The document discusses cervical spinal cord injuries known as tetraplegia or quadriplegia, outlining the effects of injuries at different vertebral levels from C1-C6 and providing instructions for dressing and undressing someone with such an injury. Minimal criteria for lower extremity function is described to determine if a patient can transfer independently or requires assistance with activities like dressing. Methods for donning and doffing pants with the use of dressing aids are explained.

1. By- SYED MASOOD

2.  Cervical (neck) injuries usually results in 4
limb paralysis.
 Referred as Tetraplegia & quadriplegia.
 2 types
 incomplete tetraplegia
 complete tetraplegia

3.  C1-4 Tetraplegia:
Patients with C-1 & C-2 lesions may
have functional phrenic nerves.
patients with C-3 lesions have impaired
breathing & may be ventilator- dependent.
( shrugging shoulder & neck movt may present)

4.  C-5 paralysis:
– Have functional triceps & biceps.
– They can external & internal rotate , abduct
shoulder
– Can supinate & pronate
– Wrist extension.
• C-6 paralysis:
– Permits almost all movt of shoulder &elbow bending.
– But not elbow & wrist extension.
– Can perform upper body dressing without assistance.
– But require assistance in lower & bowel activity.

5.  WHEN THE SPINE STABLE.
Minimal criteria for lower extremity:
 Fair to Good power of pectoralis major, serratus
anterior, rhomboids
 ROM 0-120 Knee flexion
 0-110 Hip flexion
 0-80 hip external rotation.
??ability to transfer weight from bed to wheelchair.
???Roll from side to side
????balance in side lying
???? Turning supine to prone

6.  Spine unstable
 50% less VC
 Pressure sores
 Uncontrollable muscle spasm.

7. Put pants in lying
Transfer to
wheelchair
Put shirt, socks &
shoes

8.  Clothing should be loose and have front opening.
 Trousers need to be a size larger than the size.
( so as to accommodate the urine bag or leg brace
etc)
 Wrap around shirts & rubber pants are more
helpful to wear.
 Zippers & Velcro closures.
 Belt loops on the trousers are used for pulling.
 Shoes can be ½ to 1 larger than normal. ( to
accommodate edema & spasticity & to avoid
pressure sores.

9.  Shoe fasteners, Velcro, elastic shoelaces, large
buckles, or flip – back tongue closure.
 Loose woolen or Cotton socks without elastic
cuffs should be used.

10.  Donning-
1. Sit on bed with bed rails up.
2. Trousers are positioned at foot of bed with
trouser legs over end of bed and front side up.
3. Sit up & lift 1 knee at a time by hooking rt
hand under the rt knee to pull in flexion. Put
the trousers to the rt foot.
4. Return the leg to extension.
5. Repeat the procedure to the left side.
If the patient is unable to maintain the leg in
flexion by holding with arm or advantageous
spasticity we can use
DRESSING BAND

11.  Is a elastic webbing that has been sewn into
fig 8 pattern with small loop & the larger
loop
 Smaller loop – foot.
 lager loop- knee.
 Band measure according to individual client.
 Once flexion is done then remove band from
knee and for foot can use DRESSING STICK.

12. 6. Work trousers up the legs, using patting and
sliding motion with palms of hands.
7. When the pants reaches the mid calf height,
insert DRESSINGSTICK in front belt loop.
8. Pull on dressing sticks while extending trunk,
returning to supine position.
9. ALERNATIVE-
 If the balance is adequate, an alternative is to
remain in sitting- lean to left elbow & pull the
trousers over the rt side buttock.
 Patient remain in the supine position & roll the
opp side. Put the hand in the pant’s pocket or
with the belt loop.

13. 10. using palms push & smoothing motion.
Straighten the trouser legs.
11. in supine position fasten trouser belt. Patting
the Velcro closed or using hand splints

14.  Lying supine in the bed with bed rails up. Un
fasten the belt.
 Placing the hands in pocket or with the help
of waist band. Work trousers past stabilizing
arms in extension & scooting body towards
head of bed.
 Roll from side to side to get off the trousers
from buttocks.
 coming to sitting position alternately pulling
the leg in flexion, push trousers down legs.
 Trousers can be pushed off over feet with
dressing stick or hooking thumb in waist band