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OTA 210 - Assistive Tech > Seating Technology > Flashcards

Seating Technology Flashcards

1
Q

ICF Foundational Classifications influenced by seating position

A
  • Lifting and carrying in the hands (transfer of objects)
  • Fine hand use (pick up/grasp/manipulate/release)
  • Hand and arm use (pull/push/reach/turn/twist in hands/throw-catch)
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2
Q

Stability (postural control issue)

A

Sliding forward in the seat or lateral or anterior trunk flexion; influenced by activity, emotion, and amount of effort expended in performance.

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3
Q

Protective Factors against pressure ulcers

A
  • Being married
  • Being female
  • Having higher level of education
  • Employment
  • Going to school
  • Maintaining health behaviors (diet, activity, skin care)
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4
Q

Factors that Contribute to Pressure Ulcer Development

A
  • Mobility/activity level
  • SCI
  • Weight status
  • Nutrition
  • Comorbidities
  • Age
  • Sitting posture
  • Microclimate
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5
Q

Human Aspect of Seating Considerations

A
  • Postural Control
  • Tissue Integrity/Pressure Redistribution
  • Comfort
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6
Q

Context Aspect of Seating Considerations

A
  • Physical
  • Social
  • Institutional
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7
Q

Biomechanical Principles

A
  • Kinematics (study of motion)
  • Kinetics (forces)
  • Types of forces
  • Stress
  • Pressure
  • Newton’s Laws of Motion
  • Friction
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8
Q

Kinematics: Displacement

A

Change in position of a body in space (rate of change in position is called VELOCITY). (ie: achieving postural control may require displacement from rest position to midline by application of external lateral trunk support.)

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9
Q

Kinematics: Acceleration

A

Rate of change of the VELOCITY, or rate of change in position (increasing or decreasing). Gravity (acceleration of object toward center of earth) is one of most common accelerations.

Acceleration of object is directly related to force applied to the object.

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10
Q

Kinematics: Linear Movement vs. Rotational Movement

A

LINEAR: Type of displacement when all parts of body move in same direction at same time and for same distance (ie: walking).

ROTATIONAL: Body’s movement occurs through an angle instead of straight line (around an axis/fulcrum). Majority of body movements are rotational, such as hip/elbow flexion or shoulder flex/ext. Some positioning causes rotational displacement (ie: reclining back of wheelchair causes pelvic rotation).

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11
Q

Kinetics: Force

A

Anything that acts on a body to change its acceleration or alter its momentum. Has four properties:
• Magnitude: amt or size of force in newtons pounds-force, or kilograms-force.
• Direction: Push or pull direction force applied in
• Line of Application: Line along which a force is applied
• Point of application: Point on which force acts on body

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12
Q

Tension vs. Compression vs. Shear

A

Tension: forces acting in same line but away from each other (pulling apart), such as antagonist muscle during agonist contraction.

Compression: forces act toward each other (pushing together), such as force of weight of body on the cushion when sitting on it.

Shear: superficial layer is stationary relative to support surface, but deeper structures move, such as during weight shift, client’s skin may not move while muscles/bones do, resulting in pressure/deformation of soft tissue.

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13
Q

Stress

A

Resulting molecular change inside biologic (soft tissue, bone) or nonbiologic (metals, plastics, foams) materials. Caused by tension, compression, shear, and can result in damage if prolonged. (ie: tearing of foam cushion due to shear force.)

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14
Q

Pressure

A

Force per unit area; force applied over a very small area generates more pressure than same force applied over larger area. Distribute pressure by increasing area of application.

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15
Q

Newton’s Laws of Motion

A

Third law related to forces on bodies at rest and in motion. Every force exerted by human body while sitting is balanced by opposite force exerted by seat surface on person.

EQUILIBRIUM: Force generated by body equal in magnitude and opposite in direction to force generated by seating system.

  • Static equilibrium = body at rest and internal/external forces are balanced.
  • Dynamic equilibrium = forces balanced around a body during movement, creating a constant velocity.
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16
Q

Friction

A

Force betw two bodies in contact moving in opposite directions.

Static Friction = force must be overcome to start body in motion. Proportional in magnitude to perpendicular (compression) force holding bodies together. Independent of the area of contact betw the 2 bodies.

Dynamic Friction = during movement, when resistive force is generally smaller and it takes less force to keep bodies moving relative to each other than to start movement.

All affected by surface conditions (moisture, heat, texture, lubricants); important considerations in seating surface selection.

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17
Q

Base of Support during Seating

A

Area around outside edge of sections of the body in contact with the ground/surface. In seating, it is the area encompassing the buttocks and thighs. Must maintain center of gravity over base of support to maintain upright posture.

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18
Q

Stability Zone

A

Balance limits for a person either sitting or standing. Affected by seat back and armrests. Also affected by person’s age, strength, ROM.

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19
Q

ITs (abbrev.)

A

Ischial Tuberosities

20
Q

Potential Outcomes of Proper Seating/Positioning

A
  • Optimal posture control for activities
  • Optimal balance betw stability/mobility while seated
  • Maintenance of neutral skeletal alignment
  • Prevention/Minimization of skeletal deformities
  • Maintenance of tissue integrity/pressure redistribution
  • Maintenance of position of comfort
  • Provide comfortable, supportive position that reduces fatigue while sitting
  • Enhance respiratory/circulatory functions
  • Facilitate caregiver activities
21
Q

Planar vs. Contour Cushions

A

PLANAR = flat surfaces that rely on properties of cushion material to conform to body’s shape. Minimal support, shorter use times.

