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Thread: Pt/ot

  1. #1


    What are some of the typical things a C4 complete should be doing in PT and OT? My friend does what she calls CB slings and arm skates in OT and then just a bunch of stretching (arms, legs, back) in PT. Is this normal? It seems like she should be doing more, but maybe I'm wrong. She is almost 4 months post-injury and has regained her shoulders and some biceps.

  2. #2

    re: Pt/ot

    hi christina, i am 3 years post injury. i am also a C4 complete injury. i was in rehab for about 6 months. and was in halo and neck brace for that whole time. i did then do quite a bit of outpatient ot/pt. is your friend still in a halo or neck brace?

    remember all injuries can be different, but with complete injuries, not alot of return function occurrs. but if she at this point has some shoulder movement/shrug she is doing well and you mentioned biceps, for a C4 complete, that is amazing. i am just over 3 years post injury and have return sensation/feeling to my shoulder tops and slight up and down shoulder shrug. i have good neck movement also, nothing below my shoulders.

    let me know if you have any questions i would love to talk. as for what she is doing, stretching, rom, neck exercises, and pool therapy were what i did. take care

    c4 complete injury

  3. #3
    Hi Scott,

    Christina no longer has to wear her neck brace and she had tongs in the hospital, but not a halo. She has had shoulder movement since she was in the ICU in June and her biceps are coming back slowly. Her left arm is much stronger than her right at this point - she has a pic (sp?) line in her right so they haven't been able to do any E Stim on that one yet.


  4. #4
    How strong are her biceps? I assume she also has deltoids if she has biceps? If they are a 3 or better, she should be working on functional activities too. Examples would be:

    Upper extremity dressing (putting on a shirt and bra)
    Feeding herself after set-up
    Brushing teeth, combing hair, washing face after set-up
    Typing and using a computer with assistive devices

    Rolling/turning in bed using side rails
    Sitting balance activities
    Pushing a manual wheelchair on smooth uncarpeted level surfaces

    Where is she getting her therapy? Is is a major SCI center, a nursing home, or a community PT clinic. It does not sound like she is being pushed enough in the functional areas. Is she getting any e-stim on her weaker shoulder and arm muscles?


  5. #5

    I'm not sure what level her biceps are or if she has deltoids - I'll find out today.

    However, her biceps are definitely not strong enough to lift her arms and do some of the things you described. Right now she can only slide her left arm in towards her body either when she's laying down or in her chair. She can lift it slightly, but not enough to raise her hand off the pillow. Her right arm is significantly weaker because they have not been doing an E Stim on that one at all due to her pic (sp?) line.

    She is at Kessler and may be moving to Cheshire Home sometime in the next month for the meantime until she can go home.

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