811:(ADLs), such as getting dressed, eating, and bowel/bladder care. Individuals with C5 injuries retain some function in their biceps, deltoids, and other muscles; they typically can perform many ADLs including feeding, bathing, and grooming but require total assistance with bowel/bladder care. The C6 level adds function in the extensor carpi radialis, longus, and other muscles allowing for wrist extension, scapular abduction, and wrist flexion; typically, these patients have modified independent feeding and grooming with adaptive equipment, independent with dressing, can use both a manual and power wheelchair but require assistance with some activities of daily living. The C7 level is where function is retained in the triceps allowing for arm extension; C7 is considered the key level at which most activities can be performed independently with a wheelchair and assistive devices; activities include feeding, grooming, dressing, light meal preparation, and transfers on level surfaces. Even in complete spinal cord injury, it is common for individuals to recover up to 1 level of motor function.
642:(ASIA) classification. The ASIA scale grades patients based on their functional impairment as a result of the injury, grading a patient from A to D. This has considerable consequences for surgical planning and therapy. After a comprehensive neurologic exam testing segments of the body corresponding to spinal nerve roots, the examiner will determine the patient's motor level and sensory level (i.e. motor level C6, sensory level C7). These levels are unique for the patient's left and right side. This level is assigned based on the lowest (closest to the patient's feet) intact motor and sensory level. After this assignment, a neurological level of injury (NLI) is determined. The NLI is the lowest segment with intact sensory and motor function provided there is normal sensory and motor function above this segment.
51:
618:
897:"Tetraplegia", meaning the paralysis of four limbs, may be confused with "tetraparesis", meaning the weakness of four limbs. In medicine, it is important to not use these terms when making a diagnosis. When diagnosing and classifying spinal cord injuries, the ASIA classification is used to distinguish between weakness vs. no weakness, and to classify neurologically complete vs. incomplete lesions. Use of "tetraparesis" is discouraged as it inaccurately describes an incomplete lesion and incorrectly implies tetraplegia applies only to cases of complete lesions.
799:
433:(elbow flexion) will be spared; in this case, an injury at the C6 root level affects all function at that level and below whereas the C5 nerve root, which controls the biceps, is spared since it is above the C6 level in the spinal column. When classifying an individual's level of function, there are numerous functional assessment tools that may be used in a clinical setting and it is often up to the clinician's discretion as to which tools are used. A comprehensive list of these tools may be found on the
228:
tetraplegia is that the victim cannot move legs, arms, or any other major body regions; this is often not the case. Some tetraplegics can walk and use their hands, as though they did not have a spinal cord injury, while others may use wheelchairs and retain some functions in their arms and fingers; again, this varies based on the degree of damage to the spinal cord and is mostly seen with incomplete tetraplegia.
756:
be performed. In contrast, for patients with ASIA D (incomplete) tetraplegia it is difficult to assign an
International Classification other than International Classification level X (others). Therefore, it is more difficult to decide which surgical procedures should be performed. A far more personalized approach is needed for these patients. Decisions must be based more on experience than on texts or journals.
224:-dependent. An individual with a C7 injury may lose function from the chest down but still retain use of the arms and much of the hands. An individual in between, with a C5 injury may lose some function from the chest down and fine motor skills in his/her hands but still have flexion and extension abilities of certain muscles around the back or arm area.
751:: a lesion similar to cauda equina syndrome however this lesion is typically found higher in the cord. This presents clinically similarly to cauda equina syndrome however there may be intact sacral reflexes. Unlike cauda equina, the unique location of this syndrome leads it to present with mixed upper and lower motor neuron signs.
704:
sensation in the perineal area. S4 and S5 are both sacral nerve roots found at the lowest portion of the spinal cord. In simpler terms, "complete" is meant as a way to express that the spinal cord is injured such that no signal, motor or sensory, is carried to or from the level of injury to these lower levels of the spinal cord.
767:
Spasticity is a frequent consequence of incomplete injuries. Spasticity often decreases function, but sometimes a patient can control the spasticity in a way that it is useful to their function. The location and the effect of the spasticity should be analyzed carefully before treatment is planned. An
755:
For most patients with ASIA A (complete) tetraplegia, ASIA B (incomplete) tetraplegia and ASIA C (incomplete) tetraplegia, the
International Classification level of the patient can be established without great difficulty. The surgical procedures according to the International Classification level can
789:
Upper limb paralysis refers to the loss of function of the elbow and hand. When upper limb function is absent as a result of a spinal cord injury it is a major barrier to regain autonomy. People with tetraplegia should be examined and informed concerning the options for reconstructive surgery of the
763:
Patients with an incomplete lesion also often need therapy or surgery before the procedure to restore function to correct the consequences of the injury. These consequences are hypertonicity/spasticity, contractures, painful hyperesthesias and paralyzed proximal upper limb muscles with distal muscle
394:
Tetraplegia is defined in many ways; C1âC4 usually affects arm movement more so than a C5âC7 injury; however, all tetraplegics have or have had some kind of finger dysfunction. So, it is not uncommon to have a tetraplegic with fully functional arms but no nervous control of their fingers and thumbs.
853:
The estimated lifetime costs for a 25-year-old in 2018 is $ 3.6 million when affected by low tetraplegia and $ 4.9 million when affected by high tetraplegia. In 2009, it was estimated that the lifetime care of a 25-year-old rendered with low tetraplegia was about $ 1.7 million, and $
759:
The results of tendon transfers for patients with complete injuries are predictable. On the other hand, it is well known that muscles lacking normal excitation perform unreliably after surgical tendon transfers. Despite the unpredictable aspect in incomplete lesions, tendon transfers may be useful.
