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5 Neurological Dysfunction > L11 W/C > Flashcards

L11 W/C Flashcards

1
Q

steps to prescribing a w/c

A

1.determine the need
2. examine the pt
3. select a positioning device and pressure relief
4. Determine funding
5. Document medical necessity
6. Evaluate the pt with new w/c
7. Re-assess and follow-up

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2
Q

Team members for prescribing w/c

A

Patient
Caregivers
Referral source
Pt/OT
ATP
manufacturer reps
insurance reps

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3
Q

Equipment needed to prescribe w/c

A

high/low mat table
measuring tools
transfer equipment
camera
pressure mapping system

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4
Q

How long does a w/c eval take?

A

90 to 120 minutes

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5
Q

How long does a w/c fitting appointment take?

A

60 to 120 minutes

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6
Q

Subjective eval for w/c

A

Medical status and hx
living situation (w/c accessibility)
current functional level
transportation
cognitive issues
visual/perceptual deficits
time spent in current w/c, current measurements

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7
Q

Mat evaluation

A
  1. posture
  2. sitting balance
  3. ROM
  4. Strength
  5. Tone
  6. Measurements
  7. Skin check
  8. Functional Eval
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8
Q

Posture eval

A

measure in the 3 following situations:
1. In current w/c
2. Edge of mat
3. Supine

helps you to see with gravity, gravity eliminated, and how equipment impacts it

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9
Q

In all 3 positions of posture, look at

A

balance
pelvic tilt, rotation, obliquity
lego position
lumbar lordosis
thoracic kyphosis
scoliosis
shoulder position
head position

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10
Q

Windswept deformity

A

describes the appearance of abnormal valgus deformity in one knee in association with varus deformity in the other

named for the lower ASIS

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11
Q

Pelvic obliquity

A

frontal plane deformity and is always named for the lower ASIS

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12
Q

Posterior pelvic tilt is associated with

A

thoracic kyphosis

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13
Q

ROM that should be measured for w/c

A

Hip
Knee w/hips flexed
Ankle w/knees flexed
Hamstring length
UE

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14
Q

Strength eval

A

necessary to note grip strength, UE, and LE

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15
Q

Functional Eval includes

A

transfer ability
balance assessment
gait
pressure relief
manual w/c propulsion
power w/c driving

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16
Q

Types of manual w/c

A

Standard weight
Bariatric
High Strength Lightweight
Ultralight
Tilt in space

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17
Q

Standard weight

A

least expensive
designed for infrequent, short duration use
little adjustability

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18
Q

Bariatric w/c

A

accommodate users over 250 lbs
accessibility is an issue because of wider seat widths

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19
Q

High strength light weight wheelchair

A

justified for a full time user of w/c
height is adjustable
flip back armrests
limited vertical axle adjustability

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20
Q

Ultralight w/c

A

fully customizable
typically under 25 lbs
must have features that match anatomical dimesions of individual and functional ability

21
Q

Customizable features of ultralight w/c

A
  1. seat surface height at front and rear edge
  2. seat plane angle
  3. seat width and depth
  4. back support height
  5. seat to back support angle
  6. foot support to seat height
  7. leg to seat surface angle
  8. horizontal and vertical position of rear axle
  9. rear wheel camber
  10. wheel and caster type/size
22
Q

More forward axle on ultralight w/c

A

decreases overall rolling resistance, allows easier negotiation of variable terrain, limits the risk of UE strain or injury over time

ideal set up is to have fingertips reach the hub, with the hub directly behind the shoulder

23
Q

Too far forward axle on ultralight

A

injury from tipping backwards

24
Q

Tilt in space manual w/c

A

dependent user who typically does not self-propel
needs pressure relief with tilt in space

can tilt from 0-50°
pediatric ones can adjust for growth changes

25
Q

Power assist systems

A

with the first stroke, the motor engages and keeps the chair going until the user decides to stop or needs to stop

medicare requires at least 1 year in a manual chair prior to this

good for patients that wants a manual w/c, but has power w/c needs

26
Q

Power w/c types

A

Scooters
Group 2 power
Group 3 power

27
Q

Scooters

A

typically used for outdoor use only, houses don’t have enough room for them

difficult to get covered by medicare

28
Q

Group 2 power w/c

A

rental
medicare rents these for 13 months
lower end power, used mostly for mobility for little need for specialty seating

29
Q

Group 3 power w/c

A

most common of power w/c
can be set up with speciality seating, custom seating, power seat functions, specialty controls

30
Q

When will medicare cover a Group 3 power w/c?

A

if mobility limitation is due to a neurological condition, myopathy, or congenital skeletal deformity

31
Q

Power drive wheel configurations

A

rear wheel
front wheel
mid wheel

32
Q

Rear wheel drive configuration

A

used to be most available
have large turning radius and accessibility issues

33
Q

Mid-wheel drive configuration

A

majority of current w/c are this

is most maneuverable, tightest turning radius, and smallest turning circumference

34
Q

Front wheel drive configuration

A

navigate tight corners better due to small front end. difficult to turn 360° due to long back end

large drive wheels at front let you traverse obstacles, can do variable terrains

35
Q

Things to help with safety for power w/c

A

improved suspension systems
tracking tech
lights
charging ports
bluetooth

36
Q

Power seat functions

A
  1. power tilt in space
  2. power recline
  3. power elevating leg rests
  4. power seat elevators
37
Q

What are power tilt in space used for?

A

at least 45° of tilt for pressure relief

anterior tilt for transfers

38
Q

What are power recline capabilities used for?

A

cathether

39
Q

Uses of power elevating leg rests

A

edema

40
Q

power seat elevators use

A

transferring

41
Q

Recline vs Tilt

A
42
Q

Medicare requirements for power seat functions

A
  1. user meets all coverage criteria
  2. speciality evaluation was performed by licensed professional
  3. a RESNA certified ATP had direct in person involvement with w/c selection
43
Q

Seat elevators

A

allows for seat to rise up to 14 inches

44
Q

Alternative Drive controls

A

head array
sip/puff
speciality joysticks
chin control

45
Q

Cushion types

A

general use
pressure relieving
positioning
positioning/pressure relieving
positioning/pressure relieving/adjustable
custom

46
Q

Other positioning needs

A

backrests
head rests
armrests
hip guides
abductor wedges
side guards
footrest configuration

47
Q

Plan AFTER w/c eval

A

trial at home
follow up clinic appointments for custom seating
home health or outpatient therapy to work on driving
fitting at home or in clinic

48
Q

Letter of medical necessity

A

speciality letter versus through eval documentation that includes medical justification of w/c

includes summary, measurements, recommendations

5 Neurological Dysfunction (16 decks)

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