screen and assessment

Question 1

Screen questions (8)

Answer 1

o Is the pelvis in a neutral position in the seating system?
o If the pelvis is not in a neutral position, can you correct the pelvis? Will the pelvis stay in the corrected position over time in the current seating system?
o Is the trunk upright and midline?
o Is the head upright and midline?
o Are the LE aligned with the pelvis without abduction, adduction or rotation?
o Back height: with the pelvis in a neutral orientation, is the back at the correct height?
o Seat depth: with the pelvis at a neutral orientation, is there approx.. 1” between the end of the seat and back of the knee?
o Lower leg length: with the pelvis at a neutral orientation, is the distance between the top of the seat and the footplate, correct?
 If the thighs are not touching the seat, they are too short. If the feet are not making full contact with the footplate, they are too long.

Question 2

posterior tilt

Answer 2

kyphosis

Question 3

anterior tilt

Answer 3

lordosis

Question 4

obliquity

Answer 4

one side of the pelvis is higher than the other

Question 5

rotation

Answer 5

one IT is off the seat and/or forward in the seat creating a rotation

Question 6

who is a wheelchair assessment typically done with?

Answer 6

a mobility supplier

Question 7

stages of a wheelchair assessment (4)

Answer 7

1. intake
2. assessment of current posture in the current system
3. mat examination
4. simulation

Question 8

what should you do during intake of a wheelchair assessment?

Answer 8

context and direction. Should include clients’ goals, home and car accessibility, medical issues, independence in ADLs, and current equipment

Question 9

how should you assess their current system

Answer 9

position of the pelvis, trunk, neck, and extremities

Question 10

what is a MAT examination used for?

Answer 10

to determine the available ROM for seated posture, where support surfaces are required, and what seated angles will be used. Looks at available range, where supports are required, and at what angles.

Question 11

what does the Mat examination contain?

Answer 11

o Describe reflexes and muscle tone, ROM limitations, and postural changes (cause and effect)
o With the pelvis in a neutral position, begin to flex the hip. When the pelvis begins to rock posteriorly, this indicates the end of the available hip flexion = seat t0 back angle.
o Recheck this with the knees at 90 degrees of extension to ensure the feet can be placed on a footrest at the angle without posterior tilt of the hips

Question 12

seating system categories: sling upholstery

Answer 12

found on transport wheelchairs. Surfaces are a vinyl sling and seat depth and height are not adjustable. For people who will only sit in it for a short period of time

Question 13

seating system categories: captain seats

Answer 13

generic contours that fit the average sized person. Used in scooters. Make of foam and vinyl with a separate head rest. Not for people who sit in their seating system for long periods of time but transfer to other surfaces

Question 14

seating system categories: linear seating

Answer 14

flat surfaces on the primary and secondary support surfaces. A variety of material and upholstery types. For pediatric population because it is easily outgrown

Question 15

seating system categories: generic contours

Answer 15

encourage clients to remain in position within the seating system. May be custom built or off the shelf

Question 16

seating system categories: aggressively contoured seating

Answer 16

• provide more intimate contact with the body for increased postural support and pressure distribution
• Impede transfers

Question 17

seating system categories: molded seating systems

Answer 17

provide the most contact with the body. For clients who have orthopedic asymmetries (scoliosis) and require intimate contact for postural support and pressure distribution

Question 18

cause of pressure injuries

Answer 18

• caused by pressure over an area of tissue, which leads to reduced or loss of blood flow to the area and tissue death
• Heat, moisture, poor pressure distribution, lack of sensation, incontinence, poor hygiene, poor nutrition, prior pressure injuries, immobility, friction, shears, inactivity, and decreased mental status

Question 19

seating options to decrease pressure injuries (3)

Answer 19

1. Seat shape and materials can distribute pressure over a large surface area. Highly contoured shape can distribute pressure but impedes independent transfers. Some materials can distribute pressure, but are less stable and do not provide postural support
2. Pressure relief – tilt and recline can take pressure from the butt to the posterior trunk for short periods of time or the client can shift the weight themselves.
3. Seating and upholstery reduce head and moisture