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Finn Final > Wheelchair > Flashcards

Wheelchair Flashcards

1
Q

The primary attention is given to

A

user and family goals for use of wheelchair as part of a functional mobility system.

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2
Q

The therapist evaluates

A
  • the skills of the user
  • the user’s ability to develop new skills
  • changes expected from diagnosis
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3
Q

Evaluation of needs:

A
  • interview
  • observation
  • examination
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4
Q

Trial with the following is useful to confirm appropriate prescription:

A
  • seating stimulators
  • trial seating systems
  • self-propulsion methods
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5
Q

Contexts to consider:

A
  • setting
  • caregiver support
  • physical contexts
  • accessibility
  • transportation
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6
Q

Functional skills consist of:

A
  • transfers- level of assist
  • self-care- FIM
  • mobility, propulsion
  • communication
  • bowel/bladder function
  • other equipment
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7
Q

Personal capacity and needs:

A
  • age and stature
  • developmental status
  • living environment
  • educational routines and work
  • recreational pursuits
  • assistive technology needs and uses
  • anticipated future needs
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8
Q

What does the medical profile consist of:

A
  • medical history and physical assessment
  • neuromuscular status
  • musculoskeletal status- exam and see if there are restrictions
  • sensory status
  • physiological status
  • whether condition is temporary, stable, or progressive
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9
Q

What joints would be restricted to sit 90/90

A
  • hip flexion- limited hip flexion

- knee flexion- causes them to slide out of chair

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10
Q

Seating assessment

A
  • vision, visual perception
  • tactile sensation
  • cognitive skills
  • psychosocial factors
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11
Q

Surgeries

A
  • tendon release
  • removal of heter-otopic ossification
  • G-tube or peg
  • Correction of scoliosis
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12
Q

Swallowing and digestion can be

A

high tone or low tone

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13
Q

High tone

A

reclining them 40 degrees makes it easier to swallow

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14
Q

Recommended guideline for swallowing

A

90-90-90

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15
Q

Skin history

A
  • present breakdown
  • past breakdown
  • surgeries
  • sensation
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16
Q

Social and environmental considerations

A
  • work or school
  • transportation
  • desk space
  • access to bathroom, cafeteria and playground
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17
Q

Special characteristics for wheel chairs:

A
  • Ascending or descending stairs
  • Use at the beach
  • Cycling configurations or adaptions
  • Sport wheel chairs for basketball or racing
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18
Q

Attention to the seating and posture needs is

A

critical in selecting a wheelchair system

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19
Q

Effective seating has several broad goals:

A
  • enhancing posture, comfort, physiological maintenance, and skin protection
  • preventing injury
  • accomodating existing deformity
  • enabling vision readiness and upper limb function
  • attending to cosmetic apperance and social acceptance
  • assisting with or enabling functional access and performance in specific settings or environments
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20
Q

Posture affects

A

vision and function

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21
Q

Candidates for manual mobility

A

-those who can propel and brake using upper extremities

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22
Q

Frame types

A
  • folding
  • amputee
  • indoor frame
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23
Q

Weights:

A
  • standard
  • lightweight
  • ultralightweight
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24
Q

Head and neck support would be for

A

Spinal cord injury

25
Q

Wheel chair types: Manual chairs->

A
  • hand rims- steel tube, vinyl coated, knobs, projections, hemi or two rims on one side, single-lever drive
  • augmentation for braking systems- grade aid devices, electric motor to aide braking and propulsion
  • antirotation locks on casters
26
Q

Wheel chair sizing:

A

measurements of the individual form the basis of determining wheelchair frame size, needs for adjustable ranges in component parts, and needs customization to meet special needs

27
Q

Sizing-

A
  • seat width
  • seat depth
  • back height and width
  • seat height and leg rests
  • armrest height
28
Q

Postural control is influenced by:

A

-the seat and back contact surfaces and by orientation adjustments to the seat-back angle and the angle in space

