Final Practical

Question 1

How to prescribe appropriate AT

Answer 1

1. Determine a schedule for using AT that optimizes benefits without impeding other areas
2. Must be individualized and considers the pts environment, resources, functional capacity, goals of the patient
3. Anticipate change when selecting AT
4. Consider cost
5. Make sure to think about trial, safety, cognitive ability, and stigma

Question 2

Things to remember for home modifications

Answer 2

1. Ramps are 12 ft of run for every 1 foot rise
2. Doorways and spaces in the home need to be large enough to accommodate the w/cand allow for pts to reach critical items for ADLs
3. Modifications need to be cost effective for patient
4. Medicare will only pay for ATs that can be used in the home

Question 3

Mat Eval Steps

Answer 3

Balance
Pelvic Tilt
Pelvic Obliquity
Pelvic Rotation
Leg Position
Lumbar lordosis/Thoracic Kyphosis
Scoliosis
Shoulder position
Head position

Question 4

Pelvic Tilt

Answer 4

neutral, anterior, posterior

Question 5

Pelvic Obliquity

Answer 5

Uses ASIS to measure
Named for the lower side

Level, L lower, R lower

Question 6

Pelvic Rotation

Answer 6

Use Knees, ASIS
named for the side that is farther back

neutral, right forward, left forward

Question 7

Leg Position

Answer 7

Windswept, abducted, adducted

Question 8

Lumbar Lordosis/Thoracic Kyphosis

Answer 8

Noting normal, kyphosis, lordosis

Question 9

Scoliosis

Answer 9

Convex Left
Convex right
Left lean
Right lean

Question 10

Shoulder position

Answer 10

Note where inferior angle hits the chair

elevated, protracted, retracted, depressed

Question 11

Head position

Answer 11

midline, cervical flexion, cervical extension, rotated R/L, Lateral flexion

Question 12

Measurements

Answer 12

Length of lower leg
Armrest height
Length of upper arm
shoulder height
top of head
inferior angle of scapula
shoulder width
trunk width
hip width
upper leg length
Foot length
Feet width
Occiput height

Question 13

Length of lower leg

Answer 13

First ask what shoes they are going to wear in W/C
bottom of heel to hamstring tendon

height of w/c

Question 14

Arm height

Answer 14

“sit up tall”

measure from mat to olecranon

armrest height

Question 15

Length of upper arm

Answer 15

Elbow at side and flexed to 90°, pronated.
“Spread your fingers”

Measure from olecranon to fingertips = length of arm rest plus joy stick

Measure from olecranon to wrist = length of arm rest

Question 16

Shoulder Height

Answer 16

sit up tall
measure from mat to top of shoulder

back rest

Question 17

Top of head

Answer 17

sit up tall
measure from mat to top of head

clearance for entering houses, cars, ADLs

Question 18

Inferior Angle of Scapula

Answer 18

Sit up tall
measure from mat to inferior angle

important for manual w/c back rest height

Question 19

Shoulder width

Answer 19

measure from shoulder to shoudler
back rest

determining how far arm rests should be apart

Question 20

Trunk/Chest Width

Answer 20

widest part of the trunk

backrest width
also lateral trunk supports if needed

Question 21

Hip Width

Answer 21

have knees about shoulder width apart
patient hold two transfer boards

One without squeezing = soft tissue boundary, uses for seat width

One with squeexzing = bony boundary, tells us cushion width

Question 22

Upper Leg Length

Answer 22

measure transfer board to popliteal space
tells us seat depth, should be shorter to allow for knee flexion

Question 23

Trunk depth

Answer 23

for maximal users for their backrest, measuring trunk length