McKenzie M W, Buck G L
Phys Ther. 1978 Mar;58(3):294-303. doi: 10.1093/ptj/58.3.294.
For clarity in presenting the concepts of care, the patients have been divided into discrete neurological levels according to their dominant patterns of muscle strength. Individuals can vary considerably, however, and these differences must be accommodated by corresponding modification in the orthotic functional plan. The C6 level patient, with his effective wrist extensor as well as arm musculature, can recover a single mode of grasp and release through a wrist-driven, flexor-hinge-hand orthosis, or a natural tenodesis. Available arm function, despite the loss of all wrist and hand musculature, enables the C5 quadriplegic patient to regain prehension with a passive ratchet flexor-hinge or an electric flexor-hinge-hand orthosis. Both groups of patients also require various aids to accomplish wheelchair propulsion, ischial pressure relief, bed transfers, and, for the C6 level, driving.
为了清晰地呈现护理概念，根据患者主要的肌肉力量模式，将患者分为不同的神经功能水平。然而，个体之间差异很大，这些差异必须通过对矫形功能计划进行相应调整来适应。C6水平的患者，因其有效的腕伸肌以及手臂肌肉组织，可以通过腕驱动的屈肌铰链手矫形器或自然的肌腱固定恢复单一的抓握和松开模式。尽管所有腕部和手部肌肉组织都丧失了，但现有的手臂功能使C5四肢瘫痪患者能够通过被动棘轮屈肌铰链或电动屈肌铰链手矫形器重新获得抓握能力。这两组患者还需要各种辅助工具来完成轮椅推进、坐骨减压、床椅转移，对于C6水平的患者，还需要辅助驾驶。
