S1_L2: Wheelchair Prescription Flashcards
1
Q
Contraindicated for Severe Extensor Spasticity
A
Elevating Leg Rests
2
Q
Leg Rest for ease of transferring?
A
Swing-Away Leg Rests
3
Q
Heaviest seat cushion, high maintenance, and efficient
A
Pressure-Relieving Gel Cushion
4
Q
A device attached to a door that closes the door through the use of compressed fluid or air.
A
Self-closing device
Source: Pierson & Fairchild, 5th ed. p.133
5
Q
TRUE OR FALSE: Proper seating and positioning should promote function, prevent deformity, improve body alignment, prevent tissue damage, and prevent additional complications.
A
True
Source: Pierson & Fairchild, 5th ed. p.134
6
Q
Type of w/c prescribed for C6-C8 SCI?
A
Manual w/c; pt. uses own energy to propel
7
Q
Type of w/c prescribed for C1-C5 SCI?
A
Motorized/Robotic/Powered/Electrical or
Caregiver-propelled w/c
8
Q
Possible risk of prescribing low back rest?
A
Increased risk for LBP.
PT must thoroughly explained to the pt that there is an increased risk for LBP. PT must also prescribe strengthening exercises (HEP) on low back area/muscles.
9
Q
Seat cushion for pts with risk of mild deformities
A
Pressure-Relieving Foam Cushion
10
Q
Disadvantage of Pressure-Relieving Foam Cushion?
A
Foam can absorb moisture, which can result to wound and pressure sore formation.
11
Q
W/c control for C5 level SCI?
A
Joystick
12
Q
W/c control for C1-C3 level SCI?
A
Sip and puff (through a tube, straw or wand)
13
Q
What muscle is innervated by C3 nerve that may be utilized in w/c control?
A
Diaphragm
Sip - inhalation; puff - exhalation
14
Q
W/c control for C4 level SCI?
A
Chin piece
15
Q
Standard w/c prescription is for which SCI level?
A
C8
16
Q
Drive/Rear wheel type for C6 level SCI?
A
Projection rims
17
Q
Drive/Rear wheel type for C7 level SCI?
A
Friction rim
18
Q
TRUE OR FALSE: Sling or hammock
seat tends to cause IR of the femurs, posterior pelvic tilt, a forward head position, and a tendency for the
pelvis to slide forward.
A
True.
Source: Pierson & Fairchild, 5th ed. p. 134
19
Q
TRUE OR FALSE: Lateral sitting transfers may be more difficult to perform from the sling or hammock type of seat.
A
True.
Source: Pierson & Fairchild, 5th ed. p. 134
20
Q
TRUE OR FALSE: Using a seat cushion does not provide adequate pressure relief.
A
True.
Frequent position changes should be performed by the wheelchair user while he or she is seated to relieve pressure on various body sites.
Source: Pierson & Fairchild, 5th ed. p. 135
21
Q
“Two hand rims are fabricated on one drive wheel, and the two drive wheels are connected by a linkage bar.”
What type of w/c is described?
A
One-Arm Drive
Source: Pierson & Fairchild, 5th ed. p. 135
22
Q
“The seat is lowered approx. 2” to allow better use of the user’s lower extremities to propel the chair.”
What type of w/c is described?
A
Hemiplegic
Source: Pierson & Fairchild, 5th ed. p. 135
23
Q
“The rear wheel axles are positioned approx. 2” posterior to their normal position to widen the BOS of the chair and compensate for the loss of the weight of the user’s lower extremities.”
What type of w/c is described?
A
Amputee
Source: Pierson & Fairchild, 5th ed. p. 135
24
Q
“Designed to permit adjustments in the frame to accommodate the growth of the user”
What type of w/c is described?
A
Growing w/c
Source: Pierson & Fairchild, 5th ed. p. 135
25
"Designed for persons up to the approximate age of 6 y"
What type of w/c is described?
Child or youth
Source: Pierson & Fairchild, 5th ed. p. 135
26
TRUE OR FALSE: The importance of proper fit of the chair must be ensured to enable the patient to attain maximal comfort, stability, function, and safety.
True.
Source: Pierson & Fairchild, 5th ed. p. 135
27
How to measure seat width?
Measure the widest aspect of the user’s buttocks, hips, or thighs, and add
approx 1.5" **(2" in lecture)**
Source: Pierson & Fairchild, 5th ed. p. 136
28
How to measure seat depth?
Measure from posterior buttock, along the lateral thigh, to the popliteal
fold/fossa then subtract approx 2" **(2-3" in lecture)**
This is to avoid pressure from the front edge of the seat against the popliteal space.
Source: Pierson & Fairchild, 5th ed. p. 136
29
How to measure armrest height?