424:
can be determined. This informs the evaluator as to what activities may be limited as a result of the injury. This is typically done at 72 hours post-injury; exams done prior to this time have been found to be inaccurate due to the presence of swelling and other confounding factors. For example, an
703:
As in the above ASIA chart, a complete spinal cord injury is any injury which has absent motor and sensory function in the sacral segments S4 and S5. This is verified during the physical exam by the absence of all three of: voluntary anal contraction, deep anal pressure, and pinprick+light touch
407:
Since tetraplegia is defined as dysfunction in the cervical spinal cord, this section will focus on the anatomy of the cervical spinal cord. To understand how tetraplegia presents after injury, it is imperative to have a broad knowledge of the cervical spinal roots and its many functions. In the
235:
Another important factor is the possibility that the patient may exhibit sporadic movement in the affected areas. One of the main causes for this would be myoclonus, or muscle spasms. "After a spinal cord injury, the normal flow of signals is disrupted, and the message does not reach the brain.
806:
Delayed diagnosis of cervical spine injury has grave consequences for the victim. About one in 20 cervical fractures are missed and about two-thirds of these patients have further spinal-cord damage as a result. About 30% of cases of delayed diagnosis of cervical spine injury develop permanent
231:
It is common to have partial movement in limbs, such as the ability to move the arms but not the hands, or to be able to use the fingers but not to the same extent as before the injury. Furthermore, the deficit in the limbs may not be the same on both sides of the body; either side may be more
227:
The extent of the injury is also important. A complete severing of the spinal cord will result in complete loss of function from that vertebra down. A partial severing or even bruising of the spinal cord results in varying degrees of mixed function and paralysis. A common misconception with
737:: a lesion of the lumbosacral nerve roots that may spare the spinal cord. As these nerve roots are lower motor neurons, a flaccid lower limb paralysis is typically seen along with loss of bowel and bladder reflexes, varying degrees of impairment of sensation, and loss of sacral reflexes (
893:
for "four". In the past, "tetraplegia" and "quadriplegia" were used interchangeably in the medical literature. Medical literature favors using "tetraplegia" as the standardized term, as it is frowned upon to mix Greek and Latin roots, although "quadriplegia" remains in use.
219:
The severity of the condition depends on both the level at which the spinal cord is injured and the extent of the injury. An individual with an injury at C1 (the highest cervical vertebra, at the base of the skull) will probably lose function from the neck down and be
395:
It is possible to have a broken neck without becoming tetraplegic if the vertebrae are fractured or dislocated but the spinal cord is not damaged. Conversely, it is possible to injure the spinal cord without breaking the spine, for example when a ruptured
725:: hemisection of the spinal cord with resultant loss in: a.) ipsilateral proprioception, vibration, and motor control below the level of injury b.) complete sensory loss at the level of injury c.) contralateral pain and temperature loss.
832:
Tetraplegics can improve muscle strength by performing resistance training at least three times per week. Combining resistance training with proper nutrition intake can greatly reduce co-morbidities such as obesity and type 2 diabetes.
719:: an injury to the central area of the spinal cord, most often seen as a result of a fall with subsequent hyperextension injury. This typically presents with weakness greater in the upper limbs than in the lower limbs.
1840:
1825:
829:, which is caused by damage to the motor cortex either before, during (10%), or after birth, some people with incomplete tetraplegia are gradually able to learn to stand or walk through physical therapy.
731:: a lesion of the anterior two-thirds of the spinal cord, most commonly due to ischemia. This typically presents with loss of pain, temperature, and motor function at and below the level of injury.
760:
The surgeon should be confident that the muscle to be transferred has enough power and is under good voluntary control. Pre-operative assessment is more difficult to assess in incomplete lesions.
58:
Affected areas (pink) representing differences between paraplegia (left), hemiplegia (middle), and tetraplegia (right). Areas may differ for each condition and are dependent upon level of injury.
72:
847:
There are an estimated 17,700 spinal cord injuries each year in the United States; the total number of people affected by spinal cord injuries is estimated to be approximately 290,000 people.
807:
neurological deficits. In high-level cervical injuries, total paralysis from the neck can result. High-level tetraplegics (C4 and higher) will likely need constant care and assistance in
1793:
2183:
180:
Although the most obvious symptom is impairment of the limbs, functioning is also impaired in the trunk and pelvic organs. This can lead to loss or impairment of controlling
712:
Incomplete spinal cord injuries result in varied post injury presentations. There are three main syndromes described, depending on the exact site and extent of the lesion.
850:
In the US, spinal cord injuries alone cost approximately $ 40.5 billion each year, which is a 317 percent increase from costs estimated in 1998 ($ 9.7 billion).
236:
Instead, the signals are sent back to the motor cells in the spinal cord and cause a reflex muscle spasm. This can result in a twitch, jerk or stiffening of the muscle."
1177:
2930:
2094:
1567:
2176:
1695:"The SCIRehab project: treatment time spent in SCI rehabilitation. Physical therapy treatment time during inpatient spinal cord injury rehabilitation"
692:
Motor function is preserved below the neurological level; at least half of key muscles below the neurological level have a muscle grade of 3 or more.
681:
Motor function is preserved below the neurological level; more than half of key muscles below the neurological level have a muscle grade less than 3.
256:, causes the loss of partial or total function of all four limbs, meaning the arms and the legs. Typical causes of this damage are trauma (such as a
1798:
670:
Sensory but not motor function is preserved at S4âS5. No motor function is preserved >3 levels below the motor neurological level of injury.
1118:
2169:
168:. A loss of sensory function can present as an impairment or complete inability to sense light touch, pressure, heat, pinprick/pain, and
772:(Botox) into spastic muscles is a treatment to reduce spasticity. This can be used to prevent muscle shortening and early contractures.
2128:
1929:
1544:
1094:
192:
functions. Furthermore, sensation is usually impaired in affected areas. This may manifest as numbness, reduced sensation or
1574:
1525:
1370:
Hentz VR, Leclercq C (May 2008). "The management of the upper limb in incomplete lesions of the cervical spinal cord".
