vary depending on dexterity.
• The person will require total assistance when transferring from a bed to a wheelchair and from a wheelchair into a car. 
• A hoist will have to be used, possibly by two assistants for safety.
• Complete assistance required during mealtimes.

SCI

Level C4

• Full head and neck movement depending on muscle strength. Limited shoulder movement.
• Complete paralysis of body and legs. No finger, wrist or elbow flexion or extension.
• Sympathetic nervous system will be compromised, possibility of Autonomic Dysreflexia.
• Electric wheelchair may be controlled by either a chin or "sip and puff" controller, this will vary depending on dexterity.
• The person will require total assistance when transferring from a bed to a wheelchair and from a wheelchair into a car. A hoist will have to be used, possibly by two assistants for safety.
• Complete assistance required during mealtimes.
• Complete personal assistance required

SCI

Level C5

• Full head and neck movement with good muscle strength. Good shoulder movement.
• Complete paralysis of body and legs. No finger or wrist movement. No elbow extension, good elbow flexion.
• Sympathetic nervous system will be compromised, possibility of Autonomic Dysreflexia.
• Electric wheelchair can be controlled with a hand control for uneven surfaces. A manual wheelchair may be used for short distances on flat surfaces.
• The person will require total assistance when transferring from a bed to a wheelchair and from a wheelchair into a car. A hoist will have to be used, possibly by one to two assistants for safety.
• Ability to feed self using feeding strap and fork or spoon during mealtimes. Food will need cutting.
• Ability to drive a car adapted with hand controls. Assistance may be required to load wheelchair into car independently.

SCI

Level C-6

• Full head and neck movement with good muscle strength. Good shoulder movement.
• Complete paralysis of body and legs. No finger movement, no elbow extension, no wrist flexion. Good wrist extension, good elbow flexion.
• A passive key grip may be present by flexing the wrist backwards, but will be weak.
• Sympathetic nervous system will be compromised, possibility of Autonomic Dysreflexia.
• Electric wheelchair can be controlled with a hand control for uneven outdoor surfaces. A manual wheelchair may be used for short distances on flat surfaces.
• The person will require total assistance when transferring from floor to chair. Assistance will vary for transfer from bed to wheelchair, and wheelchair to car. A sliding board may be used in assisting with the transfer
• Ability to feed self using feeding strap and fork or spoon during mealtimes. Food will need cutting. Able to make hot drinks with adapted kettle using a "kettle tipper".
• Ability to drive a car adapted with hand controls. Assistance may be required to load wheelchair into car independently.

SCI

Level C7-C8

• Full head and neck movement with good muscle strength. Good shoulder movement.
• Complete paralysis of body and legs. Partial finger movement,full elbow extension and flexion, full wrist extension and flexion.
• A C7 injured person will have movement in the thumb.
• Sympathetic nervous system will be compromised, possibility of Autonomic Dysreflexia.
• May use an electric wheelchair for long independent travel or uneven outdoor surfaces. A manual wheelchair may be used for short distances on flat surfaces.
• Ability to transfer independently from bed to chair, and chair to car. Car transfers may need assistance depending on upper body strength.
• Ability to drive a car adapted with hand controls. Assistance may be required to load wheelchair into car independently.
• Ability to feed self independently during mealtimes. Food may need cutting. Able to make hot drinks , may require an adapted kettle using a "kettle tipper".

SCI

Levels T1-T4

• Full head and neck movement with normal muscle strength. Normal shoulder movement. Full use of arms, wrists and fingers.
• Complete paralysis of lower body and legs. Upper body strength will vary depending on level of injury, but the lower the level, the stronger the upper body strength and balance.
• A T4 injured person will have good strength in the chest muscles, however this will get progressively weaker the higher up the injury.
• Sympathetic nervous system may be compromised, possibility of Autonomic Dysreflexia.
• May use an electric wheelchair for long distance independent travel or uneven outdoor surfaces. A manual wheelchair may be used for everyday living, with the ability to go over uneven ground for short distances.
• Ability to transfer independently from bed to chair, and chair to car. Car transfers may need assistance depending on upper body strength.
• Ability to drive a car adapted with hand controls. Assistance may be required to load wheelchair into car.
• Ability to feed self independently during mealtimes.

SCI

Level T5-T9

• Full head and neck movement with normal muscle strength. Normal shoulder movement. Full use of arms, wrists and fingers.
• Complete paralysis of lower body and legs. Upper body strength will vary depending on level of injury, but the lower the level, the stronger the upper body strength and balance.
• A manual wheelchair may be used for everyday living, with the ability to go over uneven ground.
• Ability to transfer independently from bed to chair, and chair to car. Car transfers may need assistance depending on upper body strength.
• Ability to drive a car adapted with hand controls. Assistance may be required to load wheelchair into car.

SCI

Level T10-L1

• Full head and neck movement with normal muscle strength. Normal shoulder movement. Full use of arms, wrists and fingers.
• Partial paralysis of lower body and legs. Upper body strength and balance will vary depending on level of injury, but the lower the level, the stronger the upper body strength and balance.
• A manual wheelchair may be used for everyday living, with the ability to go over uneven ground.
• Ability to transfer independently from bed to chair, and chair to car. It may be possible to transfer from floor to chair depending on upper body strength. It may also be possible to transfer from sitting position to standing frame independently.
• Ability to drive a car adapted with hand controls. Ability to load wheelchair into car independently.

SCI

Level L2-S5

• Full head and neck movement with normal muscle strength. Normal shoulder movement. Full use of arms, wrists and fingers.
• Full upper body control and balance.
• Some hip, knee and foot movement depending on the level of injury. The lower the injury, the more control over movement.
• A manual wheelchair may be used for everyday living, with the ability to go over uneven ground.
• Ability to transfer independently from bed to chair, and chair to car. It may be possible to transfer from floor to chair depending on upper body strength.
• Depending on the level of injury, walking may be possible with assistance or aids. Walking will be slow and difficult though.
• Ability to drive a car adapted with hand controls. Ability to load wheelchair into car independently.

• A - Complete-No motor or sensory function in the lowest sacral segment (S4-S5)
• B - Incomplete- Sensory function below neurologic level and in S4-S5, no motor function below neurologic level
• C - Incomplete-Motor function is preserved below neurologic level and more than half of the key muscle groups below neurologic level have a muscle grade less than 3.
• D - Incomplete-Motor function is preserved below neurologic level and at least half of the key muscle groups below neurologic level have a muscle grade 3.
• E - Normal- Sensory and motor function is normal