Wheelchair Prescription Flashcards
What components separate a wheelchair from a prescription wheelchair?
a prescriptive wheelchair is an individualized dynamic seating system composed a postural support system and a mobility base, and each of these components can be individualized to meet unique patient needs
What is the first seating principle for wheelchair prescription?
Stabilize proximally to promote improved distal mobility and function
What becomes the central focus of stabilization once a patient is in a wheelchair?
Once the pelvis is stabilized what should be the next step?
The pelvis
evaluate control at joints distally from stabilized pelvic position
What is the second seating principle for wheelchair prescription?
Achieve and maintain pelvic alignment
What is optimal pelvic alignment positioning for wheelchair prescription?
What are the benefits of this position?
neutral to slight anterior tilt w/o oblique positioning or rotation
- improves weight bearing across the ischial tuberosity
- flexion at the pelvis can decrease tonal patterns
What is the third seating principle for wheelchair prescription?
What are important aspects to consider with this principle?
Facilitate Optimal postural alignment in all body segments
- Can an individual attain optimal alignment independently?
- Do I need accommodative support?
What does optimal alignment in a wheelchair enhance?
- stability
- comfort
- function
What is the fourth seating principle for wheelchair prescription?
What is a key skill for this principle?
Limit abnormal movement and improve function
Observational skills
- abnormal movement leads to secondary sequela related to seated postures and limits function
- hunt and look for abnormal movement patterns and their causes
What is the fifth seating principle for wheelchair prescription?
Provide the minimum support necessary to achieve anticipated goals and expected outcome
What is the sixth seating principle for wheelchair prescription?
Provide Comfort
What does a loss of comfort often lead to?
- abnormal movement
- asymmetry
- fatigue
- poor endurance
- lack of attention
- poor concentration
- avoidance
What are the 6 seating principles for wheelchair prescription?
- Stabilize proximally to promote improved distal mobility and function
- achieve and maintain pelvic alignment
- facilitate optimal postural alignment in all body segments
- limit abnormal movement and improve function
- provide the minimum support necessary to achieve anticipated goals and expected outcomes
- provide comfort
What makes up the support team for a patient in a wheelchair?
anybody invested in the individuals present and future function, this includes therapists, physicians, nurses, family, friends, caregivers, etc.
What is the process for prescribing a wheelchair?
- determine need
- perform exam
- prescribe wheelchair
- obtain funding/make order
- fit wheelchair
- wheelchair training
- maintenance
What tests and measures should be tested during the wheelchair examination?
What functional abilities should be assessed?
tests and measures include:
- strength and endurance
- sensation and skin integrity
- vision and hearing
- health status
- cognition and behavior
Functional abilities:
- toileting/bathing
- dressing
- eating
- communication
- transfers
- ambulation
- wheelchair mobility
Where does a majority of wheelchair prescription take place? Why?
On the mat table because it can highlight flexible vs. rigid deformities and is an opportunity to look at pelvic, spine and hip alignments
What are the measurements need to be made when performing the wheelchair prescription exam?
- sitting depth
- popliteal fossa to heel
- surface of lower scapula
- hanging elbow to sitting surface
- width of trunk
- depth of trunk
- width of hips
- knee flexion angle
- back height from surface of PSIS
- surface to top of shoulder
- surface to back of occiput
- surface to crown of head
- foot length
How deep should the wheelchair seat be?
True or False: floor to seat height should not include the cushion height
True or False: back height will improve trunk stability but can limit propulsion
1-2 inches back from popliteal space
false, it should include the cushion height and should aim for 2 inches of foot clearance
True
True or False: The chair should be as narrow as possible
True, but there should be space for weight fluctuation, clothes and to prevent skin irritation
How are pelvic obliquity deviations named?
What often accompanies pelvic obliquity?
named after the lower side of the pelvis
accompanied by a compensatory lateral flexion of the spine