Wheelchairs Flashcards
What is the name for the standard wheelchair seat?
- Sling seat
What is the effect of a sling seat on posture?
- Hips slide forward, adduct, IR
- Posterior pelvic tilt
What is an insert or contour seat?
Wood or plastic padded with foam.
What are the advantages of an insert or contour seat?
- Stable, firm
- Improves pelvic position
What is a seat cushion used for?
- Distributes weight bearing pressure to prevent decubitis ulcers
What is a countoured foam cushion for?
- Accomodates moderate to severe posture deformities
What do contour foam cushions make easier for caregivers? What does it make harder?
- Repositioning easier
- Slide transfers more difficult
What is the advantage of a fluid/gel combination cushion?
- Custom molded
- Accommodates moderate to severe postural deformity
What is the advantage of an air cushion?
- Accommodates moderate to severe postural deformity
- Light weight improves pressure distribution
What is the disadvantage of an air cushion?
- May be too unstable for some patients
- Requires constant maintainence
What can the patient do to relieve pressure?
Push ups every 15 - 20 minutes
Up to what level do most sling back chairs support?
- Mid scapula
What is the advantage, and disadvantage of a low back chair?
- Increases functional mobility
- Increases back strain
What is the advantage, and disadvantage of a high back chair?
- Helps with trunk stability
- Limits functional mobility
What can back inserts help a patient with?
Improve trunk extension and upright posture
What is the purpose of lateral trunk supports?
- Improves alignment
What are 4 variables to consider when picking out arm rests?
- Full/ desk length
- Fixed or adjustable height
- Removable or permanent
- Wraparound or not
What is the advantage of adjustable height and removable arm rests?
- Facilitate transfers
What is the advantage of a wraparound arm rest?
- Reduce width of chair by 1.5”
What can be attached to the arm rests?
- Support surfaces for additional posture assistance
What are 3 types of leg rests?
- Fixed
- Swing away/ detachable
- Elevating
What is the advantage of swing away/ detachable leg rests?
- Ease in transfers
What is the advantage of elevating legs rests? For whom is it contraindicated?
- Helps with edema and postural support
- Contraindicated for hamstring hypertonicity/ tightness
What are the 3 elements of foot rests?
- Foot plates
- Heel loops
- Straps
What effect does the weight of the wheel chair frame have?
- Lighter makes for better ease of use
What is the advantage of a folding and a fixed/ rigid chair?
- Fold facilitates mobility/ storage
- Fixed facilitates stroke efficiency
What are casters? How large are they typically?
- Small front wheels
- 8” in diameter
How can casters be made more stable during transfers?
Lock ‘em
What are the main wheels of the chair called?
Drive wheels
What can help increase grip on the outer rims of the drive wheels?
- Friction rims
- Leather gloves
- Projections to rims
What is a standard tire? What are its advantages?
- Hard rubber
- Durable and low maintainence
What is a pneumatic tire? What is its advantage and disadvantage?
- Air filled
- Smoother ride with shock absorption
- More maintainence
When are wheelchair brakes always engaged?
During transfers
When are extensions added to the brakes?
UE weakness and arthritis
What angle should seatbelts grasp the pelvis at?
45 degree angles
What is the advantage and disadvantage of an antitipping device?
- Prevent tipping with posterior extension of lower horizontal supports
- Limits curb and door mobility
What is a hill-holder device?
Automatically breaks when chair goes into reverse.
What patients need hill-holder devices?
Those who need to take breaks
What is the primary outcome of wheelchair prescription?
- Independence
- Maximum function
What are the 6 key wheelchair measurements?
- Seat width
- Seat depth
- Leg length/ seat to foot plate length
- Seat height
- Arm rest height
- Back height
How are seat width measurements taken?
- Width of patient’s hips at the widest part + 2 inches
What happens if the seat is too wide?
Can’t reach wheels
What happens if the seat is too narrow?
Pressure on lateral pelvis and thighs
What should be considered about the environment when measuring seat width?
Doorway width
How do you measure seat depth?
- Posterior buttock to posterior aspect of lower leg in popliteal fossa - 2 - 3 inches
What if the seat depth is too short?
Fails to support thighs accurately
What is the seat depth is too long? (4 effects)
Compromises knee circulation
- Kyphotic posture
- Sacral sitting
- Posterior pelvic tilting
How do you measure leg length?
- Bottom of shoe to just below the thigh in the popliteal fossa - seat cushion height
What if the leg length is too short?
Uneven weight distribution on thigh with excessive weight on ischial seat
What is the leg length is too long?
Sacral sitting; posterior pelvic tilting; sliding forward in chair
How is seat height mesured?
+ 2 to leg length, unless patient propels with feet
How is arm rest height measured?
- Should neutral, elbow flexed 90 degrees
- Measure from platform to just below elbow + 1 inch
What if the arm rest is too high?
- Shoulder elevation
What if the arm rest is too low?
- Leaning forward
How is back height measured?
- Seat platform to inferior angle of scapula, mid scapula, or top of shoulder based on patient support needs + seat cushion
What if the back height is too high?
- Difficulty getting into and out of van
- Prevents patient from accessing push handle for stabilization and weight relief
Describe patient education on maintainence.
- Wash, keep clean
- Maintain battery
Describe patient education on orientation to features.
- Locks
- Foot support
- Leg rests elevation
- Arm rests
What are 2 pressure relief techniques?
- Push offs
- Weight side to side shifting
What are 3 methods of propulsion? (dependent on patient)
- Both arms on wheels
- One arm on wheel, one foot pulling diagonally
- One arm on drive wheel controlling both
What is the 4 step patient education of power chair training?
- Driving skill and safety
- Use of switches/ controls (on/off, turns, joysticks)
- Maneuvers
- Safe stopping
How do you turn in a wheelchair?
- Push one hand harder than the other
- Or reciprocal push and pull
How does a pt ascend a ramp?
- Lean head and trunk forward; short, quick strokes
How does a pt descend a ramp?
- Control chair on the the way down with loose grip
OR - Wheelie down steep ramps
When in a wheelie, which wheel movement tips the chair back?
- Forward movement
When in a wheelie, which wheel movement tips the chair upright?
- Pulling back
How does one ascend curbs independently?
- Place casters
- Push rear wheels
- Use momentum and hips
How does one descend a curb independently?
- Backwards with forward head and trunk lean
- Forward in wheelie position
How do you get back into your chair!?
Read pages 347 - 363
