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PM&R > WC/seating > Flashcards

WC/seating Flashcards

1
Q

Purpose of WC prescription (6

A
  1. maximal efficient, independent mobility
  2. prevent/minimize deformity or injury
  3. maximal independent function
  4. congruent with “body image”
  5. short-term/long-term cost effective
  6. transportability
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2
Q

In evaluation process for WC, diagnosis includes what three aspects

A
  1. rate of neurological change
  2. prognosis
  3. precautions - what is the patient’s judgement level
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3
Q

In history portion of evaluation process for WC, what are 4 important issues to discuss?

A
  1. environmental issues
  2. transportation
  3. seating and mobility hx
  4. insurance coverage
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4
Q

in exam portion of eval process for WC, must perform which 4 portions of exam?

A
  1. general PE
  2. mat exam - simulate ROM and trunk control.
  3. seated exam - use cushion that is going to be used.
  4. measurements
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5
Q

the correct mobility device and seating system will make all the difference between ____

A

independence and dependence

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6
Q

Seating system is comprised of ___ and ____

A

seat and seat back

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7
Q

What are the two types of cushions?
Broken down into 5 types

A
  1. Custom - planar/linear; contoured
  2. Commercial

a. Simple foam
b. Contour
c. Closed cell foam (swedish foam)
d. comb-foam base and foam/gel
3. air “roho/star”

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8
Q

Goals of seating system:
1. Control ____
2. Correct/accomodate ___
3. Enhance ____
4. Improved ____
5. Provide ____
6. Facilitate ____.

A
  1. abnormal tone/reflexes
  2. deformities
  3. function/improve control
  4. comfort/seating tolerance
  5. pressure relief and skin protection
  6. facilitate care
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9
Q

Wheel chair types:
(7

A
  1. Age: adult vs peds
  2. Power: manual/manual assist/power
  3. Weight: heavy/standard/lightweight/ultralight
  4. Mobility: folding rigid/stand up frame
  5. reclining/non-reclining
  6. tilting/non-tilting
  7. metal/composite
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10
Q

Indications for manual WC:

A
  1. Physical limitations not compatible with ambulation
    - cardiopulmonary
    - neurological
    - MSK
  2. need for increased independence or transport
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11
Q

name the 9 manual WC parts

A
  1. frame
  2. wheels/tires
  3. handrims
  4. casters
  5. seat/back
  6. front-rigging
  7. arm rests
  8. brakes
  9. accessories
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12
Q

what are the three types of manual WC frames

A
  1. folding - will have cross bars!
  2. rigid
  3. semi-rigid
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13
Q

Benefit of a folding frame?
Con of folding frame?
Weight is: _____

A

Easy to transport
Limited width (max 20-22”)
heavier than rigid (28lbs prior to parts (~40-45lbs)

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14
Q

Benefit of rigid frame?
Con of rigid frame?
Difficult for ____ patients.

A

Lighter weight (11lbs); more durable
Not as easy to transport
ambulatory patients - due to sit to stand transfers being difficult

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15
Q

benefit of semi-rigid frame?
WEight?

A

Easy to transport, easier for ambulatory patients
Not as heavy/light (16lbs)

Has one-piece foot plate which folds. This is the “compromise chair”

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16
Q

Manual WC weights: (without addition of pieces and parts)
1. Standard:
2. Lightweight:
3. Ultra lightweight

A
  1. 40-65lbs
  2. 28-35lbs
  3. 11-20lbs
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17
Q

4 types of manual wheel chair wheels

A
  1. mag wheels
  2. spoke wheels
  3. spinergy - high tension composite rim has less flexibility creating propulsion efficiency
  4. X core - carbon graphite - propulsion efficiency
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18
Q

Advantage of weight/adjustabilityof manual WCs
1. Overall decreased ____
2. Allows patients with ecreased UE strength to:
3. Adjustability improves pushrim mechanics due to (3)

A
  1. repetitive strain injuries with prolonged use
  2. propel and break down/fold wheelchair for vehicle loading
  3. Better hand contact, lower stroke frequency, improved propulsion efficiency
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19
Q

