TRAINING FOR W/C USERS Flashcards
What happens with regular exercise training (benefits)?
physical independance self-confidence ADLs social interaction reduces stress EFFICIENCY OF HEART AND BLOOD FLOW TO LOWER EXTREMITIES muscle strength and bone mineral density decreases the risk of HEART DISEASE
One of the leading causes of death in persons with spinal cord injury??
HEART DISEASE
If you have a non-motor control wheelchair, you typically will have which diseases?
cardiovascular - myocardial infarction pulmonary - cystic fibrosis, COPD metabolic - diabetes, obesity, frailty immunological and hematologic - cancer, AIDS orthopedic - arthritis, amputation
If you have a motor control wheelchair, you typically will have which diseases?
neuromuscular - stroke, parkinsons, CP, SCI, MS
How to avoid overstress to the wheelchair structure
respect the maximum recommended weight capacity of the wheelchair
Pulling up = less or more weight?
Less
What happens when you exceed the max payload?
failure of one or more components of wheelchair and could result in severe injury or death
Most wheelchairs are only tested to ______ maximum use weight
250 lbs
Stability issues for wheelchair users
1) attempt exercise for first time with assistance of a spotter
2) be aware chair might tip over
3) lock wheelchair
4) powered w/cs should be turned off (heavier and dont move)
Which chairs dont have wheel locks?
sports chairs
How close should the wheelchair be to the exercise equipment?
as close as possible
What are step risers used for?
used to block the wheels of the wheelchair to further assist in preventing movement of your wheelchair during ex
What else can you do to weigh down the wheelchair other than step risers?
use a weight (like a dumbbell) if you have no spotter
or just use a spotter if possible
Are anti-tip wheels enough for exercise?
no
(Forward stability) To prevent tipping forward, what should you do?
rotate the front casters forward before locking the wheel locks
essentially by moving the w/c BACKWARDS, you are making it more stable for yourself
Should COG be within the base support or out of it for stability?
WITHIN
(Rearward stability) To prevent tipping backwards, what should you do?
rear wheels should be REARWARD and not forward, because you could tip back
Benefits of wheels forward in rearward stability? p221
easier to lift front part of wheelchair to avoid obstacles. Less stable tho
Benefits of wheels rearward in rearward stability?
more stable because COG falls in base of support
Disadvantages of wheel rearward in rearward stability?
Decreased shoulder joint forces
therefore, decreased push frequency
What causes rearward tipping?
pushing weights forward or upward, or lifting weights above and behind the head.
What should the spotter do to avoid rearward tipping?
hold down the front of the w/c near the front casters or leg supports to prevent the w/c from tipping over
Explain the use of a restraint
A large plate that sits underneath all wheels of the wheelchair witht wo ratchet straps at the FRONT to hold down the front of the wheelchair. Wheelchair user can back onto this plate
What if you dont have restraints to use?
spotter
step risers
wooden blocks
3 methods for lateral stability
leaning
holding
use of a psotter to prevent
Which direction should you lean for lateral stability?
lean towards the side of the w/c opposite to the tipping direction
Explain holding for lateral stability
hold wheelchair frame or wheel on opposite side
OR hold a handrail or other piece of stationary fitness equipment
Better to lean or hold for laterals tability?
hold
What do postural positioning straps do?
hold participant securely in seat
How is the model of positioning straps chosen?
Sport/activity
and on trunk function
The better your trunk muscles, the (less/more) of a need for positioning straps
less
What happens if theres no fixed grips for the purpose of having to transfer?
adjust weight of machine to MAX and use grip thats designed to move as a transfer point
MAKE SURE THAT BODY WEIGHT IS LESS THAN WEIGHT OF MACHINE
Transfer is made towards the (stronger/weaker) side of body.
stronger
Adaptive equipment (2)
grasping cuff or ctivity mitts
wrist cuff
When are grasping cuffs or activity mitts useful?
when grip strength or hand function is limited
very helpful and effective for hands to grip weight machines or dumbbells
When are wrist cuffs helpful?
to perform resistance exercises
What can wrist cuffs be attached to?
resistance bands or cable resistance
Grasping cuffs or activity mitts for quadriplegics or paraplegics?
quadriplegics (para dont need it)
Elastic bands or tubing provide exercise comparable to?
free weights
resistance of elastic bands or tubing can be modified by which 2 things?
changing colour
increasing stretch
How is elastic bands good for motorized exercise cycles?
very good for passive range of lower limbs, and circulation
CAN IT INDUCE A EX RESPONSE?
NO BECAUSE NO CONTRACTION
When looking at a graph for elastic bands, how do you know which is stronger than the other in the table?
the lower one is STRONGER than the one directly above by 25%
100% elongation =?
double
200% elongation=?
4x
force production of bands is directly related to
elongation
Each color will provide a specfic amoutn of resistance at the ______ percent elongation , regardless of initial resting length
same
CHEST STRETCH
clasp hands behind your back
exhale and role shoulders back as you stick out your chest and hold 10 seconds
HAMSTRING STRETCH
place leg on chair mat or bench
exhale as you reach forward
Hold 20 sec
repeat with other leg
SHOULDER SHRUG
hold 10 seconds
exhale when your shoulders go back down
SHOULDER RETRACTION
Exhale while bringing shoulders back as far as poss
TRICEPS STRETCH
exhale pressing down
TRUNK ROTATION
Place hand on opposite thigh. Take a deep breath in and exhale while twisting the torso, looking over the shoulder.
SEATED CHEST STRETCH IN DOORWAY
Place arm bent at 90 degrees in doorway. take deep breath in, exhale while turning the head to the opp side, looking over that shoulder. repeat with other arm, looking over the opposite
LATERAL TRUNK FUNCTION
Take deep breath in, exhale as trunk bends to the left and right arm extends overhead. hold and repeat on other side
TRICEPS KICKBACK
place hand ur not lifting on stationary object
for stability and to allow yout o slightly lean forward
with one hand grasping the hand grip of the free weight or cable resistance, move elow behind the midline of the body, keeping arm at 90 degrees. take a deep breath in. exhale and extend the elbow.
Improving tricep stretch in wheelchair users can help which ADLs?
to propel wheelchair
UPRIGHT ROW: MUSCLES??
delts, traps and biceps
UPRIGHT ROW
start with arms down at both sides, palms facing back. use a strap to support your upper body if needed. exhale and bend your elbows to bring your hands to your armpits. keep your hands close to the body through the motion. inhale and slowly lower to the starting position.
Individuals with a complete injury at or above _______ may not be able to perform this movement.
C5-C6
Vertebrals most common in card accident whiplash
C5-C6
SEATED ROW: MUSCLES??
lower, middle, upper back
also, shoulder and chest!
ROWING MACHINE
hold onto single or double hand and reach forward AS FAR AS POSSIBLE without losing balance in the forward direction. Pull back, leading with your shoulders to the rear while pulling your arms back as far as possible.
WHat should you keep in mind while doing rowing machine?
important to lock wheelchair and to use risers to block the wheels and secure the stationary position