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OTA 210 - Assistive Tech > Mobility and Transportation > Flashcards

Mobility and Transportation Flashcards

1
Q

Benefits of Standing Frames

A
  • Reduced incidence of pressure ulcers
  • Improved bladder and bowel function
  • Alleviation of orthostatic hypotension
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2
Q

Proportional Control

A

The greater the displacement, the faster the chair moves. (ie: joystick control)

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3
Q

Prone Standers

A
  • Most common
  • Support on anterior
  • Weightbearing on long bones
  • Tilted forward to use gravity
  • Does not move to seated position
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4
Q

Supine Standers

A
  • Less common
  • Supports posterior side
  • Harder to use hands and sight (due to angle)
  • For poor head control
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5
Q

Upright Standers

A

• Complete weightbearing on LEs

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6
Q

Mobile Standers

A
  • Wheelchair to standing position
  • Can be manual or power-driven lifters
  • May not be mobile in upright position
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7
Q

Increase in use of mobility systems related to:

A
  • Rising rates of obesity
  • Accessibility legislation
  • Increasing proportion of older adults in many countries
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8
Q

Most often use Scooters:

A

Marginal ambulators and those who need to conserve energy (ie: COPD)

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9
Q

Powered Wheelchair Controllers Offer:

A
  • Short throw adjustment (degree of ROM required)
  • Programmability
  • Momentary or latched control
  • Sensitivity (ie: tremor dampening)
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10
Q

Leading group of mobility device users:

A

STROKE (leading in US, 11.1%)

also top users: CP, Muscular Dystrophy, SCI

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11
Q

Marginal Ambulators

A

Able to move independently in their environment but function only at a slow rate or for short distances.

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12
Q

Benefits of powered mobility for young children:

A
  • Social
  • Cognitive
  • Physical
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13
Q

Needs specific to older adults and mobility devices:

A
  • Safety, increased function, and a feeling of security when moving in their environment
  • Loss of motor and sensory abilities that make it difficult to propel a manual wheelchair.
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14
Q

Independent Manual Mobility Systems used for:

A

Individuals who are physically able to propel a wheelchair.

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15
Q

Supporting structure of wheelchairs include:

A
  • Frame

* Attachments to it

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16
Q

Bariatrics

A

Medical field concerning individuals who are obese

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17
Q

Important elements of person’s functional abilities evaluation:

A
  • ADLs/IADLs

* Wheelchair skills

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18
Q

Tilt

A

The ability to rotate a specific seating position around a fixed axis.

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19
Q

Recline

A

Changing the seat-to-back angle, resulting in a seat-to-back angle greater than 90˚.

20
Q

Article 9 from UN Convention on Rights of Persons with Disabilities (2009)

A

“When an individual is denied the ability to travel to the location of a desired occupation, she is clearly unable to engage in that occupation. Lack of accessible transportation limits employment, education, recreation and civic occupational activities.”

21
Q

3 Key Activities Related to Transportation

A

1) Occupant Protection
2) Vehicle Accessibility
3) Driving

22
Q

Occupant Protection

A
  • Seat Belts
  • Car Seats
  • Wheelchair Tie-Downs
23
Q

What is Required for Use of Seat Belts?

A
  • Trunk control
  • Hands-free sitter
  • Joint contractures/casts may limit function
  • Cognitive impairment may result in unsafe behavior
24
Q

Car Seat Varieties

A

Commercially Available: accommodate children under 65 lbs (sometimes up to 100 lbs)

Specialized: For children with casts or in need of abduction support; for children with low tone who cannot hold upright head; for children who may exhibit unsafe behaviors

25
Q

Wheelchair Tie-Down Securement

A

Must include 4-Point Strap Tie-Down system AND 3-Point Occupant Restraint System to be safe!
• Seatbelt that comes with w/c is NOT rated motor vehicle safe
• Tie-down secures w/c to vehicle, seatbelt must secure person.

26
Q

Vehicle Accessibility Considerations:

A
  • Ramps

* Handles

27
Q

Driving Modifications

A
  • Primary Driving Controls: steering and pedals
  • Secondary Driving Controls: turn signals, parking brakes, lights, horn, ignition, temp control, wipers
  • Handled separately since secondary controls differ by vehicle.
28
Q

Steering Wheel Modifications

A
  • Tri-Pin (for driver with minimal grip strength or wrist stability)
  • Fork/V or Palm Grip
  • Spinner knob
  • Amputee Driving Ring (for prosthetic hook)
29
Q

Driving Pedal Modifications

A
  • Left Foot Accelerator
  • Pedal Extensions
  • Hand Controls (accelerator and brake)
30
Q

Safest location for Child in Vehicle

A

Center rear seat. If not available, seat that borders road shoulder is 2nd best.

