WC & AT & Driving Flashcards
WC seat width measure
Widest point across hip/thighs to allow for max seating space and comfort - then add 2in!
Allows for clearance to prevent rubbing
WC seat depth measure
both LEs and take greatest length - measure from post portion of butt to popliteal fossa and then subtract 2in!
Prevents rubbing
WC back height measure
Based on need for postural stability Take measurement from seat surface (inc. cushion) to one below dep on postural need 1. Mid back under scap: 1-2in below 2. Mid scap or axilla 3. Top of shoulder
Lower back height can increase
Fx’al mobility in sport chairs but also can increase back strain d/t less support
WC seat height measure
Knees and ankles at 90
Footrests need a 2” clearance from floor
Standard: 19.5” -Hemi: 17.5”- Superlow: 14.5”
WC arm rest measure
shoulders in neutral, elbows at 90
Measure under elbow to cushion
*Too low will encourage leaning forward
*Too high will encourage shoulder elevation
Reclining Back WC
For pt unable to independently maintain and upright sitting position
Tilt-in-Space WC
Pressure relief
Or pt with severe extensor spasm
Recreational WC
Deigned with large think inner tube type tires and large front casters for all terrain use
Sport WC
Racing, cycling, basketball
Typically ultra light weight
Stander WC
Enable pt to independently change seat height and/or elevate to standing position
Stair Climbing WC
Navigates stairs while balancing on 2 wheels using sensors and gyroscopes
Bariatric WC
Heavy-duty, extra-wide - designed for obese
Body mass positioned several in forward in comp to non-obese
Rear axel is displaced forward - allowing for a more effective arm push
WC mobility training
Cog/phys capabilities; goals for community mobility; adjust fit; proper seating posture; pressure relief (push ups, lateral leans); additional devices; w/c propulsion (gloves/compensation); safety concerns; maneuverability; wc on various terrains; basic maintenance; developmental considerations
Assessment considerations for seating and positioning
First the pelvis, then LEs, trunk, UEs, head, neck and feet
Linear seating
Flat, non-contoured; custom/factory ordered; Firm/rigid seating
For active pts who perform own transfers & pts with min musculoskeletal involvment
Contoured/Custom Contoured seating
Ergo supportive, excellent support, enhances postural alignment, decreases abnorm posture, provided pressure relief, may be difficult for I transfers if decreased UE strength
Good for individuals with mod-severe CNS dysfunction or neuro dx
Bed mobility consists of
Bridging, sidelying, supine and sitting
Mobility/Positioning s/p THR
May not be able to roll on non-op side d/t internal rot of op side
May req aBductor pillow to prevent aDduction of op-hip
Mobility/Positioning s/p CVA
May req positioning edu to increase awareness, min pain, decrease swelling and promo tone normalization
May use pillows between legs while sidelying to increase comfort and promo proper positioning
Mobility/Positioning s/p amp of LE
May req edu on use of pillows for edema prevention
May req training on passive stretch of residual limb to prevent contractures
Tips for safe transfers
Clear areas of clutter Ask for help or SBA if needed Use gait belt if needed Stabilize locks/brakes Swing away legrest/flip up footplates Remove armrests if necessary
Pop-over or seated sitting transfer
full stand position not req
used for those with decreased endurance and/or WBP
Sliding board transfer
for pts not able to stand (SCI/amps)
Can be used with tenoedesis grasp while WB on clenched fist with wrists extended
ATDs
Assistive Tech Devices
Any piece of equ/product used to increase, maintain and improve functional abilities of pts with disabilities
High Tech vs Low Tech ADTs
costly devices that may req custom ordering
inexpensive household/catalog items that are readily available for use
EADLs
Electronic Aids to Daily Living - formerly ECUs
Means to purposefully manipulate/interact with environment by alternately accessing one or more electrical devices via switch, voice activation, remote control, comp interfaces, etc
Used to increase I, compensate for limitations, conserve energy
EADLs uses
Turn on/off lights, control appliances, open/close doors/drapes/windows
Allow use of phones/office machinery
Summon assistance
Consideration in AD selection
Input method, output method, portability, safety, reliability, durability, assembly ease, operation ease, maintenance sched, current/future affordability
When choosing AAC
Augmentative Alternative Communication
- Speed at which message is conveyed
- Portability
- Accessibility
- Dependability: quality, durability
- I of use
- Vocab flexibility
- Repairs/maintenance
AT Intervention Principles
Select/use several diff devices on trial basis
Incorporate all team input
Keep devices as simple as possible
If stationary, ensure device is properly positioned
Provide multiple training sessions
Funding for ATDs/EADLs
State Voc and Edu Services for Individuals with Disabilities (VESID); Office for Voc Rehab (OVRs); Divisions of Voc Rehab (DVRs) - if enable pt to go to work/school
Private co - ensure ADA compliance
Private, Medicare, Medicaid and Workers Comp*
Community Mobility
Ability to move around ones community to engage in desired occ/meaningful activities
Includes driving, walking, bicycling and pub transportation
OT role in driver rehab
Must know state regs and statutes related to ppl w disabilities
Must become state licensed driving instructor
*Should become certified driving rehab specialist
Driving eval
Operation: ability to steer, break, turn
Tactical: ability to respond to road changes
Driving Rehab Funding
VESID, OVRs, DVRs
Private, medicare, medicaid, WC