Measure from seat to the olecranon process with elbow flexed to 90º, shoulder neutral, and then add approx 1"
NOTE: Person should be measured while seated on the cushion, or the thickness of the cushion must be added to the actual measurement.
Source: Pierson & Fairchild, 5th ed. p. 136
30
How to measure back height for standard backrest?
Measure from seat to mid scapula
Note: If with cushion, include cushion in measurement
31
TRUE OR FALSE: Spokeless wheels are prescribed to those who will not be actively using the w/c, while spoke wheels are prescribed for their improved efficiency, better wheel distribution, utility for outdoors, uneven pathways, & sports.
True.
32
How to measure back height for low backrest?
Measure from seat to below the inferior angle of scapula
Note: If with cushion, include cushion in measurement
33
How to measure back height for high backrest?
Measure from seat to above the superior angle of scapula
Note: If with cushion, include cushion in measurement
34
How to measure leg length / seat to foot plate length?
Measure from bottom of shoe to popliteal fossa
35
How to measure seat height?
Measure from floor to the bottom of the footrest / lowest point of the footplate and add 2".
Two inches provide adequate distance from the bottom of the footplate to the floor so the chair can be maneuvered easily and safely on most surfaces.
Source: Pierson & Fairchild, 5th ed. p. 136
36
TRUE OR FALSE: If the seat is too high, the wheelchair user may experience (1) insufficient trunk support because the back upholstery will be too low; (2) difficulty positioning the knees beneath a table or desk; (3) difficulty propelling the wheelchair because of the difficulty in reaching the hand rims on the drive wheels; or (4) poor posture when the forearms rest on the armrests.
True.
Source: Pierson & Fairchild, 5th ed. p. 138
37
TRUE OR FALSE: If the seat is too low, the wheelchair user may experience difficulty performing a standing or lateral swing transfer because COG will be lower, making it difficult to elevate the body. A low seat also may cause improper weight distribution. The footplates may also contact objects on the floor or ground, leading to decreased mobility and unsafe use of the chair.
True.
Source: Pierson & Fairchild, 5th ed. p. 138
38
Armrest which are permanently attached to the chair frame that is recommended for users who will be performing standing transfers and have no need to remove the armrest.
Fixed Armrest
Source: Pierson & Fairchild, 5th ed. p. 140
39
Armrest recommended for users who will perform a lateral swinging or sliding transfer in a sitting posture.
Removable / Reversible Armrest
Source: Pierson & Fairchild, 5th ed. p. 140
40
Armrests used by persons who need varying armrest heights for different activities, sit-to-stand transfers, or when cushions with different thickness or bulky outer garments are used.
Adjustable (Height) Armrest
Source: Pierson & Fairchild, 5th ed. p. 140
41
Armrest for bed <-> w/c transfers
Removable / Reversible Armrest
42
(1)--- are located at the front of the chair to permit changes of direction and turns. They are usually (2)--- in diameter.
(1) Caster wheels
(2) 5 to 8" **(8" in lecture)**
43
Tires that are lightweight and provide a smoother, more comfortable ride and function better on rough and soft surfaces such as sand, gravel, and grass.
Pneumatic or Semipneumatic tires
Note: These may require greater energy expenditure by the user to propel the chair because they are wider than solid tires and create more friction, especially on carpeting.
This type also increases shock absorption
Source: Pierson & Fairchild, 5th ed. p. 140
44
Wheels used to propel the chair
Drive / Rear wheels
45
TRUE OR FALSE: A one-arm-drive chair may be used for independent propulsion when the user has only one functional UE and no functional LE.
True.
Additional: Two hand rims are attached to the same wheel. When the user grasps and moves both hand rims simultaneously, the chair is propelled in a straight line forward or backward. Use of one hand rim independently causes the chair to turn.
Source: Pierson & Fairchild, 5th ed. p. 140
46
Footrests attached permanently to the chair frame.
Fixed Footrests / Leg Rests
This type of footrest prevents the chair from being positioned close to and directly in front of most objects.
Source: Pierson & Fairchild, 5th ed. p. 142
47
Leg rest that allows the user to position the chair closer to objects and to provide greater unimpaired space at the front of the chair for the feet during transfers.
Swing-Away / Removable Leg Rests
Release of a locking mechanism allows the front rigging to be pivoted outward, and lifting the leg rest removes the front rigging from the chair frame. (Source: Pierson & Fairchild, 5th ed. p. 142)
48
Leg rest useful for patients who are unable to fully flex their knees or when knee flexion must be avoided (e.g., in cases of a fused knee or a long leg cast).
Elevating Leg Rest
Note: It is important to protect the patient’s LE when the leg rest is lowered because the weight of the leg will cause it to descend rapidly if the patient cannot control its descent.
