In a patient with a complete C3 spinal cord injury, which activity would most likely be independent after setup?

• A. Minimal assistance for bathing activities
• B. Independent after setup for using an environmental control unit
• C. Minimal assistance to modified independent for sliding board transfers
• D. Modified independence for feeding with adaptive equipment

Answer: (B)

High cervical injuries leave the person with tetraplegia and little to no use of arms or trunk, but they can often control assistive technology with preserved neck, mouth, or breath-based actions. An environmental control unit is designed to be operated with such interfaces—mouth sticks, sip-and-puff switches, head controls—after initial setup. Once the clinician configures the ECU to the patient’s control method, the device can be used independently, allowing the person to manage lights, TV, phone, and other controls without further hands-on help. Other tasks like bathing, transferring with a board, or feeding require more arm, hand, or trunk function than a complete C3 injury typically retains, making those activities unlikely to be independent after setup.