A physical therapist is discussing long-term mobility expectations with a patient who has a T6 AIS A SCI. Which statement BEST describes this patient's ambulation prognosis?

A physical therapist is discussing long-term mobility expectations with a patient who has a T6 AIS A SCI. Which statement BEST describes this patient's ambulation prognosis?

• A. Community ambulation with bilateral AFOs and forearm crutches
• B. Independent ambulation without assistive devices
• C. Unlikely to functionally ambulate; may ambulate physiologically with RGOs, HKAFOs, or KAFOs; will likely prefer wheelchair mobility due to high energy requirements
• D. Household ambulation with bilateral KAFOs and a swing-through gait pattern as a primary mode of mobility

Answer: (C)

At T6 with a complete spinal cord injury, the person has no motor or sensory function below the level of injury. There can be some trunk control, but not enough to achieve functional, energy-efficient walking without substantial devices. Therefore, long-term ambulation is unlikely without heavy orthotic support and significant energy expenditure. If ambulation is attempted, it would typically require braces such as a KAFO (knee-ankle-foot orthosis), HKAFO (hip-knee-ankle-foot orthosis), or an RGO (reciprocating gait orthosis) and assistive devices, but the energy cost is so high that wheelchair mobility is usually the preferred mode for most activities. This aligns with the described prognosis: unlikely to walk functionally; possible with orthoses that enable limited gait, yet overall mobility is dominated by wheelchair use due to energy demands.

At T6 with a complete spinal cord injury, the person has no motor or sensory function below the level of injury. There can be some trunk control, but not enough to achieve functional, energy-efficient walking without substantial devices. Therefore, long-term ambulation is unlikely without heavy orthotic support and significant energy expenditure. If ambulation is attempted, it would typically require braces such as a KAFO (knee-ankle-foot orthosis), HKAFO (hip-knee-ankle-foot orthosis), or an RGO (reciprocating gait orthosis) and assistive devices, but the energy cost is so high that wheelchair mobility is usually the preferred mode for most activities. This aligns with the described prognosis: unlikely to walk functionally; possible with orthoses that enable limited gait, yet overall mobility is dominated by wheelchair use due to energy demands.