3 characteristics of mag wheels:

A
  1. slightly heavier
  2. less shock absorption
  3. requires no maintenance
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20
Q

3 characteristics of X core wheels

A
  1. light weight
  2. no maintenance
  3. expensive

Carbon graphite creates propulsion efficiency

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21
Q

4 characteristics of spoke wheels

A
  1. lighter
  2. easier to propel
  3. improved shock absorption
  4. requires maintenance
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22
Q

Manual WC tire types (3)

A
  1. hard rubber
  2. pneumatic
  3. pneumatic with flat free inserts
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23
Q

5 characteristics of hard rubber (solid) mWC tires

A
  1. durable
  2. low rolling resistance
  3. heavy
  4. harsh ride
  5. no risk of flat tire
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24
Q

4 characteristics of pneumatic mWC tire

A
  1. air inner tube
  2. light weight
  3. smoothest ride
  4. can get flats
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25
Q

3 characteristics of pneumatic with airless insert mWC tire:

A
  1. rubber inner tube
  2. heavier than pneumatic -not as heavy as solid
  3. flat-free
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26
Q

Things to consider when choosing mWC handrim/pushrim

A
  1. diameter - large vs small (small loses propulsion efficiency)
  2. thickness
  3. projection knobs (“quad knobs” for impaired hand function)
  4. plastic coating
  5. natural fit? has thumb trough and oblong rim instead of round. great for carpal tunnelsyndrome
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27
Q

mWC projection knobs can be what two types? which portion of hand controls it?

A
  1. oblique - project with hypothenar eminence
  2. vertical - between thumb and 1st digit
28
Q

Manual wheel chair casters come in 3 sizes:

A
  1. Micro - 2”
  2. Small - 3-6”
  3. large - 8”
29
Q

5 characteristics for larger (8’) casters

A
  1. heavier
  2. more durable
  3. better for rough terrain
  4. increase rolling resistance
  5. increase chair length
30
Q

3 characteristics for micro casters (2’)

A
  1. lightest
  2. most maneuverable
  3. most likely to get stuck
31
Q

4 characteristics for smaller casters (3-6”)

A
  1. lighter
  2. more maneuverable
  3. shorten turning radius
  4. function poorly on uneven terrain and sidewalk cracks
32
Q

four types of wheelchair seat

A
  1. sling
  2. solid
  3. custom
  4. tension adjustable
33
Q

5 characteristics for sling (mWC seat)

A
  1. vinyl or Nylon
  2. easy to fold
  3. light weight
  4. cleans easily
  5. promotes poor poster - like sitting in a hammock, need trunk control
34
Q

4 characteristics for custom mWC seat

A
  1. variable firmness
  2. optimal postural support
  3. heavy
  4. positionally unforgiving
35
Q

4 characteristics for solid mWC seat

A
  1. firm
  2. provides better postural support
  3. heavier
  4. harder to transport - wont fold
36
Q

2 characteristics of tension adjustable mWC seat

A
  1. contour to fit back needs
  2. folds easily.
37
Q

Types of manual wheelchair back rest: (4)

A
  1. sling
  2. solid
  3. tension adjustable - straps/velcro in back of chair. allows for change incontour folds still so dont have to remove.
  4. variable height - low back allows patient to use back/trunk/scapular movement to propel.
38
Q

Rules for mwC back rest: the higher the back rest, the ____and ___

A

more support and less freedom

39
Q

Three types of footrest with or without leg rests

A

swingaway
elevating
fixed

40
Q

Name the four most common angles of mWC front rigging

A
  1. 60 - better for ROM issues or some compromise
  2. 70
    3 80
    4 90 - shortest front to back length

determined by size of castor

41
Q

Foot rigging = ____ + _____

A

hanger and foot plate

42
Q

Elevating foot rigging only appropriate for ___ or ____

A

new BKA or knee immobilization

43
Q

5 types of manual WC armrests

A
  1. fixed/removable
  2. full length/desk length
  3. adjustable/fixed height
  4. wrap around
  5. flip up
44
Q

