lecture 3: introduction to wheelchair ambulation Flashcards
where do chariots with spoked wheels date back to
1300 BC CHINA
in 1595 what was develipped
the first dedicated wheelchair was devlipped
what was the first dedicated wheelchair called
invalids chair
who was the invalids chair originalyl designed for
king phillip II of spain
what did the first dedicated wheelchair feature
reclining back and moveable armrests and footrests. It had four small wheels, one on each corner leg.
what was th e problem with the first wheelchair models
they were dependatn on others for ambulation
when ws steven farflerr and why is he imporant
German watchmaker with a disability that limited his mobility. He is the first known person to invent and use a wheelchair that could be independently propelled.
who invented the first arm cranked wheelchari
steven farflerr
explain the firsrt arm cranked wheelchair
It was a stable chair mounted on a 3-wheeled chassis with attached handles on both sides of the front wheel used to propel the chair forward.
what age did setven farflerr createt the wheelchair and why
22 because believed to be paraplegia
in the first wheelchair models, where were the big wheels
in the front
when was the invention of the frist folding chair
1932
who invented the first folding wheelchais
everest and jennings
why was the first folding chair imporatnt
became possible to easily transport tones wheelchair to differentt locations
why was there the development of the folding chair?
desire of Everest, who had broken his back in a mining accident and became confined to a chair, to have a unit that was collapsible and could easily be transported in an automobile.
true or false: todays wheelchairs have the same models of the first wheelchair models
false, no , as the folding chair model
explain the type of wheelchair user that is an loss of limb
someone who has absense of loss of lower extremtity (due to a truama or surgery)
true or false: all of those who have a loss of lower extremeity go in wheelchairs
false, depending on the portion/injury they may not need a wheelchair
explain how arthritus can make someone a wheelchair suer
they have pain in joints which reduced the range of motion and can cause weakness
in severe cases
explain multiple sclerosis and how they are wheelchair users
MS is a disease causing progressive msucular weakness, loss of msuuclar contol and diffulty in walking
explain para[legia as a wheelchair user
they have impairement in motor and senspry function of the lower limbs
what determines if someone will need a wheelchair
it always depends on the severety of the condition
explain how those with stroke can be wheelchair users
stoke (from a cerebral vascular accident) causes lision to brain causing paralyssi one one side of the body
what is another name for stroke
cerebral vascular accident
does stroke always lead to wheelchair use
no
what is quadriplegia (tetrapelfgia)
impairment in motor and sensory function of the upper and lower limbs
explain how diabetes can make someone a wheelchair user
diabtes is a metabolic disease in which a person who has high blood gluocse
often results in neropathy and limb loss
cerebral palsy causes damage to what area od the brain and when
damage to the motor area of the brain prior to brain injury
true or false: to be considered cerebral palsy the motor area of the brain HAS to be damaged t
true
which wheelchair requries fitting
marys wheelchair
why is having a properly fitted wheelchair imporatnt
because it allows you to be seated proreply
cant be too tight so that it causes blisters
which chair tapers (medical or custom)
custom
why is a taper important in a wheelchair
maintains postiion of the legs and draws eye to the body and not the chair
can you adjust center of gravity in medical wheelchait
no
why is it important to be able move the center of gravity
to find perfect balance between support and function (being able to go over surfaces)
what is the difference is wheel type b/w medical and custom
custom is usually air filled while medical is plastic
the seat back for a medical chaor is high or low
high
the backseat for custom is low or high
low
do the coustum wheelchairs have arm rests? medical>
custum no medical yes
what types of breaks are there usually on custom wheelchairs
scisosors (mounted underneath)
what types of breaks are most common for medical wheelchairs
mounted in the front of the chair but causes more injury
does the medical wheelchair have psuh handles
yes
true or false: both medical and custom have rigid sidegaurds and why
yes because they can sue it as a lift up
how do you know a tire is at a good height for u
arm/fingers reached the center of the axle
what is the price range for a manual wheelchair
2000-8000
what is the price range for a motorixed wheelchair
10k - 15k
what type of wheelchair is good for tetrapleigcs
motorixed
explain the foortests on a manual wheelchair
support feet and lower legs (can be fixed/folding)
true or false: the footrests on a manual wheenchair can be fixed or folding
true
what do the arm rests in a manual wheelchair do
support arms when the person is not moving
why is fit important for armrests
because armrst position can alter the way the wheelchair is propellyed
what is the wight of a manual wheelchair
15-60 lbs
what is the weight of a motorized wheelchair
50-250 lbs
tires of a manual tires are commonly what
air filled (pneumatic)
what is a pro about air filled tires in manual wheelchairs
lighttweight
what is a con about air filled manual wheelchair tires
they require maintenance and can puncture
what do the wheelocks act as in manual wheelchairs
parking brakes
why are wheel locks imporant for transfers q
they are used for ambulation/descend etc to not allow the chair to move during the transfer
what is the problem with wheel locks in manual wheelchairs
they can get i nthe way during propulsion (most indivaiduals choose to remove them)
why are gloves popular for wheelchair users
to propel the push rims and prevent bruns
tur oe false: there is only 1 standard of push rims
false, theere are a variety of push rims with different friction coatings and shapes
when you are desceing a ramp, you should put the wheellocks
no you will fall forward
how can wheelchair users slow down when descening a ramp