926:
775:
Over the last ten years, an increase in traumatic incomplete lesions is seen, due to the better protection in traffic.
639:
814:
Even with "complete" injuries, in some rare cases, through intensive rehabilitation, function can be regained through
784:
1736:
2029:
842:
590:
2779:
2064:
196:. Secondarily, because of their depressed functioning and immobility, tetraplegics are often more vulnerable to
1539:
386:
265:
1762:
857:
About 1,000 people are affected each year in the UK (~1 in 60,000âassuming a population of 60 million).
367:
1447:
2827:
1967:
1962:
1518:
931:
906:
172:. In these types of spinal cord injury, it is common to have a loss of both sensation and motor control.
17:
1138:"Does sacral posterior rhizotomy suppress autonomic hyper-reflexia in patients with spinal cord injury?"
1122:
808:
356:
1253:
2679:
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2110:
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2014:
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2019:
1946:
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728:
1884:
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Taylor-Schroeder S, LaBarbera J, McDowell S, Zanca JM, Natale A, Mumma S, et al. (2011).
2786:
2079:
2074:
2036:
974:"International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019"
972:
Rupp R, Biering-SĂžrensen F, Burns SP, Graves DE, Guest J, Jones L, et al. (2021-03-01).
734:
716:
496:
308:
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50:
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8:
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2714:
2041:
2004:
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815:
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396:
277:
261:
1178:"Spasticity and Spinal Cord Injury | Model Systems Knowledge Translation Center (MSKTC)"
2626:
2616:
2611:
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2283:
2192:
2056:
1999:
1719:
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1665:
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1289:
1112:
1055:
998:
973:
921:
281:
269:
181:
149:
129:
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1849:
1312:"Classifications In Brief: American Spinal Injury Association (ASIA) Impairment Scale"
1227:
2606:
2417:
2375:
2233:
2223:
2150:
1982:
1977:
1756:
1724:
1710:
1670:
1619:
1497:
1476:"Effects of resistance training on adiposity and metabolism after spinal cord injury"
1428:
1387:
1343:
1293:
1281:
1273:
1231:
1159:
1154:
1137:
1100:
1090:
1047:
1003:
819:
340:
257:
161:
99:
63:
144:
leading to partial or total loss of function in the arms, legs, trunk, and pelvis. (
2742:
2621:
2580:
2268:
2210:
1994:
1714:
1706:
1660:
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1609:
1601:
1487:
1418:
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993:
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153:
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2248:
1860:
1788:
1492:
1475:
769:
417:
344:
105:
1895:
160:
segments of the spinal cord and arm function is retained.) The paralysis may be
2874:
2837:
2402:
2390:
2278:
2263:
1568:"National Spinal Cord Injury Statistical Center, Facts and Figures at a Glance"
1519:"National Spinal Cord Injury Statistical Center, Facts and Figures at a Glance"
1423:
1406:
882:
826:
479:
326:
169:
1834:
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2769:
2737:
2704:
2474:
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2305:
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1890:
1879:
412:(i.e. the C6 nerve root exits above the C6 vertebra). By evaluating what
249:
133:
91:
1655:
798:
659:
No motor or sensory function is preserved in the sacral segments S4âS5.
260:, diving into shallow water, a fall, a sports injury), disease (such as
2832:
2650:
2645:
2636:
2565:
2499:
2489:
2427:
2350:
2084:
2009:
989:
916:
911:
413:
352:
221:
205:
145:
1817:
1136:
Schurch B, Knapp PA, Jeanmonod D, Rodic B, Rossier AB (January 1998).
865:
The condition of paralysis affecting four limbs is alternately termed
232:
affected, depending on the location of the lesion on the spinal cord.
2904:
2864:
2842:
2822:
2796:
2759:
2747:
2655:
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2575:
2504:
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2465:
2435:
2407:
2380:
2315:
2295:
742:
193:
141:
2191:
1407:"Current concepts in reconstruction of hand function in tetraplegia"
2801:
2641:
2479:
2460:
1538:
409:
336:
304:
137:
1089:. Steven Kirshblum, Vernon W. Lin (3rd ed.). New York. 2019.
425:
injury at the C6 nerve root level will affect the function of the
2879:
2550:
426:
348:
197:
621:
Cervical spine illustration showing the vertebra and nerve roots
408:
cervical spine, nerve roots exit the spine above the associated
2899:
2560:
2445:
2440:
2412:
2370:
2228:
1829:
1802:
1214:
McDonald JW, Sadowsky C (February 2002). "Spinal-cord injury".
971:
608:
430:
399:
or bone spur on the vertebra protrudes into the spinal column.
253:
157:
1907:
377:
Transverse myelitis (from viral, bacterial, or fungal source)
2555:
2545:
1590:"Challenging questions regarding the international standards"
1258:
Physical
Medicine and Rehabilitation Clinics of North America
874:
273:
245:
125:
2335:
2196:
1637:
Nas K, Yazmalar L, Ćah V, Aydın A, ĂneĆ K (January 2015).
889:, for "paralysis". Tetraplegia uses the Greek root ÏΔÏÏα
1474:
Gorgey AS, Mather KJ, Cupp HR, Gater DR (January 2012).
1692:
1807:
648:
94:
or brain by illness or injury; congenital conditions
2095:
Spinal cord injury without radiographic abnormality
1636:
188:, sexual function, digestion, breathing and other
1587:
707:
638:are classified as complete and incomplete by the
252:at a high level. The injury, which is known as a
136:. A loss of motor function can present as either
2922:
1213:
1743:. n.d. Archived from the original on 5 Jan 2014
1404:
1209:
1207:
1205:
1203:
1201:
1199:
1197:
698:
416:of the cervical spine is injured, the affected
1513:
1511:
1310:Roberts TT, Leonard GR, Cepela DJ (May 2017).
