Wheelchairs

Question 1

List the types of seats used in wheelchairs

Answer 1

sling seat

insert or contour seat

Question 2

describe some general concepts pertaining to back support and wheelchairs

Answer 2

1. generally back goes up to midscapular region on standard wheelchair
2. lower back height may increase functional mobility (sport chairs)
3. high back height may be necessary for individuals with poor trunk control or extensor spasm
4. lateral trunk support for scoliosis

Question 3

what would elevating leg supports on wheelchairs be used for?

Answer 3

LE edema control

postural support

Question 4

what do heel loops on foot rests do?

Answer 4

help maintain foot position, prevent posterior sliding of foot

Question 5

what is a one-arm drive wheelchair?

Answer 5

used if pt has only one functional UE

2 hand rims attached to same wheel

larger rim controls far drive wheel, smaller rim controls near drive wheel

pushing both rims simulataneously moves W/C forward/backward

Question 6

what is a hemiplegic chair?

Answer 6

wheelchair that is low to the ground

allows propulsion with noninvolved UE and LE

Question 7

what is an AMP chair?

Answer 7

a LE amputation moves the pt’s COM posteriorly when seated making a normal W/C have an increased chance to tip posteriorly

AMP drive wheels set behind the vertical back support to move the BOS further to the rear

Question 8

list some considerations for selection of wheelchairs

Answer 8

1. pt prognosis
   
   • temporary or permanent?
2. Functional abilities
3. environmental constraints
4. safety
5. expense
6. low vs high tech

Question 9

list some principles for positioning in wheelchairs

Answer 9

1. patient comfort
2. stability and alignment
3. pressure sore prevention
4. respect precautions/contraindications

Question 10

list measurements on wheelchair we should know

Answer 10

1. seat to floor height
2. seat depth
3. seat width
4. back height
5. armrest height
6. seat-to-footplate length

Question 11

the seat depth provides ______________

Answer 11

support for pelvis and thighs

Question 12

if the seat depth is too narrow:

Answer 12

thighs are not properly supported, affecting weight distribution and comfort as well as pelvic position

Question 13

if the seat depth is too deep:

Answer 13

sacral seating

• individual slouches, sliding buttocks forward and posterioly tilting pelvis
• posterior aspect of sacrum on seat, can lead to improper postural alignment
• increases pressure on sacrum
• not optimal for efficient propulsion

Question 14

seat width too narrow:

Answer 14

excessive pressure on lateral aspects of pelvis and thighs

Question 15

seat width too wide:

Answer 15

difficult to reach the drive wheels

ineffective propulsion

individual may lean to one side to rest on the armrests

Question 16

back height too high:

Answer 16

restricts movement, skin irritation over inferior angle of scapulae

Question 17

back height too low:

Answer 17

decreased trunk stability, postural deviations

Question 18

describe the ideal seat-to-footplate length

Answer 18

set so that the thigh rests parallel to the cushion surface with the foot comfortably placed on the footrest

Question 19

too great of a seat-to-footplate length

Answer 19

individual may sacral sit in order to rest feet on footplates

Question 20

too short of a seat-to-footplate length

Answer 20

pressure distribution along thighs is uneven

Question 21

list areas that are of greater risk to pressure on a wheelchair

Answer 21

1. inferior angle of scapulae
2. ischial tuberosity
   
   1. sacrum/coccyx
3. greater trochanter
4. popliteal fossa