Wheelchair Prescription and Mobility Flashcards
How should you measure a wheelchair’s seat height?
What is the average adult size?
measure from the user’s heel to the popliteal fold and add 2 inches to allow clearance of the foot rest
19.5 to 20.5 inches
How should you measure a wheelchair’s seat depth?
What is the average adult size?
measure from the user’s posterior buttock, along the lateral thigh to the popliteal fold; then subtract approximately 2 inches to avoid pressure from the seat against the popliteal space
16 inches
How should you measure a wheelchair’s seat width?
What is the average adult size?
Widest aspect of user’s buttocks, hips or thighs and add approximately 2 inches
18 inches
How should you measure a wheelchair’s back height?
What is the average adult size?
Approximately 4 inches shorter than patient’s axilla with their shoulder in 90 deg. flexion in order to avoid inferior border of scapulae and should be measured while sitting on seat cushion they are planning on using
16-16.5 inches
How should you measure a wheelchair’s armrest height?
What is the average adult size?
measure from seat to olecranon process with elbow flexed to 90 degrees and add 1 inch use proper cushion when measuring)
9 inches above chair seat
What patient would most likely benefit from using an ultralight frame?
a highly active patient with no need for postural support
this wheelchair is usually used for sports
What patient would most likely benefit from using an standard of lightweight frame?
a patient who is able to self propel using both UE and has adequate LE ROM and sitting ability for comfortable seating
What patient would most likely benefit from using a Hemi frame?
a patient able to self propel using lower extremities
What patient would most likely benefit from using a one hand drive frame?
patient is able to self propel using one UE
What patient would most likely benefit from using an amputee frame?
patient is able to self propel but center of gravity is shifted posteriorly due to amputation
What patient would most likely benefit from using a Power Wheelchair frame?
patient cannot self propel but is able to safely operate a power mobility device
What patient would most likely benefit from using a Geri Chair frame?
patient cannot self propel or safely operate a power mobility device and requires assistance for seated mobility
What patient would most likely benefit from using a reclining frame?
patient’s who cannot perform weight shifting tasks and/or is unable to sit upright for extended periods; moderate to severe trunk involvement
What patient would most likely benefit from using a backward tilt-in space frame?
patient is unable to sit upright or perform weight shifts, but also has issues with sliding or extensor tone
What patient would benefit from using a planar posterior (flat) headrest?
a patient who uses a reclining or tilt-in space wheelchair frame or who tends to maintain a hyperextended head/neck position in upright sitting
What patient would benefit from using a curved headrest?
patient’s who tend to maintain backward listing and/or lateral head and neck position in sitting, side panels provide more aggressive support
What patients would need a sling back insert?
a patient who requires no postural support and has no neuromuscular deficits, usually not for long term use
What patients would need a planar back insert?
patients who require mild to moderate postural support
What patients would need a curved back insert?
Patient who require moderate trunk support
What patients would need a custom molded back insert?
patient who require significant postural support due to severe postural concerns
What patients would need a removable back insert?
patients who’s wheelchair must be able to fold
What patients would need a back insert that is below the inferior angle of the scapula?
patient who is able to self propel and has good trunk control
What patients would need a back insert that is above the inferior angle of the scapula?
patient is either able to self propel but requires some spinal support or uses a power wheelchair with or without poor postural control
What patient would need a sling seat?
does not need postural support and has no neuromuscular deficits, not intended for long term use
What patient would need a planar seat?
patient has no seated deformity
What patient would need a curved seat?
need mild to aggressive supportive curvature to provide increased contact between the lower body and seat
What patient would need a custom molded seat?
requires custom seat to support or correct a pelvic obliquity or a fixed asymmetrical deformity
What patient would need a bevel front edge seat?
patient’s who self propel with LEs
What patient would benefit from using planar lateral trunk supports?
requires mild to moderate lateral support
What patient would benefit from using contoured or curved lateral trunk supports?
requires total contact lateral support for severe postural abnormalities
What patient would benefit from using a chest strap trunk support?
requires anterior trunk support
What patient would benefit from using a chest harness trunk support?
requires both trunk and shoulder support for anterior listing
What patient would benefit from removable armrests?
patients who transfer via slide board or two person max assist
What patient would benefit from having no armrests?
does not need any UE or trunk support
What patient would benefit from full length armrests?
performs sit to stand transfers, requires additional postural support, or uses a lap board
What patient would benefit from tubular or single posted armrests?
requires minimal support for the UEs but requires easy access to wheels for propulsion and needs easy removal of arms
What patient would benefit from using toggle/lever brakes (push/pull)?
has coordinated motor ability to operate brakes
What patient would benefit from using brake extension brakes?
requires additional leverage to operate toggle breaks or has limited ability to reach brake mechanism
What patient would benefit from using small diameter handrims?
Patients who have adequate strength to efficiently propel chair without adaptation
speedier
What patient would benefit from using large diameter handrims?
patient has some degree of weakness in UEs
requires more power
What is proportional control power mobility wheelchair controls?
What is non-proportional
allows user to modulate speed of device based on the displacement of the joystick
Device moves at one speed regardless of joystick displacement
What type of power mobility control is best for patients with high spinal level injuries?
sip-and-puff controls
Can head controls be proportional or non-proportional?
yes they can be either depending on patient’s needs and abilities
What are the pros and cons of solid seat cushions?
Pros: vareity of thickness and stiffness, typically lightweight
Cons: can produce shear forces
What are the pros and cons of liquid seat cushions?
Pros: Vary greatly in density and stiffness, limit shear forces
Cons: Heavy
What are the pros and cons of air filled seat cushions?
Pros: lightweight and minimal shear
Cons: require diligent monitoring and inflation levels
How does a patient in a wheelchair ascend a curb with a forward approach?
- elevate front casters of the wheelchair by tipping the wheelchair backwards
- move wheelchair forward until the rear wheels are in contact with the curb and casters are above the curb
- lower the casters on the elevated surface and ascend the curb with the rear wheels until the rear wheels and the casters are in contact with the elevated surface
How does a patient in a wheelchair ascend a curb with a backward approach?
- position patient facing away from the curb
- stand on upper surface, lift and roll the rear wheels backwards up the curb
- continue to roll the wheelchair backwards until the casters are in contact with the upper surface
How does a patient in a wheelchair descend a curb with a forward approach?
- position casters close tot he elevated edge of the curb
- tip the wheelchair backwards and slowly roll the wheelchair forward until the rear wheels are in contact with the lower surface
- gently lower the casters to the lower surface
How does a patient in a wheelchair descend a curb with a backward approach?
- position patient facing away from curb
- move wheelchair backwards and slowly lower the rear wheels to the lower surface maintaining contact with the curb
- continue to roll the wheelchair backwards and gently lower the casters to the lower surface