1309:
1305:
1303:
1254:"Predicting Outcomes After Spinal Cord Injury"
1252:Chay, Wesley; Kirshblum, Steven (2020-08-01).
1135:
2177:
1923:
1741:Apparelyzed â Spinal Cord Injury Peer Support
1473:
1439:
1369:
1251:
2931:Cerebral palsy and other paralytic syndromes
1365:
1363:
1361:
1359:
1357:
1194:
1019:
1017:
967:
1560:
1508:
1480:Medicine and Science in Sports and Exercise
1467:
1398:
1300:
1129:
978:Topics in Spinal Cord Injury Rehabilitation
965:
963:
961:
959:
957:
955:
953:
951:
949:
947:
120:, is defined as the dysfunction or loss of
2184:
2170:
1930:
1916:
1588:Solinsky R, Kirshblum SC (November 2018).
1532:
1316:Clinical Orthopaedics and Related Research
1117:: CS1 maint: location missing publisher (
1023:
49:
1718:
1664:
1654:
1613:
1491:
1422:
1354:
1337:
1327:
1153:
1041:
1014:
997:
208:, respiratory complications, infections,
1792:) is being considered for deletion. See
1639:"Rehabilitation of spinal cord injuries"
1630:
1445:
944:
854:3.1 million with high tetraplegia.
797:
616:
461:Spinal Motor & Sensory Innervations
1735:
1545:Christopher & Dana Reeve Foundation
802:Christopher Reeve speaking at MIT, 2003
402:
244:Tetraplegia is caused by damage to the
14:
2923:
1566:
1517:
73:physical medicine & rehabilitation
2165:
1911:
1026:"Spasticity after spinal cord injury"
442:Key Muscle Groups and Sensory Points
175:
27:Paralysis of all four limbs and torso
1247:
1245:
1170:
1079:
1077:
1075:
1073:
1071:
1069:
1699:The Journal of Spinal Cord Medicine
1594:The Journal of Spinal Cord Medicine
1575:University of Alabama at Birmingham
1526:University of Alabama at Birmingham
1024:Adams MM, Hicks AL (October 2005).
24:
2234:Festinating gait/Parkinsonian gait
1685:
927:Sexuality after spinal cord injury
640:American Spinal Injury Association
25:
2947:
1796:to help reach a consensus. âș
1775:
1242:
1066:
785:Upper-limb surgery in tetraplegia
630:
2828:Overpronation/Flexible flat feet
2030:Chronic traumatic encephalopathy
1711:10.1179/107902611X12971826988057
1155:10.1046/j.1464-410x.1998.00482.x
843:List of people with quadriplegia
2065:Anterior spinal artery syndrome
1937:
1581:
1411:Scandinavian Journal of Surgery
836:
303:Motor vehicle accident, falls,
1737:"Quadriplegia and Tetraplegia"
1405:Fridén J, Reinholdt C (2008).
860:
708:Incomplete spinal-cord lesions
435:ShirleyRyan AbilityLab website
216:, and cardiovascular disease.
204:and fractures, frozen joints,
13:
1:
1781:
1606:10.1080/10790268.2017.1362929
1228:10.1016/S0140-6736(02)07603-1
937:
816:"rewiring" neural connections
368:Amyotrophic lateral sclerosis
2279:Myopathic gait/Waddling gait
1643:World Journal of Orthopedics
1493:10.1249/MSS.0b013e31822672aa
873:. Quadriplegia combines the
793:
790:tetraplegic arms and hands.
778:
699:Complete spinal-cord lesions
625:
7:
1968:Intraventricular hemorrhage
1963:Intraparenchymal hemorrhage
932:Spinal cord injury research
907:Clearing the cervical spine
900:
148:is similar but affects the
10:
2952:
1424:10.1177/145749690809700411
1142:British Journal of Urology
840:
818:, as in the case of actor
809:activities of daily living
782:
499:at the midclavicular line
429:(elbow extension) but the
2810:
2728:
2695:
2680:Lower motor neuron lesion
2675:Upper motor neuron lesion
2597:
2513:
2480:Myotonia / Pseudomyotonia
2426:
2361:
2203:
2195:relating to movement and
2141:Injury of accessory nerve
2109:
2055:
1945:
1870:
1811:
1761:: CS1 maint: unfit URL (
1384:10.1016/j.hcl.2008.01.003
1329:10.1007/s11999-016-5133-4
1270:10.1016/j.pmr.2020.03.003
749:Conus medullaris syndrome
647:
478:1 cm lateral to the
239:
98:
86:
78:
62:
57:
48:
40:
35:
2015:Post-concussion syndrome
1794:templates for discussion
2124:Peripheral nerve injury
2090:Posterior cord syndrome
2047:Penetrating head injury
1988:Subarachnoid hemorrhage
1955:Intracranial hemorrhage
1540:"Stats about paralysis"
881:, for "four", with the
515:acromioclavicular joint
387:GuillainâBarrĂ© syndrome
323:spinal muscular atrophy
266:GuillainâBarrĂ© syndrome
2146:Brachial plexus injury
2136:Wallerian degeneration
2070:Brown-SĂ©quard syndrome
2020:Second-impact syndrome
1947:Traumatic brain injury
803:
739:bulbocavernosus reflex
729:Anterior cord syndrome
723:Brown-SĂ©quard syndrome
622:
583:Small finger abductors
2787:Boutonniere deformity
2080:Central cord syndrome
2075:Cauda equina syndrome
2037:Diffuse axonal injury
1121:) CS1 maint: others (
1043:10.1038/sj.sc.3101757
801:
735:Cauda equina syndrome
717:Central cord syndrome
620:
575:Dorsal little finger
561:Dorsal middle finger
497:supraclavicular fossa
309:recreational activity
210:autonomic dysreflexia
2858:Clasp-knife response
2025:Dementia pugilistica
1086:Spinal cord medicine
636:Spinal cord injuries
403:Anatomy and function
385:Multiple sclerosis,
278:congenital disorders
214:deep vein thrombosis
82:Complete, incomplete
2890:Conversion disorder
2792:Swan neck deformity
2715:Locomotive syndrome
2042:Abusive head trauma
2005:Cerebral laceration
1765:) CS1 maint: year (
1656:10.5312/wjo.v6.i1.8
1446:Burkeman O (2002).
