Introduction to Wheelchairs Flashcards
Describe a standard wheelchair
- <200 lbs limit
- limited use on rough surfaces
- not designed for vigorous activities
- chair weighs about 35 lbs
- patient is able to self propel using both UE, adequate LE ROM, & sitting ability for comfortable sitting
Describe a heavy duty wheelchair
- > 200 lbs or for a patient who performs vigorous activities
Describe an ultralight rigid wheelchair
- 12-30 lbs total weight
- efficiency in propulsion & reduction in trauma in the upper extremity
- up to 300 lbs weight limit
- patient is highly active with no need for postural supports & used commonly in sports
Patient characteristics for a hemiframe wheelchair
- patient is able to self propel using the LEs
Patient characteristics for a one hand drive frame wheelchair
- patient is able to self propel using one UE
Patient characteristics for an amputee frame wheelchair
- patient is able to self propel, but center of gravity is shifted posteriorly due to amputation
Patient characteristics for a power wheelchair
- patient is not able to self propel, but is safe to operate a power mobility device
- patient may have transfer, sitting and/or UE limitations
Patient characteristics for a geri chair
- patient is not able to self propel
- requires assistance from a caregiver to push them in a WC
Patient characteristics for a reclining frame wheelchair
- patient is unable to sit upright due to pain, ROM restriction, vitals, or poor trunk support
Patient characteristics for a backward tilt in space frame wheelchair
- patient is unable to sit upright or perform weight shifts, but also has issues with sliding out of the WC or extensor tone
Pros and Cons of foam cushions
Pros: lightweight & cheap, customizable, stable base, breathable, readily available
Cons: not moisture resistant, increases temperatures, hard to clean, poor durability, loses support, not a good long term option
Pros and Cons of air cushions
Pros: lightweight, easy to clean, compartments allow for pressure distribution, best for pressure
Cons: difficult to transfer/less stable, high maintenance
Pros and Cons of gel cushions
Pros: great immersion & envelopment, pull sheet away, easy to clean, adjusts to body
Cons: heavy, localized areas of increased gel/hardness, can leak, expensive
Define immersion
- placing a body part into fluid
Define envelopment
- ability to form fit around a person’s boney prominences
How much weight can an ultra lightweight, standard lightweight, and heavy duty frames hold
Ultra lightweight: about 250 lbs
Standard lightweight: 250-300 lbs
Heavy duty: 350-850 lbs
Describe a posterior axle
- moves center of gravity anterior to axle resulting in a more stable WC, but more difficult to push
Describe an anterior axle
- moves center of gravity over axle & unweight the front of the chair resulting in a more unstable WC & much easier to push
Describe the relationship between shoulder injuries and WC axle position
- efficient WC propulsion is related to the vertical alignment of the shoulder to the axle of the wheel
- avoid excessive anterior position of the shoulders if able to prevent injury
Define camber
- the inward angle of the wheel relative to the vertical position
- typical WC is 3 degrees
Describe front wheel drive
- “pull” the WC
- good maneuverability over obstacles
Describe mid wheel drive
- “push” the WC
- tight turning radius but can get stuck on obstacles
Weight of different wheelchairs
Lightweight/ultralight: 15-25 lbs
Steel framed WCs: >50 lbs
Standard WC: about 45 lbs
How to fit a wheelchair
Seat height: measure heel to popliteal fold & add 2” if no cushion present
Leg length: allow 2” from the floor
Seat depth: measure posterior buttocks to popliteal fold & subtract 2”
Seat width: measure widest aspect of the buttocks, hips, or thigh & add 2”
Back height: measure buttocks to inferior angle of scapula
Armrest height: measure seat of chair to olecranon process with elbow flexed to 90 degrees & add 1”
Describe the 2 finger test for wheelchair fitting
- 2 fingers should be able to fit under the patient’s distal thigh, between end of seat & patient’s popliteal, between the greater trochanter & WC, and between the back of WC & inferior angle of scapula
How to fall backwards in a wheelchair
- grab opposite armrest with one hand
- tuck chin to chest
- semi flexed trunk position is maintained
- free arm reaches forward for the hand rims
How to get up from falling backwards in a wheelchair
- remain in the WC
- lock to rear wheels
- place one hand on the floor behind the chair while holding the opposite armrest
- walk the hand on the floor forward while keeping the head & trunk flexed
How to fall forward in a wheelchair
- reach forward with both UEs
- when hands contact the floor, elbows are flexed to absorb some of the force of the fall
- attempt to turn or pivot the pelvis to land on one hip
