Assistive Devices - Wheelchair components & measurements

Question 1

sling seat

Answer 1

standard on wheelchairs

Question 2

what is the position of the hips in a standard sling seat

Answer 2

• slide forward
• adduct and IR
• posterior pelvic tilt

Question 3

what does the insert or contour seat do

Answer 3

• creates a stable surface
• improves pelvic position
• reduces tendency for pt to slide forward

Question 4

what does the seat cushion do

Answer 4

• distribute weight bearing pressure

- assist in preventing decubitus ulcers in pt’s with decreased sensation

Question 5

back support

Answer 5

• generally goes up to mid scapular region on standard wheelchairs

Question 6

what would a low back height support increase

Answer 6

functional mobility

sports chairs

Question 7

what would a high back height support do

Answer 7

necessary for individuals with poor trunk control or extensor spasm

Question 8

lateral trunk support , what do you think these are beneficial for?

Answer 8

poor trunk stability, when falling to one side

Question 9

what do UE support surfaces provide

Answer 9

additional postural assistance for patient with decreased UE use

Question 10

swing away/detachable leg rests are good for

Answer 10

increase ease of transfers

Question 11

elevating leg rests are good for

Answer 11

LE edema

postural support

Question 12

what do heel loops around foot rests do

Answer 12

help maintain foot position, prevent posterior sliding of foot

Question 13

what kind of frames are available

Answer 13

heavy duty
standard
lightweight
active duty lightweight
ultra-lightweight

Question 14

why might you pick one over the other? who are you more likely to pick a ultra-lightweight vs heavy duty?

Answer 14

• weight limit
• depends on body type and what they want to get back to
• light weight frames are less stable

Question 15

caster wheels

Answer 15

• small front wheels
• solid rubber tire or pneumatic tire
• pneumatic tire ofter wider travel easier on uneven surfaces

Question 16

rollerblade wheels

Answer 16

ultra light

sport wheelchairs

Question 17

continuously propelling yourself forward on the rims of the wheelchair can lead to what

Answer 17

impingement

anterior instability

Question 18

seat positioners

Answer 18

lateral at hips or knees or medial at knees to facilitate LE alignment

Question 19

seat back positioners

Answer 19

lateral trunk support

Question 20

anti-tipping device

Answer 20

posterior extension attached to horizontal supports to prevent tipping back

Question 21

hill holder device

Answer 21

mechanical break that allows forward progression but automatically brakes if rolling back

Question 22

who would have a one-arm drive wheelchair

Answer 22

if pt has only one functional UE

Question 23

one-arm drive wheelchair

Answer 23

• 2 hand rims attached to same wheel
• larger rim control far drive wheel
• smaller rim control near drive wheel
• pushing both = moving forward

Question 24

hemiplegic chair

Answer 24

• low to ground

- allows for propulsion with noninvolved UE and LE

Question 25

AMP chair

Answer 25

• LE amputation
• move pt’s CoM posteriorly = increased chance to tip posteriorly
• wheels set behind vertical back support
• moves base of support further back

Question 26

basic concept of wheelchair fitting

Answer 26

• 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

Question 27

considerations for wheelchair selection

Answer 27

• prognosis
• functional abilities
• environmental constraints
• safety
• expense
• low tech vs high tech

Question 28

principles for positioning

Answer 28

• pt comfort
• stability and alignment
• pressure sore prevention
• respect precautions/contraindications

Question 29

seat depth

Answer 29

provides support for pelvis and thighs

Question 30

too shallow seat depth

Answer 30

• thighs are not properly supported
• affecting weight distribution and comfort
• feels like sliding off
• pressure on ischial tuberosity

Question 31

too deep seat depth

Answer 31

• popliteal crease pressure
• slide forward and slouch, sacral sitting
• not optimal for efficient propulsion

Question 32

seat width too wide

Answer 32

• difficult to reach drive wheels
• ineffective propulsion
• individual may lean to one side to rest on armrests

Question 33

seat width too narrow

Answer 33

• excessive pressure on lateral aspect of pelvis and thighs

- allow space for clothing and prosthetic devices

Question 34

back height too high

Answer 34

• restrict movement

- skin irritation over inferior angles of scapula

Question 35

back height too low

Answer 35

• decreased trunk stability
• postural deviations
• decreases WC weight and improve mobility within WC if pt does not need the support

Question 36

armrest improper height

Answer 36

• unable to rest
• promotes improper alignment
• unequal pressure on forearms and ischia
• abnormal spinal curvature

Question 37

ideal seat to footplate length

Answer 37

set so that the thigh rests parallel to the cushion surface with the foot comfortably placed on the footrest

Question 38

seat to footplate length too great

Answer 38

pt may sacral sit in order to rest feet on footplates

Question 39

seat to footplate length too short

Answer 39

• pressure distribution along thigh is uneven

- excessive WB on ischium and coccyx

Question 40

areas at risk for pressure

Answer 40

• inferior angle of scapula
• ischial tuberosity
• greater trochanter
• popliteal fossa