According to functional expectations for a complete SCI, which cervical level is the FIRST at which independent driving with an adapted vehicle using adaptive equipment is a realistic goal?

According to functional expectations for a complete SCI, which cervical level is the FIRST at which independent driving with an adapted vehicle using adaptive equipment is a realistic goal?

• A. C6
• B. C8
• C. C5
• D. T1

Answer: (A)

Independent driving with adaptive equipment hinges on having enough hand and wrist function to grip, release, and operate the vehicle’s controls while maintaining control of the wheel. When wrist extension is preserved, you can form a functional tenodesis grip that allows you to hold and manipulate steering devices and hand controls even with limited finger dexterity. Elbow flexion from the upper arm and shoulder strength help bring the hand to the controls and stabilize the arm during driving. This combination makes safe, independent driving with adaptive equipment realistically achievable. If wrist extension is lost, as occurs at lower cervical levels, the ability to reliably grasp and manipulate the necessary controls is severely compromised, making independent driving much less feasible. Therefore, the first cervical level at which independent driving with adaptive equipment is realistic is the level with preserved wrist extension.

Independent driving with adaptive equipment hinges on having enough hand and wrist function to grip, release, and operate the vehicle’s controls while maintaining control of the wheel. When wrist extension is preserved, you can form a functional tenodesis grip that allows you to hold and manipulate steering devices and hand controls even with limited finger dexterity. Elbow flexion from the upper arm and shoulder strength help bring the hand to the controls and stabilize the arm during driving. This combination makes safe, independent driving with adaptive equipment realistically achievable.

If wrist extension is lost, as occurs at lower cervical levels, the ability to reliably grasp and manipulate the necessary controls is severely compromised, making independent driving much less feasible. Therefore, the first cervical level at which independent driving with adaptive equipment is realistic is the level with preserved wrist extension.