Assistive Devices - Wheelchair components & measurements Flashcards
sling seat
standard on wheelchairs
what is the position of the hips in a standard sling seat
- slide forward
- adduct and IR
- posterior pelvic tilt
what does the insert or contour seat do
- creates a stable surface
- improves pelvic position
- reduces tendency for pt to slide forward
what does the seat cushion do
- distribute weight bearing pressure
- assist in preventing decubitus ulcers in pt’s with decreased sensation
back support
- generally goes up to mid scapular region on standard wheelchairs
what would a low back height support increase
functional mobility
sports chairs
what would a high back height support do
necessary for individuals with poor trunk control or extensor spasm
lateral trunk support , what do you think these are beneficial for?
poor trunk stability, when falling to one side
what do UE support surfaces provide
additional postural assistance for patient with decreased UE use
swing away/detachable leg rests are good for
increase ease of transfers
elevating leg rests are good for
LE edema
postural support
what do heel loops around foot rests do
help maintain foot position, prevent posterior sliding of foot
what kind of frames are available
heavy duty standard lightweight active duty lightweight ultra-lightweight
why might you pick one over the other? who are you more likely to pick a ultra-lightweight vs heavy duty?
- weight limit
- depends on body type and what they want to get back to
- light weight frames are less stable
caster wheels
- small front wheels
- solid rubber tire or pneumatic tire
- pneumatic tire ofter wider travel easier on uneven surfaces
rollerblade wheels
ultra light
sport wheelchairs
continuously propelling yourself forward on the rims of the wheelchair can lead to what
impingement
anterior instability
seat positioners
lateral at hips or knees or medial at knees to facilitate LE alignment
seat back positioners
lateral trunk support
anti-tipping device
posterior extension attached to horizontal supports to prevent tipping back
hill holder device
mechanical break that allows forward progression but automatically brakes if rolling back
who would have a one-arm drive wheelchair
if pt has only one functional UE
one-arm drive wheelchair
- 2 hand rims attached to same wheel
- larger rim control far drive wheel
- smaller rim control near drive wheel
- pushing both = moving forward
hemiplegic chair
- low to ground
- allows for propulsion with noninvolved UE and LE
AMP chair
- LE amputation
- move pt’s CoM posteriorly = increased chance to tip posteriorly
- wheels set behind vertical back support
- moves base of support further back
basic concept of wheelchair fitting
- stabilize proximally to promote improved distal mobility and function
- achieve and maintain pelvic alignment
- facilitate optimal postural alignment in all body segments, accommodating for impairments in ROM
- limit abnormal movement
- improve function
- provide minimum support necessary to achieve anticipated goals and expected outcomes
considerations for wheelchair selection
- prognosis
- functional abilities
- environmental constraints
- safety
- expense
- low tech vs high tech
principles for positioning
- pt comfort
- stability and alignment
- pressure sore prevention
- respect precautions/contraindications
seat depth
provides support for pelvis and thighs
too shallow seat depth
- thighs are not properly supported
- affecting weight distribution and comfort
- feels like sliding off
- pressure on ischial tuberosity
too deep seat depth
- popliteal crease pressure
- slide forward and slouch, sacral sitting
- not optimal for efficient propulsion
seat width too wide
- difficult to reach drive wheels
- ineffective propulsion
- individual may lean to one side to rest on armrests
seat width too narrow
- excessive pressure on lateral aspect of pelvis and thighs
- allow space for clothing and prosthetic devices
back height too high
- restrict movement
- skin irritation over inferior angles of scapula
back height too low
- decreased trunk stability
- postural deviations
- decreases WC weight and improve mobility within WC if pt does not need the support
armrest improper height
- unable to rest
- promotes improper alignment
- unequal pressure on forearms and ischia
- abnormal spinal curvature
ideal seat to footplate length
set so that the thigh rests parallel to the cushion surface with the foot comfortably placed on the footrest
seat to footplate length too great
pt may sacral sit in order to rest feet on footplates
seat to footplate length too short
- pressure distribution along thigh is uneven
- excessive WB on ischium and coccyx
areas at risk for pressure
- inferior angle of scapula
- ischial tuberosity
- greater trochanter
- popliteal fossa
