Don’t know if I should put this here or in GQ, but I’ve just gotten into watching Friday Night Lights on Netflix, and I’m a bit confused on one point. Throughout the first season, at least, Jason Street is referred to as a quadriplegic. I was under the impression that quadriplegia involves paralysis of all four limbs, or at least severely diminished use of all four limbs. While at the outset, his use of his arms and hands was compromised, he seems to have pretty good control of his upper limbs–he can wheel himself around, play wheelchair rugby, etc. Is my understanding of the difference between quadriplegia and paraplegia incorrect?
Wikipedia to the rescue:
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Tetraplegia, also known as quadriplegia, is paralysis caused by illness or injury to a human that results in the partial or total loss of use of all their limbs and torso; paraplegia is similar but does not affect the arms.*
Yes, that’s my understanding of quadriplegia. The character in this particular show seemed, to me, to be what I would call “paraplegic.” Did the writers and everybody else involved just get it wrong (possible), or is there a nuance that I’m missing (which I think is actually more probable.) The character in the wheelchair in this video clip is the one that is repeatedly identified as a quadriplegic in the series, at least in Season 1.
Looking around more, it seems those wheelchair rugby teams are called “quad” rugby, so my understanding of quadriplegia must be incorrect. I thought it meant little to no use of the upper limbs, but obviously these guys are able to play sport and wheel themselves around the court with their arms. So what is the technical difference? If, after a spinal injury, you have paralysis in the lower limbs and any difficulty whatsoever with the upper, does that make you quadriplegic, then?
Jason Street is quadriplegic.
His spinal cord injury is described in an early episode as at a level where his upper limbs are affected- in particular, he has issues using his hands (although his function improves).
One does not have to be completely paralysed or to have NO function of the upper limb to be quadriplegic, there just has to be some level of upper limb involvement.
Depending on the level and type of the spinal cord injury this impairment can be minor or severe.
It’s about the level where the sensory and motor impairment start.
Paraplegia- the impairment will typically start at T3 or below.
Quadriplegia- the impairment is typically at T3 or above.
T1 is the level of innervation of the nerves needed to abduct (spread) the fingers.
T2-T3 is level providing the sensation over the upper, inner arm.
If you have an injury at the T2/3 level you may have pretty good motor function in your arms, but have numbness over the inside of your upper arm.
T1/T2 level you will have some numbness from the inside of your forearm to the armpit and some hand weakness.
C7 or above and you will have motor problems with the upper limbs and hands, as well as numbness.
Any injuries at C2 and C1 are usually fatal.
Re-read the definition. “Partial or total”. Partial. Note the definition of paraplegia: “not affect the arms”. His arms were “affected”.
Yes, I know that; I wanted clarification as to what “partial” means exactly.
Thanks for the explanation, irishgirl. That’s what I was looking for.
I just wanted to mention that FNL gives a very good portrayal of what life is like after spinal cord injury without going into too much medical detail. There’s obviously a lot more “realism” they could portray, but what they’ve shown and at least mentioned is fantastic. His character adjusts to life as a quad faster than in real life, maybe. But that’s just TV, stories move faster. There are a ton of little jokes that he and Herc make to each other that I think people who aren’t around SCI everyday would miss. I am very glad that I didn’t watch this show until after I started working in the SCI rehab community.