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Pediatrics > Adaptive Equipment > Flashcards

Adaptive Equipment Flashcards

1
Q

what are the goals for the use of AE?

A

1- improve function

2- ease caregiver burden in ADLs

3- prevent secondary impairments in the child

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2
Q

how is AE needed differently throughout the lifespan?

infancy?
preschool?
school aged?
adolescent?

A

a child’s needs change with growth and development

infancy- social interaction and development of early concepts

preschool- learn to self initiate movement and control his/her environment and indicate needs and make choices

school aged- postural support and comfort to enable learning and adaptive function

adolescent- need to keep up with peers and be accepted socially

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3
Q

what are some general comments on equipment?

A

no way can receive constant handling

cost of direct care

daily management at home

accomplish the family’s goals

need exploration, not just static environment

how long?

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4
Q

multidisciplinary approach:

users?

team?

community?

school/work?

funding?

medical/health?

A

Users:
-client/family

Assistive technology team:

  • PT/OT/ST
  • rehab engineer
  • rehab technology supplier

Community:

  • family members
  • transportation (school and/or public)
  • architecture
  • other

School/work:

  • teacher
  • supervisor
  • vocational counselor
  • primary PT, OT, ST
  • psychologist
  • administrators

Funding:

  • funding specialist
  • social worker
  • advocacy attorney
  • insurance companies
  • charitable organizations

Medical/health:

  • family physician
  • medial specialists
  • nursing specialists
  • psychologist
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5
Q

what is RESNA?

A

“Rehab Engineering & Assistive Technology Society of North America”

est. in 1995

interdisciplinary association

credentialing

ATP (assistive technology practitioner)

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6
Q

what needs to be evaluated before getting equipment?

A
  • ROM
  • muscle tone, control, strength
  • reflexes
  • sensation
  • social-emotional
  • functional needs
  • home set up
  • community
  • school
  • financial considerations
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7
Q

what are basic seating concepts?

A

pelvis is key!

neutral pelvic alignment

symmetrical alignment of the trunk/neck

neutral head position over the pelvis

maintenance of a horizontal gaze

90-90-90 when possible and appropriate for the individual

maintenance of thighs in neutral ABD

neutral shoulder positioning

maximize weight distribution

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8
Q

why is the pelvis key?

A

neutral- pressure is on the ischial bones

APT- pressure is on the ischial bones

  • often leads to arms to assist with support in sitting
  • increases the likelihood of lordotic sitting

PPT- pressure is on the sacrum

  • increases sliding in the seat
  • increases the likelihood of kyphotic spine
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9
Q

pressure relief:

what are options with a seating system?

A

pressure sores typically occur at bony prominences

decrease risk if WB force is on WB bones

Options w/ a seating system:

  • Arm rests
  • tilt in space
  • recline
  • lumbar roll
  • cushion selection/contoured
  • cushion cover
  • foot rest
  • trunk support
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10
Q

why is UE control and fine motor function important?

A

stabilization proximally allows for distal movement

improve accuracy

improve the quality of movement

isolation of muscles vs. synergistic movement patterns

improved coordination of reach

better acquisition of fine motor skills

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11
Q

how does speech, communication and oral motor relate to AE?

A

“stabilize the hips, free up the lips”

  • increase in the type of sounds
  • increased lung capacity

Communication
-improved fine motor control to activate switches/communication board

Oral motor:
-improved eating and drinking skills

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12
Q

what are the benefits of a standing program?

A

“a child who stands is more independent, function, productive and easier to care for”

  • WBing through the LE
  • improved trunk/head control
  • decreased muscle spasms and muscle tone
  • maintain/improve joint ROM in the LEs
  • decrease muscle atrophy/strengthen the LE
  • decrease effects of osteoporosis
  • improved development of the hip joints
  • improve physiological- circulation, CV
  • improved bowel/bladder
  • psychological benefits- improves eye contact, confidence, peer interaction, and independence
  • brain works best when upright
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13
Q

what are different types of standers?

A

free standers

prone standers

supine standers

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14
Q

what are free standers? what children are they good for?

A

use for children with good head control

increased weight through the LEs

orienting to upright position

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15
Q

what are prone standers? what children are they used for?

A

promote gradual acceptance to WBing

mild to more severe levels of physical involvement

be cautious of children with compromised respiratory function

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16
Q

what are supine standers? what children are they used for?

A

gradual acceptance to WBing

increased east in positioning child. able to position and strap in supine and then bring upright

great for post op children or children who need gradual orientation to upright

17
Q

what are different types of walkers?

A 
posterior walkers
anterior walkers
gait trainers
kid walk
hart walker
up n free
lite gait
18
Q

what is a kid walk? who is it good for ?

A

single adjustment bilateral pelvic pad

quick exacting hip position

mid wheel location for better control and small turning radius

dynamic vertical movement allows for stepping phase

dynamic lateral movement allows for weight shift

mechanism aids in development of ambulation and gait

open front design

children with increased tone may not do as well as those with low tone

19
Q

what is a hart walker? who is it good for?

A

2 components; bracing system and wheeled base

holds LEs in symmetrical alignment

free motion joints at hip and knees

variable motion joint at ankles

spring suspension mechanism

swivel front wheels

reciprocal cables enhance reciprocal gait

adjustability and growth

increased difficulty donning and doffing as child grows

child doesn’t wear AFOs in walker

child must be able to initiate reciprocal stepping

20
Q

What is the up n free?

A

seating system stabilizes pelvis and maintains center of gravity

gas piston provides support

support remains constant during walking and transitions

allows for natural up and down movement of trunk during ambulation

4 levels of support (% of BW supported)

child can sit when tired by locking seat

can perform therapeutic activities in walker

can be hands free

handles available

can be too light, child isn’t able to lock/unlock walker independently

21
Q

what is the lite gait? who is it good for?

A

manual and remote BWS adjustment

can be used over ground or treadmill

walking over treadmill allows for increased speed to work on cardiovascular fitness

used mostly as a therapeutic tool

difficult to access treadmill controls

can be used for support for sitting and crawling with same harness

22
Q

transportation safety?

A

best practice- when at all possible, wheelchair users should transfer out of their wheelchair and into age/weight appropriate vehicle seat and occupant restraint system that meets federal safety standards

23
Q

suggestions for insurance issues?

A

go to manufacturer’s website

demo equipment

video and pics

research articles

access primary and secondary insurances when available

24
Q

what should the letter of medical necessity include?

A

dx

PMH

current MH

home environment

current equipment

specific equipment requested

rationale for this vs. others

justification for ALL components

summary and contact info

physician’s signature

Pediatrics (11 decks)

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