Certified Rehabilitation Counselor Practice

Individuals with SCI will generally depend on others for self-care starting at which injury level?

1. C1

2. C5

3. C3/C4

4. C6

The correct answer is: C3/C4

Individuals with spinal cord injury (SCI) typically begin to rely on others for self-care at the C3/C4 injury level. At this level of injury, significant impairment occurs affecting the ability to move and control the muscles of the neck and upper body, which limits a person’s capacity to perform activities of daily living (ADLs) independently. Individuals with injuries at this level often demonstrate very limited motor function, meaning they would require assistance for most self-care tasks, such as bathing, dressing, and feeding. In contrast, as the injury level progresses down the cervical spine, such as at C5 or C6, individuals may retain some functional movements of the arms or hands, which can enable them to perform specific tasks with varying degrees of assistive devices. However, it is at the C3/C4 level where dependence on assistance for self-care becomes more pronounced and necessary.