Wheelchair prescription Flashcards
“a wheelchair is an individualized dynamic seating system composed of a ____”
Postural support system
mobility base
Seating Principle #1
Stabilize proximally to promote improved distal mobility and function
- for wheelchairs, central focus becomes the pelvis
Seating principle #2
Achieve and maintain pelvic alignment
What is the optimal positioning for pelvis alignment?
neutral to slight anterior tilt without oblique positioning or rotation
- improves weight bearing across ischial tuberosities
- flexion at the pelvis can decrease tonal patterns
Seating principle #3
Facilitate optimal postural alignment in all body segments
Optimal alignment enhances ______
Stability
Comfort
Function
Seating principle #4
Limit abnormal movement and improve function
_________ are KEY to limiting abnormal movement and improve function
Observational Skills
Seating Principle #5
Provide the minimum support necessary to achieve anticipated goals and expected outcomes
Seating principle #6
Provide comfort
Loss of comfort leads to…
- abnormal movement
- asymmetry
- fatigue
- poor endurance
- lack of attention
- poor concentration
- avoidance
The Wheelchair Process
determine need > examination > prescription > funding/order > fitting > training > maintenance
Test and Measures important to include in wheelchair prescription
strength and endurance sensation and skin integrity vision and hearing health status cognition and behavior
Functional abilities important to include in wheelchair prescription
toileting bathing dressing eating communication transfers ambulation wheel chair mobility and skills
why is the mat table exam important?
It highlights flexible vs. rigid deformities
provides opportunity to look at pelvic, spine and hip alignments
Common postural deviations and corrections for wheelchair prescription
pelvic obliquity:
-named after lower side of the pelvis
-often accompanied by a compensatory lateral flexion of the spine
Pelvic Rotation:
-named after posterior half of the pelvis
-often accompanied by a compensatory counter rotation of the spine
What are the 7 wheelchair components?
back angle adjustment seat frame angle and height footrest system armrest system wheel options seat width and depth seat back
What are the 4 stages of pressure injuries?
stage 1
stage 2– partial thickness
stage 3– full thickness
stage 4– deep tissue exposure
What are the risk factors for pressure injuries?
sensory loss decreased mobility increased heat and/or moisture poor posture previous pressure injury poor nutrition and/or hydration increased age body weight (increased or decreased) tobacco use
“a way of testing at risk locations for skin break down, effectiveness of cushions and efficacy of pressure relief techniques”
pressure mapping
Advantages and disadvantages of foam cushions
advantages: light, inexpensive
disadvantages: cant be washed, increased skin temperature, must be replaced every 6 months
Advantages and disadvantages of air cushions
Advantages: better weight distribution, lowest interfaces pressures if inflated properly
Disadvantages: heavier, easily punctured, decreased stability, transfers difficult
Advantages and disadvantages of gel or fluid cushions
advantages: better weight distribution, minimizing shear forces during transfers, good choice for the active individual
disadvantages: heavy, promote increased skin temperature and moisture build-up at the surface, stability decreased, difficulty of transfers is increased
Advantages and disadvantages of flexible matrix cushions
still unknown; minimal research in the literature