31
Q

Contexts for Mobility Devices

A

PHYSICAL: indoor/outdoor; accessible environments; size of doorways, layouts; floor surfaces; portability of device; climate

SOCIAL: family, peers, and others in social environment influence choice of device; peers can share knowledge; others can pressure decision; accommodations at school/work/etc.

CULTURAL: culture affects w/c use and recommendations based on: values related to cultural inclusivity; availability of technology (remote community?); access to technology (funding mechanisms?).

INSTITUTIONAL: criteria for funding; eligibility; restrictions on where device can be used; requirements for client performance.

32
Q

Underlying Factors in Classification of Manual Wheelchairs

A
  • Type of frame (rigid or folding)
  • Adjustability of the position of the axle of rear wheel
  • Material used to construct w/c frame
33
Q

3 Common Frame Styles

A

1) Box (rectangular, strong and durable base)
2) Cantilever (lighter weight, box replaced by single bar betw wheels)
3) T or I Frames (T=similar to cantilever but single bar connects to single front caster; I=similar to T, but with 2 front casters)

34
Q

Stability and Maneuverability of w/c is affected by:

A

Position of the axle of the drive wheel relative to the user’s center of gravity. Make positioning adjustments based on needs/activity level of user:
• Center of Gravity FORWARD of the axis of drive wheels makes it more stable but harder to move
• Center of Gravity ABOVE axis of drive wheel, or behind, decreases stability but increases movability

35
Q

Most common w/c drive wheel type?

A

Rear and Mid Wheel Drive are most common styles.

36
Q

Locations of Casters and Anti-Tip Wheels on Different Wheel Styles:

A

Rear Wheel: Casters in front, anti-tip in back

Mid Wheel: Casters in front and back, anti-tip in back

Front Wheel: Casters in front and back, anti-tip in front

37
Q

Sip-n-Puff

A

Common w/c control for SCI. Small tube near mouth. Good oral motor control required to use.

Hard Puff = Forward
Hard Sip = Backward
Soft Puff = Right
Soft Sip = Left

*Includes “Latch”: direction continues until changed by user.

38
Q

Head Control

A

W/C control in headrest. Three-direction control.

Back Push = forward
Right Tilt = right
Left Tilt = left
Head Forward (off headrest) = stop
39
Q

Factors to Consider When Selecting a Wheelchair

A
  • Client profile (disability, date of onset, prognosis, size, weight)
  • Client needs (activities, contexts of use, preferences, transportation, durability, cost)
  • Physical/Sensory skills (ROM, motor control, strength, vision, perception)
  • Functional skills (transfers and ability to propel)
40
Q

Adjustments to w/c that help user comfort, safety and performance:

A
  • Axle position
  • Wheel camber (angle of wheels toward body)
  • Wheel alignment
  • Seat angle
  • Back height/angle
  • Leg/foot rest height/angle
41
Q

Occupant Protection (define)

A

Refers to structures provided by the original equipment manufacturer (OEM)—such as seatbelt assemblies and airbags—and those added to the vehicle—such as child restraint systems and w/c securement systems—that contribute to the protection of vehicle occupants during regular transportation and in the event of a crash. Secure and safe positioning; and limiting excess movement during a collision.

42
Q

Vehicle Ingress vs. Egress

A

Ingress = Act of entering the vehicle

Egress = Act of exiting the vehicle

Present for both private and public transportation vehicles. Includes with/without another type of AT (ie: mobility device). Includes prevention of unintentional egress (ie: cog impairment cannot open door while car moving).

43
Q

Primary vs. Secondary driving activities

A

Primary = Acceleration/deceleration, stopping, steering

Secondary = Activation of turn signals, setting parking brake, operating lights, entertainment/nav systems, temp control, turning ignition on/off.

44
Q

Types of legislation that affect AT use related to transportation

A

1) Occupant protection (seat belts, child restraints)
2) Standards related to crash-testing
3) Policies related to licenses to drive a vehicle (vision requirements, health conditions, “graduated” licensing)

45
Q

Requirements for Child Restraint System

A

Most jurisdictions require:
• Children <40 lbs must be secured in restraint system
• Use of booster seat for betw 40-80 lbs

46
Q

3 Types of Child Restraint Systems

A
  • REAR-facing infant seats (from birth to 12 mo/22 lb-Note many reach 22 lb first, but should still be rear-facing! Some rear-systems now go up to 45 lbs.)
  • FORWARD-facing infant seats (for long-term use; up to 40 lbs/40 inches; proper installation is crucial!)
  • BOOSTER seats (children > 40 lb/40 in.; positions so seat belt fits properly. Must be ~80 lb/4’9” to use regular seat).
47
Q

Hand Controls for Accelerator/Brake Design Approaches:

A 
• Push-pull
• Push-twist
• Push-right-angle-pull
• Push-tilt
(For all: First half is the brake, 2nd is the acceleration).

When released, returns to off position.
Usually operated with left hand/right for steering, but opposite is available.

OTA 210 - Assistive Tech (8 decks)

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