week 4 Flashcards
Considerations in Selecting Type of Wheelchair and Components
Patient’s decrease in body function, structure,
and activity
Participation restrictions
Size and weight of the patient
Expected use
Prognosis for change in patient
Proper Seating and Positioning
Promote function
Prevent deformity
Improve body alignment
Prevent tissue damage
Prevent additional complications
Special supports:
Wheelchair Evaluation
Sitting balance
Stability
Reaching ability
Method of propulsion
Transfer method
Ability to change positions
Sitting posture
Initial Measurements
User seated on a firm, flat surface
User wears typical clothing.
User sits erect in a comfortable position
Confirmation of Fit
Seat height from floor
Leg length
Seat depth
Seat width
Back height
Armrest height
Footplate length
Improper Fit
Seat height too high
Insufficient trunk support
Difficulty positioning the knees beneath a table
Difficulty propelling the wheelchair because of the
difficulty in reaching the hand rims
Difficulty propelling the wheelchair using the lower
extremity and a heel strike technique
Poor posture
Seat height too low
Difficulty with transfers
Leg length
Footplates too low
* Increased pressure on the distal posterior aspect of the thigh
* Decreased upper extremity function
* Unsafe wheelchair mobility
Footplates too high
* Increased pressure on ischial tuberosities
* Difficulty positioning
* Decreased trunk stability
Seat depth
Too short
* Decreased trunk stability
* Increased weight bearing on the ischial tuberosities
* Increased pressure points on posterior thighs
* Poor sitting balance
Too long
* Increased pressure in the popliteal area, leading to skin
discomfort or compromised circulation
Seat width
Too wide
* Difficulty in propelling
* Difficulty performing a lateral transfer
* Difficulty moving through narrow hallways or doorways
* Postural deviations
Too narrow
* Difficulty in changing positions
* Increased contact with armrest panel leading to excessive
pressure at the greater trochanters
* Difficulty wearing bulky outer garments or orthoses
Back height
Too high
* Difficulty in propelling
* Excessive skin irritation over the inferior angles of the
scapula
Too low
* Decreased trunk stability
* Increased postural deviations
Armrest height
Too high
* Difficulty in propelling
* Difficulty in transfers
* Postural deviation
* Limited use of the armrest leading to decreased trunk
stability and fatigue
Too low
* Poor posture or back discomfort
* Increased abdominal discomfort
* Inadequate balance
* Difficulty rising to a standing position from chair
Patient and Family Education
Routine skin inspections
Routine pressure relief activities
Signs and symptoms of decreased circulation in
the legs: ankle edema, color changes in lower
extremities, decreased sensory responses to
surface stimuli, loss of hair follicles, ischemic
skin, soft tissue ulcers
Components and Features:
Armrests
Fixed
Adjustable
Removable or reversible
Desk length or full length
Components and Features: Wheels and Tires
-Caster wheels
Rear (drive) wheels
One-arm drive
Tires may be solid rubber, pneumatic, or
semipneumatic
Components and Features: Wheel Locks
Toggle lock
Z or scissors lock
Auxiliary lock for reclining back
Caster locks
Components and Features: Front Riggings,
Legrest, and Footrest Components
Swing-away or removable legrest
Elevating legrest
Footrest: fixed or adjustable angle
Integrated positioning devices
Pelvic positioning device
Chest strap
Types of Wheelchairs
Semireclining
Fully reclining
Externally powered
Sport or recreational
Lightweight or ultralight
Folding
Operation of Wheelchair Components
Operating and tightening the wheel locks
Removing and replacing the armrests
Operating the legrests
Elevating and lowering the footplates
Folding the wheelchair
Instructing others
Independent Propulsion
Bilateral upper extremities
One upper and one lower extremity
Bilateral lower extremities
ADA
Enforceable prohibitions and standards that ban
discrimination based on disability
Extend civil rights for people with disabilities
ADA Titles
Title I: Employment
Title II: Public Service
Title III: Public Accommodations
Title IV: Telecommunications
Title V: Miscellaneous Provisions
General Aspects of ADA
Four primary titles, each addressing a specific
protected category and having separate
compliance requirements
Private sector businesses must comply based
on employment numbers.
Workplace accommodations
full equal access
Compliance and Implementation
Determine essential functions of job
On-site job analysis
Prohibited topics during an interview:
Removal of Barriers
remove structural architectural barriers when removal is
readily achievable.
Access into a facility, freedom of movement, and
access to goods and services
Accessibility Audit Requirement
Categories
Ramps and slopes
Doors and hallways
Signage
Steps, stairs, and elevators
Flooring
Obstacles and protrusions
ADA Consultant duties
Educate.
Perform on-site job analysis.
Perform on-site environmental evaluation.
Help develop function-based job descriptions.
Advise on job-related accommodation needs.
Advise on the removal
Complex Power Wheelchair
Flexibility to change their seated position into power
tilt, recline, seat elevate
Drive control style from driving with a standard
joystick to driving with the head, chin, foot, or finger.
▪Hundreds of cushion options
Power Tilt
▪Whole seat tips backward up to 55 degrees on the
wheelchair base, maintaining the seated position
Power Recline
▪Backrest itself lays backward, allowing the client
to move into a lying down position when used in
combination with elevating/articulating leg rests
Leg elevation
Provides stretching, tone/spasticity management,
ROM, edema management, and pain relief, and
when positioned down in a flexed position, allow
the chair to turn in tighter spaces. Whole seat tips
backward up to 55 degrees
Seat Elevation
▪Allows the entire seat to move upward 8 to 14 inches
ROHO Cushion
▪Decrease the amount of pressure on the sitting area through a patented technology of interconnected neoprene air cells that increase and decrease in air volume to match an individual’s contours
