Spasticity grade 4 or 3. Some demonstrable function can be observed during transfer. May be able to ambulate with assistance or assistive devices. Trunk control . Fair trunk control is shown when pushing wheelchair, but forward trunk movement is often limited by extensor tone during forceful pushing.
Rotation is limited or non-existent.
Upper extremities . Moderate limitation with spasticity grade 3 to 2 in dominant arm, shown as limitation in extension and follow-through. Hand function . Grasp and release hand movements are usually slow and labored. Dominant hand may demonstrate cylindrical and spherical grasp, but release of objects is noticeable less than a Class 4 athlete.