OTA week nine Flashcards
what are the 5 categories of a w/c
- basic user
- active user
- very active user
- very active user
- manual dynamic tilt
who would be the clientele of category 2?
- Hemiplegic
- Self-propelling with U/E and L/E
- More active users
who is the clientele of category 3?
- Amputee patients with amputee
support - Reduced mobility patients
(Parkinson, dementia, …) - Promotes U/E propulsion
who is the clientele of category 4?
- SCI patients
- Paraplegic, tetraplegic and
quadriplegic patients - Different models for sports (wheels
can be angled)
who is the clientele of category 5?
- SCI
- ALS, advanced MS
- Advanced dementia
- Skin integrity issues
what are other types of w/c?
scooters
pediatric w/c –> CP pt
bariatric w/c –> possible in every category, >250 lbs and wdith of >20
how should the positioning be in a w/c?
arms: optimally at 90
pelvis: back in chair, weight distributed equally
knees and feet: optimally at 90
back rests: to scapula for self propelling
what are the 6 types of seat cushioning?
- gel
- foam
- air
- silicone
- honeycomb
- hybrid
what are the main body types in bariatric seating?
- apple ascites –> fluid build up around abdominal
- apple pannus –> hanging abdominal pannus
- pear abducted –> fat in hips and thighs, legs will be more apart
- pear adducted –> fat in hips and thighs, legs will be more together
- pear gluteal shelf –> fat in butt and lower back, shelf like look
how to measure bariatric wheelchairs?
A: Hip width across the pelvis can
be measured using calipers.
B: Overall thigh width due to
edema and adipose tissue
C: The width across both lower
legs edema and adipose tissue may
result in the lower extremities
impinging on leg rests and hardware.
D: The width across the feet
E: The seat-pan depth from the
popliteal fossa to the posterior of
the buttocks
F: The actual seat depth from the
popliteal fossa to the posterior
trunk
G: The height of the gluteal shelf
H: The width across the elbows
I: The forearm: height with the
elbows flexed
what are the two measurements needed for depth?
E and F
where do the feet need to be for bariatric wheelchair when measuring?
farther apart
what happens if their feet are too close when measuring for bariatric wheelchair?
pressure increases at lateral aspect of feet, clients hips will abduct and externally rotate and the feet supinate to help keep feet on footplate
what is the goal for wheelchair measuring?
neutral positioning
postural considerations
reducible –> partially reducable –> non reducible
what is the goal when correcting a reducible posture?
their most neutral posture that can be maintained over time with proper support in order to optimize function
what do to do when they can’t maintain the reduced posture over time?
shift to accommodating like you would for non reducible posture. but continue to provide interventions that will prevent it from becoming truly non reducible
what are common issues for stroke patients in wheelchairs?
pelvic obliquity –> one half of pelvis is higher than the other instead of being even
what is the problem with pelvic obliquity?
lean to one side or appear to be sitting crooked
spine is curved due to positioning which could cause pain
one side is receiving more pressure when seated which can also create pain
often related to tone or muscle weakness on one side
what is the common issues in MS / ALS/ MNCD in wheelchairs?
pelvic migration –> pelvis creeps forward when sitting
- AKA - sliding or sacral sitting
what is the problem with pelvic migration?
- could lead to slipping out of wheelchair and falling
- forward sliding is often due to weakness or self propulsion
- can be a long time habit
what is the common issue in cerebral palsy in wheelchairs?
windswept posture
- legs may look as if big gush of wind has come along and swept both legs to one side of chair
- one leg is in external rotation and abduction of hip
- other legs is internally rotating and adduction towards midline
- LE look like they have been swept to one side of chair
what is the result of windswept posture in cerebral palsy?
poorly fitted chair or unsupportive surface
what is the common issue for extensor tone, (tbi, later stage dementia) or bariatric pt in wheelchairs?
anterior pelvic tilt
- patients hyperextends at thoracic region pushing post against back support as if theyre falling backwards over back support
this posture places them at risk of tipping chair over backwards and the use of anti tippers is recommended