Source: Pierson & Fairchild, 5th ed. p. 142
49
Leg rest indicated for edema
Elevating Leg Rest
50
(1) ---- prevents the foot from sliding backward, and the (2)---- prevents the foot from moving forward.
(1) Heel loop
(2) Toe loop
Note: heel loop should be moved forward before the footrest is raised to prevent damage to the heel loop fabric and to allow the footrest to be fully raised before a standing transfer or folding of the chair is attempted.
Source: Pierson & Fairchild, 5th ed. p. 143
51
TRUE OR FALSE: Footrests should be elevated before a standing transfer and before movement of a patient into or out of the chair.
True. Always do so
Source: Pierson & Fairchild, 5th ed. p. 143
52
It is used between the two leg rests to prevent posterior movement of the patient’s legs. It also stabilizes the feet on the footplates.
Straps
Source: Pierson & Fairchild, 5th ed. p. 143
53
It is attached to the frame of the chair at the mid-chest level to increase trunk stability, prevent the wheelchair user from falling out of the chair, and maintain the body upright.
Chest Belt
It may be combined with a lap belt for greater security.
The buckle may be located in back of the chair or built onto sides of chair to prevent the patient from having access to it.
Source: Pierson & Fairchild, 5th ed. p. 144
54
Designed to prevent the patient from falling out of the chair or sliding forward in the chair. It crosses the wheelchair user’s lower abdomen or pelvis.
Lap (Waist) Belt
The buckle may be located in back of the chair to prevent the patient from having access to it.
Source: Pierson & Fairchild, 5th ed. p. 144
55
W/c powered by one or more deep-cycle batteries that provide stored electrical energy to one or more belts that drive or propel the chair.
Externally Powered Wheelchair
Source: Pierson & Fairchild, 5th ed. p. 145
56
Available w/c for persons with insufficient strength or motor control of the extremities to propel a standard chair.
Motorized chair
Source: Pierson & Fairchild, 5th ed. p. 145
57
This wheelchair has specific features such as low backrests, solid, lightweight (+ rigid) frames, canted / angled / oblique rear wheels, low and narrow seats, and an overall low profile to make the chair more functional for the user.
Sport or Recreational Wheelchair
Source: Pierson & Fairchild, 5th ed. p. 145
58
W/c not recommended for patients with spatial deficits
One-Arm Drive
Reason: it will be difficult for them to navigate the w/c
59
TRUE OR FALSE: The most popular lightweight wheelchair model is the rigid wheelchair.
True
Source: Pierson & Fairchild, 5th ed. p. 145
60
TRUE OR FALSE: Titanium is the material of choice for lightweight mobility aids.
True
Titanium is not only a lighter metal, but it is more durable and features built-in shock absorption.
Source: Pierson & Fairchild, 5th ed. p. 146
61
W/c that promotes mobility. It can be wheeled (transported) most easily by elevating the caster wheels and wheeling the chair on the rear wheels, while using the push handles for control.
Folding Wheelchair
When the folded chair is to be lifted, the fixed or solid portion of the frame should be used.
Source: Pierson & Fairchild, 5th ed. p. 147
62
W/c that promotes stability, increases stroke efficiency, increases distance per stroke and is for independent w/c users.
Rigid type
63
W/c for active w/c users and requires good UE strength
Heavy Duty Wheelchair
64
This provides additional postural assistance by supporting the UE
UE Support Surface
65
Recommended for persons who wish to position the wheelchair close to a permanent surface such as a desk, table, or countertop.
Desk length / Cutout Armrest
Source: Pierson & Fairchild, 5th ed. p. 140
66
Seat that creates a stable and firm surface, improves pelvic position, and reduces the tendency of the patient to slide forward.
Insert / Contour Seat
67
This distributes WB pressures
Seat cushions
68
Pressure-relief push ups are required every ----?
15-20 minutes
69
Seat cushions for patients at risk for moderate to severe postural deformities
Pressure-Relieving Gel & Pressure-Relieving Air Cushions
70
Light, high maintenance, and expensive cushion
Pressure-Relieving Air Cushion
71
Postural support system that improves trunk extension and improves over-all alignment
Insert / Contour Backs
72
Improves trunk alignment for patients with scoliosis
Lateral trunk support
73
Low back rest is for (1) ---- trunk stability, while high back rest is for (2) ---- trunk stability.
