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Neurological Level of Injury: T4 ASIA A

Patient: Mr. John Doe is a 36-year-old man who works in the tech industry. He was in a motorcycle accident 7 months ago.

PLOF: Patient would play recreational basketball 3x a week and would go to the gym 4x a week for the last 3 years.

CLOF: Patient presents with B/L UE use, and minimal use of his trunk, patient requires moderate assistance with all ADLs; such as dressing, transferring in and out of his bed and wheelchair, and any household tasks that require bending or reaching.

Environmental Factors: Patient lives with his wife and 10-year-old daughter in a wheelchair-accessible one-story house in Miami, Florida. The house has hardwood flooring all over, one step to walk into the house, and one walk-in shower with a seat and grab bars.

Personal Factors: Patient has a supportive family willing to assist in all ADLs. Patient is a tech company owner, who is able to return to work remotely.

Recommendation: Based on the patient's Neurological Level of Injury, ASIA classification, and patient goals of increased independence and participation in recreational basketball; we are prescribing an Ultra- lightweight manual wheelchair with posterior movement rear wheel adjustments.

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Patient has functional use of upper extremities, but minimal trunk stability. Patient will be pressure relieving independently and the stability for posture added by the foam cushion will aid the patient with trunk stability.

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Mr. Doe has typical UE use, needs increased trunk control, and desires to be more independent by allowing for greater control and increased propulsion which would be beneficial for mobility during all activities and participation in recreational wheelchair basketball. The ultra-lightweight manual wheelchair is the most suitable for the maneuverability the patient needs.

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Posterior Movement Rear Wheel Adjustments with Increased Camber

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Our patient would benefit the most by using posterior movement rear wheel adjustments because they increase the stability of the chair which is beneficial due to the patient's current trunk stability and will overall be the safer option for him. We will also opt to increase the camber. Increasing the camber angle will benefit the patient because it will increase lateral stability and also make it easier for the patient to turn which aligns with his goals of increased independence and future participation in recreational basketball.

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Patient would benefit from a backrest that reaches the bottom of the shoulder blade right below the inferior angle of the scapula. This patient's injury is at T4 and he has full B/L UE function and has minimal use of the trunk. Maintaining this height will allow for full UE and scapular involvement increasing the range of motion at the shoulder allowing for increased propelling ability of the manual wheelchair while allowing for trunk support by increasing balance and postural control specifically to help with more dynamic movements such as participating in recreational basketball.