4 pro’s to mWC armrest

A
  1. maintains good posture
  2. assists with trunk balance
  3. assists with transfers and pressure relief
  4. comfort
45
Q

6 types of mWC brakes

A
  1. push-to-lock
  2. pull-to-lock
  3. high/low mount scissor - more for mobile folks
  4. disc- can have varying degrees of slowing down, better for stopping at a higher speed. only on one side.
  5. attendant
  6. caster locks - stabilized front f chair for xfers
46
Q

mWC accessories: 2

A
  1. anti-tippers
  2. grade aides - helps with inclines. so patient doesn’t roll back while readjusting grip
47
Q

Manual wheelchair seat/back abilities: 2

A
  1. recline back - opens hip to seat or back to hip angle
  2. tilt n space back
48
Q

with reclining, increase in _______ or _____ as patient will slide forward and out of chiar

A

sacral pressure ulcer
extensor spasms

tilt first then recline for pressure relief (keeps hips locked in)

49
Q

three types of specialty manual WCs

A
  1. one arm drive - two hand rims one for each wheel
  2. Standing WC (stand-up WC)
  3. hemi-height - standing frame with wheels - basically a wheeled parapodium for kids.
50
Q

Power mobility indications - 4

A
  1. Physical limitations not compatible with manual WC mobility
  2. Need for increased independence
  3. increased efficiency of mobility
  4. spare UE from secondary msk dysfunction
51
Q

SCI patient’s may last ~ ______ in manual WC until joint salvage is needed “relative rest

A

15 years

52
Q

Unique Power mobility considerations (8)

A
  1. physical ability
  2. intelligence level
  3. age (beginning around ag e4-5
  4. judgement
  5. visual/perceptual skills
  6. transportability of powered mobility
  7. reimbursement
  8. patient/family goals
53
Q

9 components to power WC

A
  1. Drive
  2. control system
  3. wheels/tires
  4. casters
  5. seats/backs
  6. front-rigging
  7. armrests
  8. brakes
  9. accessories
54
Q

three types of drive

A
  1. rear
  2. mid/center drive - most like walking - most common first chair
  3. front - can turn sooner
55
Q

Types of power WC control systems (2)

A
  1. proportional (joystick) - most common
  2. non-proportional (switch, sip-n-puff, tongue touch keypad (TTK), head array)
56
Q

power wc casters types (2)

A

large
small

size of caster determines turn radius. Where Wheel is determines radius. Rear wheeel increases turn radius.

57
Q

power wheelchair seat/back

A

sling
solid - captain seating
custom - “rehab seating”

58
Q

Types of tilt in PWC

A

power tilt-n-space seat
power recline back - tilts, reclines, then elevates leg rests

59
Q

Power wheelchair front rigging (3)

A
  1. footplate
  2. swingaway - 70 degrees of angle
  3. manual/power elevating
60
Q

three types of power WC armrests

A
  1. fixed/removable
  2. full length/desk length
  3. flip-up
61
Q

accessories for PWC or MWC (6)

A
  1. anti-tippers
  2. laptrays - acrylic
  3. headrest
  4. thoracic support
  5. hip/thigh guides
  6. abductor pommels - helps to maintain solid pelvic base
62
Q

push assist wheelchairs (two types)

A
  1. smart drive - has natural fit rims (indoor and outdoor mode)
  2. power assisted propel - heavy, stage between MWC and PWC
63
Q

_____ is technology that measures the interface pressure between two surfaces - indicates the distribution of pressures over the surface or identifies areas of localized pressure increase

A

pressure mapping

64
Q

Xsensor pressure mapping system: 4 pros

A
  1. accurate
  2. real time data
  3. ultra flexible, thin sensing element
  4. pad conforms to surface
65
Q

4 display formats of xsensor pressure mapping system

A
  1. 2D image
  2. 3D image
  3. histogram
  4. frame comparison
66
Q

Pressure mapping works through ____ sensors.
Red ______ mmHG
Blue _____ mmHG

A

copper
200mmHg
35mmHg or less ——CAP REFILL PRESSURE

PM&R (78 decks)

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