569:Long finger flexors
462:
443:
288:
262:transverse myelitis
104:Based on symptoms,
2627:Spastic paraplegia
2617:Spastic paraplegia
2612:Periodic paralysis
2521:Abnormal posturing
2386:Dysdiadochokinesia
2322:Asynchronous gait
2284:Trendelenburg gait
2244:Marche Ă petit pas
2193:Signs and symptoms
2057:Spinal cord injury
2000:Cerebral contusion
1871:External resources
1573:. Birmingham, AL:
1524:. Birmingham, AL:
990:10.46292/sci2702-1
922:Locked-in syndrome
804:
623:
460:
441:
287:
282:muscular dystrophy
270:multiple sclerosis
176:Signs and symptoms
2918:
2917:
2607:Flaccid paralysis
2428:Abnormal movement
2418:Hemimotor neglect
2376:Cerebellar ataxia
2326:Gunslinger's gait
2224:Cerebellar ataxia
2159:
2158:
2151:Traumatic neuroma
2111:Peripheral nerves
1983:Epidural hematoma
1978:Subdural hematoma
1905:
1904:
1378:(2): 175â84, vi.
1222:(9304): 417â425.
1096:978-0-8261-3775-3
820:Christopher Reeve
696:
695:
614:
613:
532:antecubital fossa
459:
392:
391:
341:aortic dissection
339:due to arterial (
258:traffic collision
111:
110:
100:Diagnostic method
30:Medical condition
16:(Redirected from
2943:
2622:Spastic diplegia
2589:Tonic immobility
2581:Waxy flexibility
2525:Stooped posture
2331:Hemiparetic gait
2312:Asymmetric gait
2211:Gait abnormality
2186:
2179:
2172:
2163:
2162:
1995:Brain herniation
1932:
1925:
1918:
1909:
1908:
1809:
1808:
1770:
1760:
1752:
1750:
1748:
1732:
1722:
1679:
1678:
1668:
1658:
1634:
1628:
1627:
1617:
1585:
1579:
1578:
1572:
1564:
1558:
1557:
1555:
1553:
1536:
1530:
1529:
1523:
1515:
1506:
1505:
1495:
1471:
1465:
1464:
1462:
1460:
1443:
1437:
1436:
1426:
1402:
1396:
1395:
1367:
1352:
1351:
1341:
1331:
1322:(5): 1499â1504.
1307:
1298:
1297:
1249:
1240:
1239:
1211:
1192:
1191:
1189:
1188:
1174:
1168:
1167:
1157:
1133:
1127:
1126:
1116:
1108:
1081:
1064:
1063:
1045:
1021:
1012:
1011:
1001:
969:
645:
644:
463:
444:
440:
355:), or combined (
289:
286:
194:neuropathic pain
128:function in the
116:, also known as
53:
33:
32:
21:
2951:
2950:
2946:
2945:
2944:
2942:
2941:
2940:
2921:
2920:
2919:
2914:
2885:Motion sickness
2818:Rachitic rosary
2806:
2755:Joint stiffness
2730:Range of motion
2724:
2691:
2687:Sleep paralysis
2671:General causes
2593:
2509:
2422:
2357:
2269:Vestibular gait
2249:Propulsive gait
2199:
2190:
2160:
2155:
2105:
2051:
1941:
1936:
1906:
1901:
1900:
1866:
1865:
1820:
1797:
1778:
1773:
1754:
1753:
1746:
1744:
1688:
1686:Further reading
1683:
1682:
1635:
1631:
1586:
1582:
1570:
1565:
1561:
1551:
1549:
1537:
1533:
1521:
1516:
1509:
1472:
1468:
1458:
1456:
1444:
1440:
1403:
1399:
1368:
1355:
1308:
1301:
1250:
1243:
1212:
1195:
1186:
1184:
1176:
1175:
1171:
1134:
1130:
1110:
1109:
1097:
1083:
1082:
1067:
1036:(10): 577â586.
