Mobility Flashcards
Mobility
The act of moving from one place to another
- functional
- community
How does mobility affect development?
Opportunity for interaction, exploration, and learning.
Haptic
Knowing what something feels like without touching it
Development and mobility
Before 6 months: stroller, carried
6 months: scoot on back, belly, or butt; crawling
8 months: creeping; what you normally think of as crawling
9-10 months: cruising
12-14: walking
Impaired mobility leads to
Mobility becomes a passive process
Missed learning opportunities
Loss of interest
Restricted environment
- cognitive
- emotional
- social
- physical
Learned helplessness
- motor disabilities
- expectations of others
Types of ambulation
Non-functional
Functional
Kitchen
Bathroom
Household
What can OTs do regarding mobility?
Provide opportunities for the child to explore their environment
- adaptive equipment
- rehabilitation
- change the environment
- mobility devices
Determine what the client can do
What are the client’s development needs
Consider cost and care
Teach them how to use it
Periodic checks and refits
Ways to improve mobility
Prone scooter
Support walker
Caster cart
Tricycle
Hand held walker
- 3-4 wheels
- anterior/posterior
Wheelchairs
- manual and power
Mobile standers
Crutches
Electric scooter
Barbie jeep
Problems with some mobility devices
Undesirable position
Cost
Cognitive understanding
Belief it will held development
- recommend early
- augmentative or transitional mobility
Classification of mobility skills
Those who will never ambulate
Inefficient or marginal ambulators
Those who have lost independent mobility
Temporary mobility issues
Johns Hopkins ADL Guide
Selecting the right device
- Purpose of device
- What environment will it be used in
- Effort needed to use it
- Appropriate features
- Caregiver; school needs
- Cost; maintenance
Manual wheelchair
Manual
Self propelled
Transport chair
- foot propelled
One arm unit
Big front or back tire
Sports chairs
Manual assist chair
Parts of manual wheelchair
Electric/Power chair
Expensive, heavy, don’t fold
3-15mph for 25 miles
Covered by insurance for indoor use only
Front drive
Mid wheel drive (0 turning radius)
- may temp
Rear wheel
- no 0 turn
How to operate
- joy stick
* proportional: harder you push, faster it goes
* nonproportional: set speed
> used with Parkinson’s
Things you must consider when picking a chair
Growth
Cushion
Does the chair need to tilt? recline?
Does it need to fold?
Head height
Foot rests
- fixed
- elevated
- swing away
- removable
- adjustable
Arm rests
- fixed
- removable
- flip
- 1/2 arm
- whole arm
Back rest height
Floor to seat height
Height of push bar for caregiver
Tipper or not
Style and position of breaks
- break extenders
Type and size of tire
- pneumatic and gel filled: uneven surfaces
- solid
Fitting a client for a wheelchair
Consider anterior and posterior pelvic tilt
Asymmetric seating
90º rule
- most patients can’t do this
Goal is always stable seating
Allows for more AROM
Spine and pelvis should be stable
Accommodate for structural and postural problems
Seating guidelines for wheelchair
Stability is achieved from 3 points
- under the pelvis
- sides of pelvis
- above the pelvis
* gravity
* lap trays
* foot rests
* increasing seat depth
Mobility evaluation
Observe the client in their current equipment
Observe client on mat
Simulators are available
Know what triggers problems
What does the client/parent need/want?
Talk to experts
What determines successful use of a mobility device?
Fit
Readiness/cognition
Proper training
How other stuff fits
- augmented devices
- IV poles
How to fit a wheelchair
- Distribute the weight over the widest possible surface
- Keep the chair as narrow as possible
- Width
- measure the widest parts (hips or thighs) and add 2 inches - Seat depth
- base of back/butt to inside of bent knee, minus 1-2 inches for clearance - Floor to seat
- thigh to bottom of heal
- foot plates need to clear by 2 inches - Back height
- lumbar for sport
- inferior scapula for free arm movement
- top of hear for recline/tilt
Standard seat size for wheelchairs
16, 18, 20, 22, 24in
Bariatric: up to 700# and 30in seat
Door width in US 24-36
Pediatric chairs start at 10in and are often adjustable
