Wheelchairs

Question 1

How often should a patient do pressure relief push ups?

Answer 1

every 15-20min

Question 2

How far up should the back of a wheelchair go?

Answer 2

mid scap height

• for standard sling back chairs, that is
• for sportier chairs, may go lower to afford more movement

Question 3

What type of w/c frame improves the stroke efficiency?

Answer 3

rigid frame increases distance per stroke

Question 4

If your patient has difficulty ascending a ramp without taking a break, what additional attachment might you want for their w/c?

Answer 4

hill holder device: mechanical brake that allows the chair to go forward, but brakes when the chair goes in reverse

Question 5

What adaptations can be made to a bariatric wheelchair to allow a more efficient push as well as stability in the chair?

Answer 5

• rear axle is displaced forward for increased stability

- positions center of body mass forward and allows for arm push that requires less wrist ext

Question 6

What kind of tires should be used for increased durability for a bariatric w/c?

Answer 6

hard tires, vs pneumatic tires

Question 7

T/F: A reclining wheelchair back might be a good idea for bariatric patients.

Answer 7

true to allow for increased girth

Question 8

How should you measure for seat width?

Answer 8

measure hip to hip, then add two inches

Question 9

Why don’t you want the width of a w/c seat too big, nor too small, but just right?

Answer 9

too big = difficulty getting to push wheels, proper propelling

too small = discomfort on pelvis/thighs

Question 10

When measuring the seat width for a patient who’s obese with a pear shape, what needs to be taken into consideration?

Answer 10

they’ll have more width with gluteal/femoral area when sitting, so consider widest portion of seated position
- aka forward edge of seated position

Question 11

How do you measure for seat depth?

Answer 11

posterior buttock to posterior aspect of lower leg in the popliteal fossa: subtract 2-3in from this measurement

Question 12

Your patient demonstrates sacral sitting in his w/c. What might you look to see regarding the seat depth?

Answer 12

too long of a seat depth can cause sacral sitting

Question 13

What are the results of improper leg length measurement for a w/c?

Answer 13

leg length = bottom of shoe to popliteal fossa

• too long = sacral sitting to help reach the foot plates, sliding forward in chair
• too short = uneven weight distribution onto thighs and ischium

Question 14

How do you measure for seat height for a w/c?

Answer 14

add two inches to pt’s leg length measurement

- footplates should be 2in above floor

Question 15

What are the standard w/c seat measurements for width, depth, and height for an adult?

Answer 15

seat width: 18in
seat depth: 16in
seat height: 20in

Question 16

How do you instruct your patient learning w/c mobility to complete a sharp turn?

Answer 16

yank back on one side, push forward on the other

- compared to just pushing forward on one side for a sloping turn

Question 17

How do you instruct your patient learning w/c mobility to ascend a ramp?

Answer 17

forward lean of head and trunk, use short quick strokes

Question 18

How do you instruct your patient learning w/c mobility to descend a steep ramp?

Answer 18

wheelie position

- if it’s too steep to just loosely grip hand rims and coast your way down, then you do wheelie

Question 19

T/F: When popping a wheelie, instruct your patient to keep their head and trunk backward to assist with attaining the position.

Answer 19

false, you throw the wheels forward while keeping your body forward so that you don’t tip all the way back
- bringing your head and body back would make you tip all the way back… ow

Question 20

Pushing the wheels forward in a wheelie makes the chair tip further…. forward? or back?

Answer 20

back

• and opposite: pulling wheels back makes chair tip to upright

Question 21

How do you instruct your patient learning w/c mobility to descend a curb?

Answer 21

can do it backwards with forward head/trunk lean, OR descend forward with a wheelie

Question 22

How do you instruct your patient learning w/c mobility to ascend a curb?

Answer 22

wheelie the castors up, then use momentum to really push yourself up

Question 23

T/F: Pts with complete C6 SCI can be independent with transfer board on level surfaces.

Answer 23

true

Question 24

T/F: Head/hips move in opposite directions.

Answer 24

true (head hips relationship)

Question 25

Why might a patient need elevating leg rests?

Answer 25

for edema control

Question 26

For your patient with extensor spasms, what can you do with your w/c to control for this?

Answer 26

• higher back support
• pelvic strap to keep hips in flexion
• tilt in space design to keep pt from coming out of chair during active spasms

Question 27

What is an appropriate seat height for a patient that’s a hemi?

Answer 27

17. 5in

- standard is 20in, but want them to be lower to have better control with unilateral leg pulling/pushing

Question 28

Children as young as how old can operate a power w/c?

Answer 28

18mo