1022:
1015:
970:
945:
940:
903:
863:
845:
839:
825:In the case of
796:
787:
781:
770:botulinum toxin
710:
701:
633:
628:
615:
555:Elbow extensors
541:Wrist extensors
405:
357:AV malformation
345:atherosclerosis
242:
178:
106:medical imaging
31:
28:
23:
22:
15:
12:
11:
5:
2949:
2939:
2938:
2933:
2916:
2915:
2913:
2912:
2907:
2902:
2897:
2892:
2887:
2882:
2877:
2875:Astasia-abasia
2872:
2867:
2862:
2861:
2860:
2850:
2845:
2840:
2838:Bow-leggedness
2835:
2830:
2825:
2820:
2814:
2812:
2808:
2807:
2805:
2804:
2799:
2794:
2789:
2784:
2783:
2782:
2777:
2772:
2762:
2757:
2752:
2751:
2750:
2745:
2734:
2732:
2726:
2725:
2723:
2722:
2717:
2712:
2707:
2701:
2699:
2693:
2692:
2690:
2689:
2684:
2683:
2682:
2677:
2669:
2668:
2667:
2658:
2653:
2648:
2639:
2631:
2630:
2629:
2624:
2614:
2609:
2603:
2601:
2595:
2594:
2592:
2591:
2586:
2583:
2578:
2573:
2568:
2563:
2558:
2553:
2548:
2543:
2538:
2537:
2536:
2531:
2523:
2517:
2515:
2511:
2510:
2508:
2507:
2502:
2497:
2492:
2487:
2482:
2477:
2468:
2463:
2458:
2453:
2448:
2443:
2438:
2432:
2430:
2424:
2423:
2421:
2420:
2415:
2410:
2405:
2403:Sensory ataxia
2400:
2399:
2398:
2393:
2391:Pronator drift
2388:
2383:
2373:
2367:
2365:
2359:
2358:
2356:
2355:
2354:
2353:
2345:
2344:
2343:
2338:
2333:
2328:
2320:
2319:
2318:
2310:
2309:
2308:
2303:
2293:
2292:
2291:
2286:
2281:
2273:
2272:
2271:
2266:
2264:Truncal ataxia
2261:
2256:
2251:
2246:
2241:
2236:
2231:
2226:
2221:
2213:
2207:
2205:
2201:
2200:
2189:
2188:
2181:
2174:
2166:
2157:
2156:
2154:
2153:
2148:
2143:
2138:
2133:
2132:
2131:
2129:classification
2126:
2115:
2113:
2107:
2106:
2104:
2103:
2102:(Quadriplegia)
2097:
2092:
2087:
2082:
2077:
2072:
2067:
2061:
2059:
2053:
2052:
2050:
2049:
2044:
2039:
2034:
2033:
2032:
2027:
2022:
2017:
2007:
2002:
1997:
1992:
1991:
1990:
1985:
1980:
1972:
1971:
1970:
1965:
1957:
1951:
1949:
1943:
1942:
1935:
1934:
1927:
1920:
1912:
1903:
1902:
1899:
1898:
1887:
1875:
1874:
1872:
1868:
1867:
1864:
1863:
1852:
1837:
1821:
1816:
1815:
1813:
1812:Classification
1806:
1805:
1777:
1776:External links
1774:
1772:
1771:
1733:
1689:
1687:
1684:
1681:
1680:
1629:
1600:(6): 684â690.
1580:
1559:
1531:
1507:
1466:
1448:"Man of steel"
1438:
1397:
1353:
1299:
1264:(3): 331â343.
1241:
1193:
1169:
1128:
1095:
1065:
1013:
942:
941:
939:
936:
935:
934:
929:
924:
919:
914:
909:
902:
899:
862:
859:
838:
835:
827:cerebral palsy
795:
792:
780:
777:
753:
752:
746:
732:
726:
720:
709:
706:
700:
697:
694:
693:
690:
687:
683:
682:
679:
676:
672:
671:
668:
665:
661:
660:
657:
654:
650:
649:
632:
631:Classification
629:
627:
624:
612:
611:
605:
602:
599:
595:
594:
587:
584:
581:
577:
576:
573:
570:
567:
563:
562:
559:
556:
553:
549:
548:
545:
542:
539:
535:
534:
528:
525:
522:
518:
517:
511:
508:
505:
501:
500:
494:
491:
488:
484:
483:
473:
470:
467:
458:
457:
456:Sensory Point
454:
451:
448:
439:
404:
401:
390:
389:
383:
382:Demyelinating
379:
378:
375:
371:
370:
365:
361:
360:
334:
330:
329:
327:cerebral palsy
316:
312:
311:
301:
297:
296:
293:
241:
238:
198:pressure sores
177:
174:
170:proprioception
109:
108:
102:
96:
95:
88:
84:
83:
80:
76:
75:
66:
60:
59:
55:
54:
46:
45:
42:
38:
37:
29:
26:
9:
6:
4:
3:
2:
2948:
2937:
2934:
2932:
2929:
2928:
2926:
2911:
2910:Dancing mania
2908:
2906:
2903:
2901:
2898:
2896:
2893:
2891:
2888:
2886:
2883:
2881:
2878:
2876:
2873:
2871:
2868:
2866:
2863:
2859:
2856:
2855:
2854:
2853:Hyperreflexia
2851:
2849:
2846:
2844:
2841:
2839:
2836:
2834:
2831:
2829:
2826:
2824:
2821:
2819:
2816:
2815:
2813:
2809:
2803:
2800:
2798:
2795:
2793:
2790:
2788:
2785:
2781:
2778:
2776:
2773:
2771:
2768:
2767:
2766:
2765:Hypermobility
2763:
2761:
2758:
2756:
2753:
2749:
2746:
2744:
2741:
2740:
2739:
2736:
2735:
2733:
2731:
2727:
2721:
2718:
2716:
2713:
2711:
2708:
2706:
2703:
2702:
2700:
2698:
2694:
2688:
2685:
2681:
2678:
2676:
2673:
2672:
2670:
2666:
2662:
2659:
2657:
2654:
2652:
2649:
2647:
2643:
2640:
2638:
2635:
2634:
2632:
2628:
2625:
2623:
2620:
2619:
2618:
2615:
2613:
2610:
2608:
2605:
2604:
2602:
2600:
2596:
2590:
2587:
2584:
2582:
2579:
2577:
2574:
2572:
2571:Joint locking
2569:
2567:
2564:
2562:
2559:
2557:
2554:
2552:
2549:
2547:
2544:
2542:
2539:
2535:
2532:
2530:
2527:
2526:
2524:
2522:
2519:
2518:
2516:
2512:
2506:
2503:
2501:
2498:
2496:
2493:
2491:
2488:
2486:
2483:
2481:
2478:
2476:
2472:
2469:
2467:
2464:
2462:
2459:
2457:
2454:
2452:
2451:Fasciculation
2449:
2447:
2444:
2442:
2439:
2437:
2434:
2433:
2431:
