Adaptive Equipment

Question 1

What are examples of adaptive equipment?

Answer 1

Ambulation devices: crutches, walkers, gait trainers, crawling devices, assistive weight bearing
Standing devices: prone standers, supine standers, prone/supine standers, mobile standers

Question 2

What is purpose of adaptive equipment?

Answer 2

Help you with daily task, environment, mobility

Tool to use and complete a task with more independence

Question 3

What are benefits of standing?

Answer 3

Neuromuscular benefits: decrease contractures, improve ROM, increase strength, normalize muscle tone, proper visual alignment
Orthopedic benefits: assist with skeletal development, increase bone mass, joint formation
Internal organ benefits: improved respiration, improved digestion, improved bladder function, improved bowel function

Question 4

What are some ADL devices?

Answer 4

Bath/shower chairs
Toileting systems
Activity chairs
Feeder seats
Adaptive car seats
Recreational/therapeutic devices

Question 5

What are some adaptive positioning devices?

Answer 5

Side lyers, corner chairs, positioning chairs, wedges, universal positioning device

Question 6

What are seating and mobility goals?

Answer 6

Maximize function and independence
Normalize tone/decrease spasticity
Minimize orthopedic deformity
Increase sitting tolerance and endurance
Manage/prevent pressure sores
Enhance quality of life
Improve self image
Increase comfort

Question 7

What are common diagnoses for children that require seating and wheeled mobility?

Answer 7

CP, developmental delay, spina bifida/myelomeningocele, MD/SMA, hydrocephalus/microcephalus

Question 8

What are wheelchair features and considerations for adjustments?

Answer 8

Seat depth: if too long there will be shear forces and posterior pelvic tilt
Seat width: if too wide they might not be able to fit through doorways at home
Back height: want it high for more dependent patients, want it low for more active patients
Arm rests: if too high they might have shoulder issues, if too low they will lean on them for support
Leg rests: if too high they will have more pressure on ischial tubs, if too low they will have unsupported feet
Seat to floor height: important for transfers and self propulsion
Front caster: smaller means they can be more mobile, bigger means they can go over cracks and heavier terrain

Question 9

What happens if the skeleton is in a correct position?

Answer 9

Joints function smoothly, ROM increases, muscles are used more effectively

Question 10

What are features of leg and foot rests?

Answer 10

Appropriate angle is 70, 80, or 90 degrees
Swing-away
Fixed
Elevating leg rests/edema/ROM limitations
Angle adjustable footplates/footboards

Question 11

What are wheel chair considerations for back height, seat width and depth, seat to floor height, and armrest height?

Answer 11

Back height: provide adequate postural support, allow for UE function
Seat width and depth: accommodate body dimensions, accommodate for future growth, provide proper support to pelvis and thighs, provide comfort, accessibility
Seat to floor: transfers, foot propulsion, table top activities, ADLs
Armrest: provide proper support for UE, assist with postural control, prevent elevation of shoulders, assist with transfers and tray mount

Question 12

What are the different types of adaptive strollers and their features?

Answer 12

Standard/umbrella style: minimal support and active family lifestyles, fold and go, no growth
Moderate positioning adaptive strollers: support of moderate deformities with decreased trunk and extremity strength, minimal growth
Full positioning adaptive stroller: for kids who have low tone and no muscle control who require aggressive positioning and future growth

Question 13

What are the basic manual wheelchairs?

Answer 13

Standard: for short of occasional use, limited size and options
High strength light weight: moderately active life style, wider range of sizes and options, more durable yet lighter frame
Heavy duty: for clients weighing over 250 lbs or demonstrate severe spasticity

Question 14

What are characteristics of ultralight manual wheel chairs?

Answer 14

Light weight and durable (Frame weighs 12 lbs)
Has many sizes and options
Adjustable axel plates allow for: optimal placement of rear wheels for efficient propulsion, adjustable seat to floor height for transfers/foot propelling, bucketing the frame for improved postural control/stabilty

Question 15

Tilt in space wheelchairs provide the client who has poor trunk control or who is unstable to reposition with the following benefits…?

Answer 15

Gravity assisted positioning to enhance head and trunk control
Pressure relief by transferring weight from the buttocks to the trunk
Decrease spasticity by maintaining a fixed hip angle

Question 16

How is growth for pediatric manual wheel chairs achieved?

Answer 16

Cross frames can be replaced to achieve more seat width
Back of the wheel chair frame can be moved posteriorly on the wheel chair frame to achieve more seat depth
Wheels can be moved forward or back on the frame to adjust the center of gravity and properly position the rear wheels for efficient propulsion

Question 17

What are indications for use of power wheelchairs?

Answer 17

UE weakness, spasticity, or paralysis
Limited UE ROM or purposeful movement
Decreased endurance as a result of weak trunk musculature and prolong sitting
Need to be able to independently, perform ADLs, and explore environment
Rapidly progressive disease that would result in a manual wheel chair not being a cost effective alternative

Question 18

What are the different types of power wheel chairs?

Answer 18

Light weight folding power wheel chairs
Power wheel chairs with programmable electronics and specialty controllers
Power wheel chairs with power tilt in space, power recline, power standers, and or power seat elevators
Mid wheel (best turning radius) drive or front wheel (easier to go up ramps) drive power wheel chairs for enhanced maneuverability in small areas
Pediatric power wheel chairs with growing frames

Question 19

What conditions might require more aggressive seating support?

Answer 19

Weakness of trunk muscles
Spasticity/abnormal muscle tone
Orthopedic deformity of the trunk, spine, and or pelvic

Question 20

What are some examples of more aggressive supports?

Answer 20

Adjustable back upholstery, solid planar seat/back cushions, off the shelf contoured seat/back cushions, custom contoured or molded seat/back cushions, lateral thoracic/pelvic supports that attach to the seat/back cushions or wheelchair frame, anterior trunk support systems, head support systems, UE support and positioning devices, LE support and positioning devices

Question 21

Clients with long term disabilities are often at high risk for pressure sores due to:

Answer 21

Absent or decreased sensation
An inability to reposition themselves to relieve pressure
Pelvic deformities
Incontinence
Shear forces

Question 22

What are solutions for pressure problems?

Answer 22

Pressure relieving seat cushion
Pressure mapping to determine most appropriate seat cushion for a client with ongoing pressure problems
Tilt in space seat frame
Reclining back