S1_L2: Wheelchair Prescription Flashcards
Contraindicated for Severe Extensor Spasticity
Elevating Leg Rests
Leg Rest for ease of transferring?
Swing-Away Leg Rests
Heaviest seat cushion, high maintenance, and efficient
Pressure-Relieving Gel Cushion
A device attached to a door that closes the door through the use of compressed fluid or air.
Self-closing device
Source: Pierson & Fairchild, 5th ed. p.133
TRUE OR FALSE: Proper seating and positioning should promote function, prevent deformity, improve body alignment, prevent tissue damage, and prevent additional complications.
True
Source: Pierson & Fairchild, 5th ed. p.134
Type of w/c prescribed for C6-C8 SCI?
Manual w/c; pt. uses own energy to propel
Type of w/c prescribed for C1-C5 SCI?
Motorized/Robotic/Powered/Electrical or
Caregiver-propelled w/c
Possible risk of prescribing low back rest?
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.
Seat cushion for pts with risk of mild deformities
Pressure-Relieving Foam Cushion
Disadvantage of Pressure-Relieving Foam Cushion?
Foam can absorb moisture, which can result to wound and pressure sore formation.
W/c control for C5 level SCI?
Joystick
W/c control for C1-C3 level SCI?
Sip and puff (through a tube, straw or wand)
What muscle is innervated by C3 nerve that may be utilized in w/c control?
Diaphragm
Sip - inhalation; puff - exhalation
W/c control for C4 level SCI?
Chin piece
Standard w/c prescription is for which SCI level?
C8
Drive/Rear wheel type for C6 level SCI?
Projection rims
Drive/Rear wheel type for C7 level SCI?
Friction rim
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.
True.
Source: Pierson & Fairchild, 5th ed. p. 134
TRUE OR FALSE: Lateral sitting transfers may be more difficult to perform from the sling or hammock type of seat.
True.
Source: Pierson & Fairchild, 5th ed. p. 134
TRUE OR FALSE: Using a seat cushion does not provide adequate pressure relief.
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
“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?
One-Arm Drive
Source: Pierson & Fairchild, 5th ed. p. 135
“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?
Hemiplegic
Source: Pierson & Fairchild, 5th ed. p. 135
“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?
Amputee
Source: Pierson & Fairchild, 5th ed. p. 135
“Designed to permit adjustments in the frame to accommodate the growth of the user”
What type of w/c is described?
Growing w/c
Source: Pierson & Fairchild, 5th ed. p. 135
“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
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
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
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
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
How to measure back height for standard backrest?
Measure from seat to mid scapula
Note: If with cushion, include cushion in measurement
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.
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
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
How to measure leg length / seat to foot plate length?
Measure from bottom of shoe to popliteal fossa
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
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
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
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
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
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
Armrest for bed <-> w/c transfers
Removable / Reversible Armrest