2429:
2425:
2419:
2416:
2414:
2411:
2409:
2406:
2404:
2401:
2397:
2394:
2392:
2389:
2387:
2384:
2382:
2379:
2378:
2377:
2374:
2372:
2369:
2368:
2366:
2364:
2360:
2352:
2349:
2348:
2346:
2342:
2341:Antalgic gait
2339:
2337:
2334:
2332:
2329:
2327:
2324:
2323:
2321:
2317:
2314:
2313:
2311:
2307:
2304:
2302:
2301:Steppage gait
2299:
2298:
2297:
2294:
2290:
2287:
2285:
2282:
2280:
2277:
2276:
2274:
2270:
2267:
2265:
2262:
2260:
2257:
2255:
2254:Stomping gait
2252:
2250:
2247:
2245:
2242:
2240:
2239:Magnetic gait
2237:
2235:
2232:
2230:
2227:
2225:
2222:
2220:
2217:
2216:
2214:
2212:
2209:
2208:
2206:
2202:
2198:
2194:
2187:
2182:
2180:
2175:
2173:
2168:
2167:
2164:
2152:
2149:
2147:
2144:
2142:
2139:
2137:
2134:
2130:
2127:
2125:
2122:
2121:
2120:
2117:
2116:
2114:
2112:
2108:
2101:
2098:
2096:
2093:
2091:
2088:
2086:
2083:
2081:
2078:
2076:
2073:
2071:
2068:
2066:
2063:
2062:
2060:
2058:
2054:
2048:
2045:
2043:
2040:
2038:
2035:
2031:
2028:
2026:
2023:
2021:
2018:
2016:
2013:
2012:
2011:
2008:
2006:
2003:
2001:
1998:
1996:
1993:
1989:
1986:
1984:
1981:
1979:
1976:
1975:
1973:
1969:
1966:
1964:
1961:
1960:
1958:
1956:
1953:
1952:
1950:
1948:
1944:
1940:
1933:
1928:
1926:
1921:
1919:
1914:
1913:
1910:
1897:
1893:
1892:
1888:
1886:
1882:
1881:
1877:
1876:
1873:
1869:
1862:
1858:
1857:
1853:
1851:
1847:
1846:
1842:
1838:
1836:
1832:
1831:
1827:
1823:
1822:
1819:
1814:
1810:
1804:
1800:
1795:
1791:
1790:
1785:
1780:
1779:
1768:
1764:
1758:
1742:
1738:
1734:
1730:
1726:
1721:
1716:
1712:
1708:
1705:(2): 149â61.
1704:
1700:
1696:
1691:
1690:
1676:
1672:
1667:
1662:
1657:
1652:
1648:
1644:
1640:
1633:
1625:
1621:
1616:
1611:
1607:
1603:
1599:
1595:
1591:
1584:
1576:
1569:
1563:
1547:
1546:
1541:
1535:
1527:
1520:
1514:
1512:
1503:
1499:
1494:
1489:
1486:(1): 165â74.
1485:
1481:
1477:
1470:
1455:
1454:
1449:
1442:
1434:
1430:
1425:
1420:
1416:
1412:
1408:
1401:
1393:
1389:
1385:
1381:
1377:
1373:
1366:
1364:
1362:
1360:
1358:
1349:
1345:
1340:
1335:
1330:
1325:
1321:
1317:
1313:
1306:
1304:
1295:
1291:
1287:
1283:
1279:
1275:
1271:
1267:
1263:
1259:
1255:
1248:
1246:
1237:
1233:
1229:
1225:
1221:
1217:
1210:
1208:
1206:
1204:
1202:
1200:
1198:
1183:
1179:
1173:
1165:
1161:
1156:
1151:
1147:
1143:
1139:
1132:
1124:
1120:
1114:
1106:
1102:
1098:
1092:
1088:
1087:
1080:
1078:
1076:
1074:
1072:
1070:
1061:
1057:
1053:
1049:
1044:
1039:
1035:
1031:
1027:
1020:
1018:
1009:
1005:
1000:
995:
991:
987:
983:
979:
975:
968:
966:
964:
962:
960:
958:
956:
954:
952:
950:
948:
943:
933:
930:
928:
925:
923:
920:
918:
915:
913:
910:
908:
905:
904:
898:
895:
892:
888:
884:
880:
876:
872:
868:
858:
855:
851:
848:
844:
834:
830:
828:
823:
821:
817:
812:
810:
800:
791:
786:
776:
773:
771:
768:injection of
765:
761:
757:
750:
747:
744:
740:
736:
733:
730:
727:
724:
721:
718:
715:
714:
713:
705:
691:
688:
685:
684:
680:
677:
674:
673:
669:
666:
663:
662:
658:
655:
652:
651:
646:
643:
641:
637:
619:
610:
606:
603:
600:
597:
596:
593:of the elbow
592:
588:
585:
582:
579:
578:
574:
571:
568:
565:
564:
560:
557:
554:
551:
550:
547:Dorsal thumb
546:
543:
540:
537:
536:
533:
529:
526:
524:Elbow flexors
523:
520:
519:
516:
512:
509:
506:
503:
502:
498:
495:
492:
489:
486:
485:
481:
477:
474:
471:
468:
465:
464:
455:
452:
449:
446:
445:
438:
436:
432:
428:
423:
419:
418:muscle groups
415:
411:
400:
398:
388:
384:
381:
380:
376:
373:
372:
369:
366:
364:Degenerative
363:
362:
358:
354:
350:
346:
342:
338:
335:
332:
331:
328:
324:
320:
317:
314:
313:
310:
306:
302:
299:
298:
294:
291:
290:
285:
283:
279:
275:
271:
267:
263:
259:
255:
251:
247:
237:
233:
229:
225:
223:
217:
215:
211:
207:
203:
199:
195:
191:
187:
183:
173:
171:
167:
163:
159:
155:
151:
147:
143:
139:
135:
131:
127:
123:
119:
115:
107:
103:
101:
97:
93:
89:
85:
81:
77:
74:
70:
67:
65:
61:
56:
52:
47:
43:
39:
34:
19:
2848:Hyporeflexia
2743:Bethlem sign
2710:Gowers' sign
2665:Quadruplegia
2660:
2541:Opisthotonus
2534:Osteoporosis
2529:Camptocormia
2471:Hyperkinesia
2456:Fibrillation
2363:Coordination
2316:Leaping gait
2259:Spastic gait
2229:Choreic gait
2219:Scissor gait
2119:Nerve injury
2099:
1974:Extra-axial
1959:Intra-axial
1889:
1878:
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1824:
1787:
1745:. Retrieved
1740:
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1543:
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1469:
1457:. Retrieved
1453:The Guardian
1451:
1441:
1417:(4): 341â6.
