A student physical therapist is reviewing functional outcomes for a patient with T4 AIS A paraplegia. Which of the following combinations of ADL expectations is MOST accurate for this level of injury?

A student physical therapist is reviewing functional outcomes for a patient with T4 AIS A paraplegia. Which of the following combinations of ADL expectations is MOST accurate for this level of injury?

• A. Independent in feeding, bathing, dressing, grooming, bowel and bladder, skin inspection, and homemaking (except heavy cleaning)
• B. Dependent in feeding; independent in dressing; requires moderate assistance with bathing
• C. Independent in feeding and grooming only; dependent in all other ADLs
• D. Requires maximum assistance for all self-care activities due to absent upper extremity function

Answer: (A)

For a person with a complete T4 spinal cord injury (AIS A), the arms and hands work well, while function below T4 is lost, which means many self-care tasks can be done independently with the right adaptations. Feeding, grooming, and dressing rely on intact upper extremity function, so independence in these activities is realistic. Bathing can also be performed independently when using a shower chair, long-handled tools, and transfers aided by adaptive equipment. Bowel and bladder management is neurogenic after a thoracic injury, but many individuals achieve independence through scheduled routines and techniques such as intermittent catheterization and bowel programs. Skin inspection is feasible with the use of mirrors or other tools to check vulnerable areas, helping prevent pressure injuries. Homemaking tasks like cooking and laundry can be accomplished with wheel chair access and adaptive devices, while heavy cleaning is typically more demanding and less feasible independently. Altogether, this profile captures the level of independence expected for someone with a T4 AIS A paraplegia.

For a person with a complete T4 spinal cord injury (AIS A), the arms and hands work well, while function below T4 is lost, which means many self-care tasks can be done independently with the right adaptations. Feeding, grooming, and dressing rely on intact upper extremity function, so independence in these activities is realistic. Bathing can also be performed independently when using a shower chair, long-handled tools, and transfers aided by adaptive equipment. Bowel and bladder management is neurogenic after a thoracic injury, but many individuals achieve independence through scheduled routines and techniques such as intermittent catheterization and bowel programs. Skin inspection is feasible with the use of mirrors or other tools to check vulnerable areas, helping prevent pressure injuries. Homemaking tasks like cooking and laundry can be accomplished with wheel chair access and adaptive devices, while heavy cleaning is typically more demanding and less feasible independently. Altogether, this profile captures the level of independence expected for someone with a T4 AIS A paraplegia.