they use their hands to apply pressure on the whell which is why they wear gloves
what does the height of the backrest in a manual wheelchair depend on
the strngth of the trunk msucels
lower=more stronger
what is the balacne to considering when it comes to the back rest height
support vs freedom of movement
when would someone need a back rest at shoulder height
if they need a harness/have poor trunk control
when would someone need a back heigh within 2 inches of lower scaptie
someone who needs only moderate support
a lower back rest is okay for who
active users with good trunk control
what are the most common backrests but what is their con
sling backrests are the most common but provide little postural support
what are 3 additional features on manual wheelchairs
anti tippers
grade aids
caster wheels
caster wheels are the front or back wheels
front
where are anti tippers located
at the back of the chair that helps from going backwards
what is the function of grade aids and where are they locaed
located on wheels
keep chair from rolling backwards
true or false: the caster wheels can rotate
true
what is the problem if tthe sight is too tight
can cause pressure sores
what is the problem if the sat is too wide
can be diffucult to reach hand rims and propel wheelchair
prvent the wheel chair from manouvering tthrough the small smpaces
how to afjust the seat heigt
Let your hands dangle at your side when sitting in the chair: your fingertips should reach the chair’s axle
which is more stable, axle is rear or forward
read
what does the rear aexle postion allow
Allows the center of gravity to be adjusted appropriately for each individual and reduces the effort required to propel the wheelchair
the rear axle postion can have an affect on what
Rear axle position can have an effect on shoulder joint forces and push frequency
troe or false: wheels forward is a bad postiion
false although it is less stable it makes it easier to avoid obstacles
wht does camber mean
degree of inclination
angle of the wheel with respect to their chair
if you increase the base of support, there is more of less support
high degree of camebr= mrore stable
what does the camber of the wheels protect
helps to protect hands (since your hands are not the most exterior part)
what is the problem with too mcuh camber
makes it hard to fit through doorwars
What is the best method to propel a wheelchair in a safe and efficient manner?
longer contact angle
true or false: short contact angles are bad
true
why is chair transfer one of the most important components for independent living in paraplegics?
it allows good independance so they do not need to rely on others to get out of the chair
explain wheel chair transfer from the chair to the floor
shoes and brakes on
Sit on the edge of the seat with feet on the floor
Lean your trunk forward
Place your non dominant fist on the floor and your dominant hand on the front frame of the chair
Slowly ease yourself to the floor and swing your rear away from the chair (most advanced users will push the wheelchair back while sitting on the floor)
what fist should be on the floor when going from chair to flood
non dom on the floor
why do we make a fist instead of a hand during wheelchair transger
to protect wrist and finers
explain wheel cahir tranfer from the floor to the chair through the forward facing method
In kneeling position facing your chair (1), use your arms (non dominant fist on the floor and dominant hand on the seat back) to bring your knees up to the foot plate (2) (same as footrest)
Then bring your dominant hand to the front of the chair frame and use both arms to push your body up while rotating your trunk and pelvis (3) until your rear is in your chair (4)
qhich method is more difficult and less practice (forward facing or rear facing)
forward facing method because they chair tends to top forward (need to support body weight)
what is step 1 of the forward facing method
In kneeling position facing your chair (1)
what is step 2 of the forward facing method
use your arms (non dominant fist on the floor and dominant hand on the seat back) to bring your knees up to the foot plate (2) (same as footrest
what is step 3 of the forward facing method
Then bring your dominant hand to the front of the chair frame and use both arms to push your body up while rotating your trunk and pelvis
what is step 4 of the forwarf facing method
until your rear is in your chair (4)
what are the steps for the rear facing methods
Feet positioned at 45⁰ from the chair (1)
Feet placed as close to your bottom as possible, use your chin (or a strap) to hold knees in place. Place non dominant fist on the floor and dominant hand on the front of the chair frame (2)
Use both arms to push your legs and body up while rotating your trunk and pelvis to be aligned with the chair (3 and 4)
For weak trunk muscles, use your hand and arm muscles to extend your trunk and reach a vertical position (5 and 6)
explain step 1 of the rear facing method
Feet positioned at 45⁰ from the chair (1)
explain step 2 for rear facing method
Feet placed as close to your bottom as possible, use your chin (or a strap) to hold knees in place. Place non dominant fist on the floor and dominant hand on the front of the chair frame (2)
explain steps 3 and 4 of the rear facing method
Use both arms to push your legs and body up while rotating your trunk and pelvis to be aligned with the chair (3 and 4)
explain steps 5 and 6 of rear facing method
For weak trunk muscles, use your hand and arm muscles to extend your trunk and reach a vertical position (5 and 6)
if someone is hemiparetic (right side is weak) what are some things to consider when transfering her out of the chair (4)
support weaker side
transfer towards stronger side
communicate with person (explain)
be attentive to your back
what are the 6 steps of wheelchair transfer to a regualr chair
1) explain the procedure
2) lock chair wheels
3) stand as close to the person as you can (to protect back)
4) grip persons belt
5) lift as person pushes up
6) pivot person around
tru or false: use your legs to move isntead of back
true
should you tranfer to the strong or weak side
strong
what are the 8 wheelchair users
- loss of lower extremity
- arthritis
- MS
- paraplegia
- stroke
- tretraplegia
- diabetes
- CP
