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Name: Karen C.

Age: 35

Sex: Female

Injury: C5 ASIA C

Date of injury: 6 weeks ago

MOI: Fall from balcony

PLOF: Active marathon runner and independent with all ADLs

Environment: Lives in single story house by herself with no stairs to enter the house.

Personal factors: Relatives live nearby and are supportive.

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Motor:

Weak intercostals and abdominal muscles

Impaired trunk control

Poor sitting balance due to impaired trunk control ​ ​ ​

Weak wrist extension (C6)​

Weak elbow extension (C7)​

Weak finger flexors and finger abductors (C8 and T1)​

Lower extremity motor loss

Sensory:

Sensation impaired below C8 on left side ​

Sensation intact on right side

Risk of autonomic dysreflexia

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Due to our patient having no motor function of her lower extremities at her current stage of recovery we believe a hybrid wheelchair cushion would be most beneficial for:

Long-term skin protection

Providing stability for posture and transfers

Adaptability over time

These can be adjusted as the patient's strength, posture, and functional levels evolve over time.

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Because the patient has impaired trunk control and poor sitting balance, we recommend a backrest with bilateral contour supports.

This is designed to help the patient maintain an upright posture in midline.

In addition, the backrest height will be adjusted to the patient's height. A backrest height that is too high may interfere with the patient's shoulder range of motion and ability to propel themselves. A backrest that is too low may result in poor posture as the backrest provides passive trunk stability.

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The patient has no motor control in her lower extremities, so a folding frame would be inappropriate, as those are good for patients who can use their LEs to help propel them.

A rigid frame is better for maneuvering, is more efficient and is easier to push. This is a good choice for her because she has weak triceps. Having a wheelchair that requires less energy to propel will be the smartest decision for this patient.

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Solid tires are a great fit for the patient because they are more durable than pneumatic tires and do not require any inflation. They also do no go flat. These tires are more convenient for the patient and she won't have to worry about added fatigue or risk of injury due to having to use more strength to propel her wheelchair should she encounter a flat tire. The only con with solid tires is they offer less shock absorption than pneumatic tires.

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Quickie 24" Lite-Spoke Wheel Completes will reduce overall wheelchair weight for easier pushing due to the patient having weak triceps, better maneuverability, and simplified transport. They also improve traction for better handling and increased shock absorption.

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Open frames are lighter and easier to lift. This makes it an appropriate choice for a patient with C5 ASIA C to be able to load it in and out of her car independently. Also, because she has partial motor preservation, reducing the overall weight of the wheelchair minimizes the fatigue and maximizes the potential for independence. Ultimately, this will reduce caregiver effort while promoting autonomy for the patient.

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An ultralight weight wheel chair would be best for this patient as she is still young and needs to have ample mobility to participate around her community. A light wheelchair would also be easier to transport in vehicles and allow the patient more freedom. The patient will also be more mobile and agile in this wheel chair and will be able to make more precise turns when needed. She will also experience less fatigue while propelling as the wheelchair will not need as much force to engage movement.