CONTOUR = Most cushions on the market (ie: Matrix) are contoured; for moderate seating/positioning needs, for postural mgmt., or those at risk for pressure ulcers. Curved surfaces more closely match body shape. Often anterior shelf supports thighs. Back has depressed pelvic loading area. Front frequently beveled to provide more comfort behind knees.

22
Q

Custom Contoured Cushions

A

Greatest amount of body contact, most support. Shaped to client’s body. Can use scanning, 3D representations, etc. to capture shape. Transfers to/from are more difficult. Static cushion, does not allow for growth or movement.

23
Q

Prefabricated Backs

A

Can be adjustable or not. Hard shell provides support with foam on top for comfort/support. Adjustable models can change height, depth, width, back angle, and placement of laterals. Can also be biplanar, allowing upper/lower segments at different angles. Pivot point can be positioned at PSIS to control pelvis.

Should be reclined ~15˚ to stabilize trunk. Back height determined by need of support. Quadriplegia need higher back/headrest for less trunk control.

24
Q

Properties of Cushion Materials

A
  • Density (ratio of mass to volume)
  • Stiffness (give under load)
  • Sliding Resistance (property related to friction; high=limits sliding)
  • Resilience (recovery of shape after load removed, or adjust as load applied; short- or long-term recovery)
  • Dampening (ability to soften impact)
  • Envelopment (degree cushion surrounds butt)
  • Recovery (degree cushion returns to preloaded state or some deformation remains)
25
Q

Categories of Support Surfaces

A

1) Reactive Support (responds with load)
2) Active Support (load distribution characteristics change with load)
3) Powered (requires external energy source)
4) Nonpowered (no energy source required)

26
Q

Levels of Postural Control in Sitting

A

1) Hands-Free Sitter (prolonged sitting without hands for support; seating system for mobility, stable base of support, and comfort)
2) Hands-Dependent Sitter (one/both hands used to maintain support while sitting; seating system to provide pelvic/trunk support to free hands)
3) Propped Sitter (lacks any ability to support self in sitting; seating system provides total body support)

27
Q

Skills Evaluated in Seating Assessment

A

Physical Skills:
• Orthopedic factors
• Neuromotor factors
• Respiratory/Circulatory factors

Sensory Skills:
• Vision
• Perception
• Tactile sensation

Cognitive/Behavioral Skills:
• Safety awareness
• Motivation (tolerance for tech; aesthetic prefs; acceptance of disability)

Functional Skills:
• Transfers
• Self-care
• Mobility, propulsion
• Communication
• Bowel/Bladder function
• Other equip used
28
Q

What to Look for in Needs Identification in Seating Assessment

A
  • Identification of contexts and related concerns (setting, caregiver support, physical contexts, accessibility, transportation)
  • Identification of previously used seating systems
  • Identification/prioritization of goals to client, family, caregivers
29
Q

Three Choices/Goals for Seating Technologies

A

1) Postural Control
2) Pressure Management
3) Comfort

30
Q

Human Factors of Seating Assessment

A
  • Physical Skills/Mat Assessment
  • Orthopedic Factors (joint ROM, deformities, alignment)
  • Postural Control
  • Respiratory/Circulatory Factors
  • Sensory/Perceptual Skills
  • Cognitive Skills
  • Psychosocial Factors
31
Q

Context/Activity Factors of Seating Assessment

A
  • Physical (environments used?)
  • Social (assistance available?)
  • Institutional (use of restraints?)
32
Q

Seating Devices are considered:

A
  • GENERAL-purpose extrinsic enablers (mobility devices are specific)
  • Used with some type of mobility base
33
Q

Mobility Devices are considered:

A

SPECIFIC-purpose extrinsic enablers (seating devices are general)

34
Q

3 Areas of Seating Intervention

A

1) Seating for pressure redistribution
2) Seating for postural control
3) Seating for comfort

35
Q

Fixed Deformity

A

Permanent changes have taken place in the bones, muscles, and other structures.

36
Q

Client’s sitting ability determined by:

A

Amount of support required to maintain a seated position, including:
• Hands-free sitter
• Hands-dependent sitter
• Dependent sitter

37
Q

Biomechanics

A

Study of body position and movement.

38
Q

Wheelchair Outcome Measure

A

Considers function in self-care, productivity, and leisure from the view of an individual who uses seating and mobility devices.

39
Q

Physical Evaluation for Seating Mobility Includes:

A
  • Orthopedic factors
  • Postural control
  • Respiratory and Circulatory Factors
  • The person in sitting and supine on flat surface
40
Q

Example of “Mobility”:

A

Sally’s ability to lean forward to reach a cell phone.

41
Q

Stability Zone

A

The balance limits of a person in either sitting or standing, affected by seat back, laterals and arm rests.

42
Q

Positioning of Pelvis/LEs Can be Accomplished With:

A
  • Belts or bars to support pelvis from the front
  • Feet positioned flat with 90 degrees ankle flexion
  • Legs positioned so femurs are neutral in regard to abduction, adduction, and rotation.
43
Q

Pelvic Obliquity

A

When pelvis angles toward one lateral side.

44
Q

Design of Seating System refers to:

A

The degree of contouring and adjustability present in seat and back components.

45
Q

5 Properties of Cushion Materials

A
  • Density
  • Stiffness
  • Resilience
  • Dampening
  • Envelopment
46
Q

Cellular Technologies such as Open Cell Foams provide:

A

Sufficient airflow for better ventilation.

OTA 210 - Assistive Tech (8 decks)

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