(1) good to normal
(2) poor
74
Rim that facilitates propulsion in patients with poor hand
grips
Projection Rims
75
Rim that increases hand grip
Friction Rim / Leather Gloves
76
Durable, low maintenance tires
Standard hard rubber tires
77
This is required in w/c that are caregiver-propelled
Brakes
78
Use of an adductor pommel
Prevent adductor spasticity
79
Additional attachment for added lateral trunk support
Seat Back Positioner
80
Posterior extensions attached for lower horizontal support
Anti-Tipping Device
81
(1)--- is a mechanical brake that allows the chair to move (2)---, but automatically brakes when the chair goes in (3)---.
(1) Hill-Holder Device
(2) Forward
(3) Reverse
82
For patients who are not able to ascend a long ramp or hill
Hill-Holder Device
83
Seat Width, Seat Depth, and Seat Height of an average adult
Seat width - 18"
Seat depth - 16"
Seat height - 20"
84
TRUE OR FALSE: It is important to routinely inspect the skin that overlies bony prominences such as the vertebral spinous processes, inferior angles of the scapulae, ischial tuberosities, greater trochanters, lateral femoral condyles, sacrum, and medial humeral epicondyles after prolonged periods of sitting.
True
Source: Pierson & Fairchild, 5th ed. p. 139
85
TRUE OR FALSE: If the footplates are too high, the user may experience increased pressure to the ischial tuberosities, difficulty positioning the chair beneath a table or desk, or decreased trunk stability caused by a lack of support by the posterior area of the thighs.
True
Source: Pierson & Fairchild, 5th ed. p. 138
86
TRUE OR FALSE: If the seat is too short from the front to the back, the wheelchair user may experience (1) decreased trunk stability because less support will be provided under the thighs; (2) increased weight bearing on the ischial tuberosities because the body weight will be shifted posteriorly as a result of the lack of support to the thighs; or (3) poor balance because the BOS has been reduced.
True
Source: Pierson & Fairchild, 5th ed. p. 138
87
TRUE OR FALSE: If the back is too low, the user may experience decreased trunk stability or postural deviations because less support will be available from the chair back.
True
Source: Pierson & Fairchild, 5th ed. p. 138
88
TRUE OR FALSE: If the armrest is too low, the user may experience (1) poor posture or back discomfort caused by excessive forward trunk inclination when leaning forward to place the forearms on the armrest; (2) increased abdominal discomfort when leaning forward; (3) inadequate balance; or (4) difficulty rising to a standing position from the chair because the armrests are too low to offer support when pushing to stand.
True
Source: Pierson & Fairchild, 5th ed. p. 138
89
TRUE OR FALSE: When evaluating seat width, both of PT's hands should be in slight contact with the user and the armrest panel or wheelchair hand rims when the user is seated in the center of the seat. This is to ensure there is sufficient space between each hip and each armrest panel when the user is in the center of the seat.
True.
Source: Pierson & Fairchild, 5th ed. p. 137
90
TRUE OR FALSE: Proper fit of seat depth will allow four fingers to be placed between the front edge of the seat and the user’s popliteal fold with your palm horizontal to the seat and your hand held parallel to the floor.
False. Proper fit should allow 2-3 fingers
Source: Pierson & Fairchild, 5th ed. p. 137
Note: In 2PTA ATLab class, Sir Tope used 4 fingers.
91
W/c indicated for patients who are unable to independently maintain an upright posture
Reclining wheelchair
92
W/c where the entire seat and back tipped backwards and is indicated for patients with extensor spasticity
Tilt-in-space wheelchair
93
TRUE OR FALSE: Bariatric wheelchairs have rear axles that are displaced forward.
True.
This allows more efficient arm push
94
In bariatric wheelchairs, the adjustable backrest accommodates excessive --- bulk.
Posterior
95
Reclining wheelchairs accommodate excessive --- bulk
Anterior
96
(1)---- armrest covers the entire forearm, while (2)---- armrest covers at least half of the forearm.
(1) Full length
(2) Desk length
97
pt with severe (1)---- spasticity : Heel loops ::
pt with severe (2)---- spasticity: Straps
1. Flexor
2. Extensor
98
Promotes mobility and it promotes a comfortable
(guide) especially during an uneven terrain.
Wheelchair frame
99
Much stable than the folding type wheelchair frame because it provides ease on wheelchair propulsion and turning
Rigid type
100
Wheels particularly directing the movement
Caster wheels
101
Seatbelts (Pelvic Positioner) should grasp the pelvis at
a (1)--- angle to the seat.
1. 45º
Note: this additional attachment is recommended for pts with severe extensor spasticity
102
heavy-duty, extra wide w/c is generally designed as a power w/c because its going to be difficult for a pt to navigate this kind of w/c
Bariatric Wheelchair
103
TRUE OR FALSE: Oblique wheels increase stroke efficiency
True
104
back rest for a pt who at least have a fair to good trunk stability
Standard Back Rest