1414:
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1375:
1372:Hand Clinics
1371:
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1181:
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886:
885:root Ïληγία
878:
871:quadriplegia
870:
866:
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852:
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837:Epidemiology
831:
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766:
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607:Apex of the
475:
450:Muscle Group
406:
393:
319:Spina bifida
243:
234:
230:
226:
218:
202:osteoporosis
179:
132:area of the
118:quadriplegia
117:
113:
112:
69:Neurosurgery
44:Quadriplegia
2936:Neurotrauma
2895:Shell shock
2870:Hypnic jerk
2770:Gorlin sign
2738:Contracture
2705:Hemiparesis
2661:Tetraplegia
2475:Hypokinesia
2396:Dyssynergia
2306:Toe walking
2289:Pigeon gait
2100:Tetraplegia
1939:Neurotrauma
1891:GeneReviews
1880:MedlinePlus
1799:Tetraplegia
1782:âč The
1747:4 September
1649:(1): 8â16.
1552:4 September
1459:4 September
1030:Spinal Cord
984:(2): 1â22.
867:tetraplegia
861:Terminology
374:Infectious
351:), venous (
315:Congenital
295:Conditions
250:spinal cord
134:spinal cord
114:Tetraplegia
92:spinal cord
41:Other names
36:Tetraplegia
18:Tetraplegic
2925:Categories
2833:Knock-knee
2651:Hemiplegia
2646:Paraplegia
2637:Monoplegia
2633:Syndromes
2566:Hypertonia
2500:Echopraxia
2490:Stereotypy
2351:Lotus gait
2347:Deformity
2085:Paraplegia
2010:Concussion
1187:2022-10-03
1105:1079055185
938:References
917:Paraplegia
912:Hemiplegia
841:See also:
783:See also:
689:Incomplete
678:Incomplete
667:Incomplete
591:epicondyle
422:dermatomes
414:nerve root
353:thrombosis
222:ventilator
206:spasticity
146:Paraplegia
90:Damage to
2905:Catatonia
2865:Shivering
2843:Back knee
2823:Flat feet
2797:Scoliosis
2760:Ankylosis
2748:Club foot
2656:Triplegia
2599:Paralysis
2585:Grimacing
2576:Catalepsy
2514:Posturing
2505:Echolalia
2495:Akathisia
2485:Hypotonia
2466:Myoclonus
2436:Athetosis
2408:Asterixis
2381:Dysmetria
2296:Foot drop
2275:Muscular
1896:NBK344254
1294:219735858
1278:1047-9651
1182:msktc.org
1113:cite book
794:Prognosis
779:Treatment
764:sparing.
743:anal wink
626:Diagnosis
513:Over the
480:occipital
359:) causes
333:Vascular
280:(such as
190:autonomic
142:paralysis
64:Specialty
2802:Kyphosis
2697:Weakness
2642:Diplegia
2461:Myokymia
1784:template
1757:cite web
1729:21675354
1675:25621206
1624:28820352
1502:21659900
1433:19211389
1392:18456124
1348:27815685
1286:32624098
1236:11844532
1052:15838527
1008:34108832
901:See also
656:Complete
530:Lateral
482:condyle
410:vertebra
337:Ischemia
305:violence
150:thoracic
138:weakness
130:cervical
2880:Vertigo
2551:Trismus
1861:D011782
1786:below (
1720:3066500
1666:4303793
1615:6217465
1577:. 2009.
1528:. 2018.
1339:5384910
1164:9467480
1060:2659838
999:8152171
589:Medial
427:triceps
349:embolus
300:Trauma
248:or the
186:bladder
166:spastic
162:flaccid
126:sensory
124:and/or
2900:Stupor
2720:Ptosis
2561:Tetany
2446:Tremor
2441:Chorea
2413:Abasia
2371:Ataxia
1885:001066
1803:Curlie
1789:Curlie
1727:
1717:
1673:
1663:
1622:
1612:
1548:. 2016
1500:
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1216:Lancet
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1103:
1093:
1058:
1050:
1006:
996:
887:plegia
879:quadra
609:axilla
431:biceps
292:Cause
276:), or
254:lesion
240:Causes
158:sacral
156:, and
154:lumbar
87:Causes
2811:Other
2556:Cramp
2546:Spasm
1850:344.0
1835:G82.5
1571:(PDF)
1522:(PDF)
1290:S2CID
1056:S2CID
891:tetra
883:Greek
877:root
875:Latin
274:polio
272:, or
246:brain
182:bowel
122:motor
79:Types
2336:Limp
2215:CNS
2204:Gait
2197:gait
1856:MeSH
1845:9-CM
1767:link
1763:link
1749:2018
1725:PMID
1671:PMID
1620:PMID
1554:2018
1498:PMID
1461:2018
1429:PMID
1388:PMID
1344:PMID
1282:PMID
1274:ISSN
1232:PMID
1160:PMID
1123:link
1119:link
1101:OCLC
1091:ISBN
1048:PMID
1004:PMID
476:>
453:Root
447:Root
420:and
397:disc
184:and
2780:HSD
2775:EDS
1841:ICD
1826:ICD
1801:at
1715:PMC
1707:doi
1661:PMC
1651:doi
1610:PMC
1602:doi
1488:doi
1419:doi
1380:doi
1334:PMC
1324:doi
1320:475
1266:doi
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