Wheelchairs Flashcards
6 Types of Wheelchairs
- Semi-reclining
- Reclining
- Externally Powered Wheelchair
- Sports Wheelchair
- Lightweight or Ultralight Wheelchair
- Standard Wheelchairs
6 Key Measurements to take in order to determine w/c size
- Seat Width
- Seat Depth
- Leg Length/Seat to footplate length
- Seat Height
- Arm Rest Height
- Back Height
How do you determine seat width?
Patients hip width at WIDEST part and then add 2 inches
What are the 2 problems with wheelchairs that are too wide?
- Patients cannot exhibit good postural stability
- They will not be able to reach their pushrims
What is the problem with wheelchairs that are too narrow?
Pressure sores begin to develop
How do you determine seat depth?
Measure posterior buttock to the posterior aspect of the lower leg on the popliteal fossa and then subtract 2-3 inches
What is the problem with wheelchairs whose seat depth is too short?
The patient will not have enough support
What are the 2 problems with wheelchairs whose seat depth is too long?
- Pressure sores begin to develop
- Circulation may begin to be cutoff (increase risk for deep vein thrombosis)
How do you determine leg Length/Seat to footplate length?
Measure from the bottom of the shoe (with footwear) to below thigh in the popliteal fossa.
*IF a seat cushion is used, subtract that height from the patient’s measurement
What is the problem with wheelchairs whose leg length is too long?
The pt ends up trying to reach out and develop sacral pressure sores
What is the problem with wheelchairs whose leg length is too short?
The patient’s posture is compensated
Do you have to measure for w/c seat height?
NO
What is the minimum clearance between floor and footplate?
2”
Typically how do you determine seat height?
Add 2 inches to the patient’s leg length measurement
What are the risks with wheelchairs whose back height is too high?
If it is too high you will put the pt in trunk flexion
What do you measure to determine the arm rest height?
From seat platform to just below the elbow held at 90 degrees with the shoulder in neutral position then add 1”
What is the problem with wheelchairs whose arm rest height is too high?
It forces the traps up causing cervical issues
What is the problem with wheelchairs whose arm rest height is too low?
The pt will slouch forward trying to reach them causing postural compensations
What does back height depend on?
The amount of needed support
What are the 3 measurements needed to determine back height?
From seat platform to…
A. Lower angle of scapula
B. Midscapula
C. Top of Shoulder
*If a cushion is used add its height to the pt measurement
What are the 2 problems associated with added back height?
- May have difficulty getting the w/c in and out of the car
- Pt cannot hook arm around back hand rests for pressure relief
Purpose of W/C Cushions
- Improves pelvic position
- Relieves Pressure
3 Types of w/c cushions
Contoured Foam
Fluid/Gel or Fluid/Gel/Plus Foam: Custom Molded
Air Cushion
What does ATP stand for?
Assistive Technology Professional
What does SMS stand for?
Seating and Mobility Specialist
ATP and SMS certifications are overseen by who?
Rehabilitation Engineering and Assistive Technology Society of North America (RESNA)
How are wheelchairs altered for amputees?
Rear Wheel Axles are positioned approx. 2” posterior to their ‘normal’ to improve BOS and compensate for the loss of weight of the user’s LEs.
How are wheelchairs altered for hemiplegia?
Seat is lowered approx. 2 inches for better use of LEs to propel chair
How can a pt drive with one hand?
Two Hand rims are fabricated on one drive wheel:
- Grip one, it will turn the chair & vice versa - Grip both rims: Drives WC forward or backward
How often does a pt need to shift in a chair?
Every 15-20 minutes
*Cushions do not increase the amount of time you can go in between pressure relief
What are some other signs/symptoms to watch for with patients in w/c’s
- Ankle Edema
- Color changes to toes, feet, or legs
- Decreased sensory response to surface stimuli
- Loss of hair follicles
- Assess LE pulses (femoral, popliteal, pedal)
- Venous stasis or ischemic skin
When ascending and descending curbs what way is easiest and why?
Facing forward because the pt is able to help
When ascending/descending stairs what is required?
At least 2 people to assist the patient
What are 2 potential problems when entering and exiting elevators?
- Castor wheels can get stuck in the crack which may result in the patient being flipped out of chair
Solution: enter back wheels first - The sensor does not detect the patient because they are typically set for a walking person
When reaching for objects on the floor in front of the chair what should the pt position the caster wheels into a forward facing position?
This will increase the BOS
When falling forward out of the wheelchair how should the patient position their pelvis?
pivot pelvis to land on one hip; or if knees hit first, then pivot to land on one hip