29
Q

Common seating positions

A

sitting position- 90 degrees hip, knee and ankle

  • slight anterior pelvic tilt
  • 95 degrees seat back angle with 3-5 degree angle in space recline
30
Q

Seating principles: solid base of support

A
  • a major principle in seating is the need to provide the individual with a solid base of support that begins with appropriate pelvic positioning
  • this is accomplished by stabilizing the pelvis on a firm surface with pressure distributed throughout the buttocks and the full length of each thigh
31
Q

Obliquities are named by

A

higher side

32
Q

By stabilizing the pelvis and aligning the spine you can enhance the function of

A
  • respiration
  • swallowing
  • digestion
33
Q

Head aligned over pelvis

A

pelvis does not have to sit evenly to align with the head and spine

34
Q

Fixed

A

surgically fused

35
Q

Flexible

A

Skeletally or muscularly limber and able to move into corrected position

36
Q

Difficult to correct

A

skeletally or muscularly stiff and maintaining some flexibility to be able to move into a corrected posture with a lot of pressure or forced

37
Q

Pressure forces:

A

Direct pressure is a perpendicular load or force exerted on a unit of area

38
Q

Dealing with direct pressure you should

A

distribute pressure evenly, over all surfaces

39
Q

What increases the risk of skin breakdown

A

posture and moisture

40
Q

How can a proper seating system help to prevent skin breakdown?

A

Colorful map, shows where increased pressure is

41
Q

Where is increased skin pressure?

A

IT’s and sacrum

42
Q

Selection of seat surfaces and cushioning:

A 
Cushion materials
-variable
-gels
-air
-honey comb
-heat and moisture
-friction
-durability
-cosmetic appearance
-sitting schedules and skin inspection
-additional pressure relieving techniques 
-Wheel chair pushups
-side leans
-forward leans
-tilt in space
-low pressure/alternating pressure
-
43
Q

Seat and back surfaces:

A
  • planar
  • precontoured
  • custom contoured
44
Q

Seat and back surfaces:

A
  • planar
  • precontoured
  • custom contoured
  • bead-seat molding
  • foam in place techniques
  • shape sensing technology
45
Q

Cushion characteristics

A
  • reduce peak pressures associated with bony lands
  • postural stability and control
  • ease of transfers
  • ability to accommodate deformity
  • moisture protection
  • ease of maintenance
46
Q

Seat belts help maintain the

A

90,90 angle

47
Q

lateral supports

A

significant trunk rotation or problems with postural control

48
Q

thigh supports

A

spasticity or tone

49
Q

anterior supports

A 
Across upper trunk
Across knees
Across ankles
Neck supports
Head supports
Specialized arm tests or lap trays
50
Q

Seating systems should allow for some ____

A

element of pressure release and freedom of movement

51
Q

Research needs to be increased to

A

address wheelchair transportation, postural control, comfort, and tissue integrity

52
Q

Final determinations

A

In making final determinations regarding seating components, size, style and control systems, the user and team take a comprehensive functional view

53
Q

The team must consider:

A
  • current and future mobility needs
  • desires of the user
  • resources of the user
  • environments of participation
  • anticipated changes in technology
54
Q

Expensive technology and options should not be ordered until

A 
less costly options are ruled out and unless justifiable for one of the following reasons:
Increased function
Health 
User satisfaction
Safety
55
Q

The clinicians responsibilities:

A
  • OT’s must remain current
  • with new technology, products and evaluations
  • advantages and disadvantages of various wheel chair components and features
  • issues related to availability
  • serviceability
  • Therapists are encouraged to explore wheelchair standards developed by the ANSI, Rehabilitation engineering society of North American, and the ISO
56
Q

If client is posterior pelvic tilt what should you consider next

A

see if they are flexible

57
Q

If client has lateral hip flexion->

A

Recline and tilt wheel chair

58
Q

What is your client has limited knee flexion: what muscle group is restricted

A

hamstrings

Finn Final (1 decks)

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