9.17 Seating Flashcards
Should you do a prolonged stretch in a WC?
NO
do NOT use a seating system for a prolonged stretch
Why should you not do a prolonged stretch in a seating system?
can’t sense
- discomfort
- skin breakdown
How would you create a prolonged stretch?
- manual approach
- orthotic
What are the two types of deformities
- fixed
- flexible
Types of fixed deformities
- heterotopic ossification
- hypertonia
What are seating goals for SCI pts?
- functional independence
- reduce risk of secondary complications
- enhance posture, respiration, etc.
- address skeletal deformities
- comfort/balance
- promote skin care
- reduce mobility related injuries
Proper WC fit helps keep a SCI pt
more mobile
What can be done with seating for skeletal deformities?
- correct
- accommodate
What is essential to promoting symmetrical and stable sitting posture?
- pelvic positioning
- proximal stability » distal mobility
How should the pelvis be positioned?
- neutral to slight anterior tilt
- level
- NOT rotated
How can poor posture impact function?
- breathing
- swallowing
- digestion
- circulation
- balance
- functional UE ROM
- ability to move outside BOS
- skin integrity
Flexible deformities are usually _______
corrected
Nonflexible deformities are usually _____
accomodated
What are some posture goals for the SCI pt?
- address deformities
- maximize comfort
- minimize effects of excessive tone
- provide support for hypotonia
LOMN is written by ____ to _____ for ______
PT to insurance company for DME
What are some important aspects to a LMN?
- very specific (movable parts, cushion type, surface, weight, etc.)
- include disease progression
- prognosis
- any other info that is pertinent to justify a need for DME
Can a PT order DME?
Can’t write an order for a DME, but can request the MD to write one
Pros of rigid chairs
- durability
- efficient
- lighter
- more adjustable
Cons of rigid chairs
- more rigid ride
- transport considerations
Pros of folding chairs
- shock absorbing
- easier transport
- smoother ride
- can propel with legs
Cons of folding chairs
- less durable
- less efficient
- weighs more
- less adjustable
- transport considerations
Pros of smaller casters
- easier tot urn
- more foot clearance
- smaller turning radius
- less shimmy
Cons of smaller casters
harder to maneuver over small obstacles
Pros of larger casters
- less rolling resistance
- easier to negotiate over rough terrain
Cons of larger casters
- less foot clearance
- harder to turn
What does increased camber do?
gives larger base of support
Larger camber is commonly seen in these types of chairs
sports
What does larger camber hinder?
ability to get out of doors
Dump: bucket improves
upright posture
An axle that is further backward is more
stable
An axle that is further forward is more ______, but easier to ______
- unstable
- push
Slowest option for drive mechanism
FWD
Problems with FWD chair
- slowest
- fishtailing at higher speeds
Pros of a FWD chair
- good downhill traction
- best climbing ability
- smoothest on rough terrain
Which chair drive has the smallest turning radius?
mid wheel drive
mid-wheel drive: traction
equal up and downhill
mid-wheel drive: issues
- need need additional casters for stability
- more rocking over obstacles
largest turning radius
RWD
Where is the pivot point for a RWD chair?
behind the user
RWD: traction and hills
- good traction uphill
- poor traction downhill
A RWD chair is the ____ option
fastest
Recline occurs here
at the hip
Why is recline needed for SCI pts?
need to be able to get them flatter early on
Problems with recline and SCI pts
could get shear on skin of back
Tilt is good for this
pressure relief
What is a flap surgery performed for?
non-healing wound on greater trochanter or sacrum
flap surgery
chunk of flesh moved to a new position (typically along with muscle)
prolonged immobility in prone
