Wheelchair And Seating Flashcards
Non wheelchair mobility devices
Hemiwalker, four wheeled walker, two wheeled walkers, canes, scooters, crutches, lofstrand cutch, trekking stick
Rollator
4 wheeled walker
Not appropriate for pts who need alot of stability or cognitive deficits impacting ability to lock brakes
Front wheeled/2 wheel walker
Used for balance deficits, front wheels can be turned inside to clear doorways, grip at wrist height
Cane
Walking aid, provide postural stability, maintaining good posture
Durable medical equipment
Withstands repeated use and primarily/customarily used to serve a medical purpose and not useful to a person in absence of illness/injury
Can be rented
Custom/complex rehab tech
Products and associated services including medically necessary, individually configured devices that require eval, configuration, fitting, adjustment, programming
Custom manual wheelchair, power wheelchair, adaptive seating, alternative positioning devices
Role of OT in seating and mobility
Holistic evals to assess skills, patterns of daily living and mobility
Identify needs, interest, goals, supports, and barriers
Assess/recommend environmental settings to understand type of mobility device
Assess/align equipment and specific features with client, needs, goals, and environment
Assist clients/caregiver education of device use
Remain current about policy/reimbursement
Assistive technology practitioner
Credential required for many type
Of systems and funding sources offered by rehab and assistive technology association of north america
rehab tech supplier ensures consumers best interest
Certified Rehab Technology specialist
Credential through national registry of rehab tech suppliers
Role of Rehab Technology supplier
Equipment vendor/distributor, access to various manufacturers, knowledge of equipment, equipment limitations, working knowledge of equipment applications, provider of equipment details for funding, helps get trial equipment
Seating evaluation
Assess all client factors to determine needs match equipment, medical information determines needs
1) primary dx that lead to mobility limitations
2) secondary dx comorbidities
3) past/future sx, hold off until after surgery posture
4) height/weight, instability need for alternative feeding
5) pertinent medical status prosthesis ventilators o2 tanke
6) environment
7) transportation
8)pain
9) functional sensory ability
10) skin integrity
11) current mobility base
12) seating system on mobility base
13) posture in current equipment
14) motor/mobility skills
Medicare mobility device algorithm
Cane/crutch to walker to manual wheelchair to manual wheelchair with power assist to scooter to power chair with joy stick to power wheelchair with alternative controls to dependent
Postural assessments
Complete on firm surface such as mat or armchair, bed will sag, wheelchair surface will hammock
Measurements
LE length=foot plate placemebt
Hip width = width of seat
Buttock to upper leg=depth of seat
Shoulder height= back support
Measure with yard stick or metal, soft measuring tape bends
If hips are abducted measure hip to hip
Seat depth measure pelvis to popliteal fossa
Back supports
Depends on need
-if you need alot of support want it to go to shoulders
-ultra low for access to wheels
Wheelchair angles
Pelvis to thigh = seat to back angle
Trunk to thigh = seat to back angle
Thigh to calf = seat to leg rest angle
Calf to foot = leg rest to foot angle
Make note of flexibility of spine against gravity, change gravitational pull for posture/head position
Posture assessment: anterior pelvic tilt
Lordosis, center of gravity forward, pressure on pubis
Posture assessment: posterior pelvic tilt
Kyphosis, sacral pressure, shoulder girdle moves forward, sliding
Posture assessment: pelvic obliquity
Pressure on ischial tuberosity, concavity at ribcage, may lead to scoliosis, lateral leaning/instability
