Wheelchairs

Question 1

6 Types of Wheelchairs

Answer 1

• Semi-reclining
• Reclining
• Externally Powered Wheelchair
• Sports Wheelchair
• Lightweight or Ultralight Wheelchair
• Standard Wheelchairs

Question 2

6 Key Measurements to take in order to determine w/c size

Answer 2

1. Seat Width
2. Seat Depth
3. Leg Length/Seat to footplate length
4. Seat Height
5. Arm Rest Height
6. Back Height

Question 3

How do you determine seat width?

Answer 3

Patients hip width at WIDEST part and then add 2 inches

Question 4

What are the 2 problems with wheelchairs that are too wide?

Answer 4

• Patients cannot exhibit good postural stability

- They will not be able to reach their pushrims

Question 5

What is the problem with wheelchairs that are too narrow?

Answer 5

Pressure sores begin to develop

Question 6

How do you determine seat depth?

Answer 6

Measure posterior buttock to the posterior aspect of the lower leg on the popliteal fossa and then subtract 2-3 inches

Question 7

What is the problem with wheelchairs whose seat depth is too short?

Answer 7

The patient will not have enough support

Question 8

What are the 2 problems with wheelchairs whose seat depth is too long?

Answer 8

• Pressure sores begin to develop

- Circulation may begin to be cutoff (increase risk for deep vein thrombosis)

Question 9

How do you determine leg Length/Seat to footplate length?

Answer 9

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

Question 10

What is the problem with wheelchairs whose leg length is too long?

Answer 10

The pt ends up trying to reach out and develop sacral pressure sores

Question 11

What is the problem with wheelchairs whose leg length is too short?

Answer 11

The patient’s posture is compensated

Question 12

Do you have to measure for w/c seat height?

Answer 12

NO

Question 13

What is the minimum clearance between floor and footplate?

Answer 13

2”

Question 14

Typically how do you determine seat height?

Answer 14

Add 2 inches to the patient’s leg length measurement

Question 15

What are the risks with wheelchairs whose back height is too high?

Answer 15

If it is too high you will put the pt in trunk flexion

Question 16

What do you measure to determine the arm rest height?

Answer 16

From seat platform to just below the elbow held at 90 degrees with the shoulder in neutral position then add 1”

Question 17

What is the problem with wheelchairs whose arm rest height is too high?

Answer 17

It forces the traps up causing cervical issues

Question 18

What is the problem with wheelchairs whose arm rest height is too low?

Answer 18

The pt will slouch forward trying to reach them causing postural compensations

Question 19

What does back height depend on?

Answer 19

The amount of needed support

Question 20

What are the 3 measurements needed to determine back height?

Answer 20

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

Question 21

What are the 2 problems associated with added back height?

Answer 21

• May have difficulty getting the w/c in and out of the car

- Pt cannot hook arm around back hand rests for pressure relief

Question 22

Purpose of W/C Cushions

Answer 22

• Improves pelvic position

- Relieves Pressure

Question 23

3 Types of w/c cushions

Answer 23

Contoured Foam
Fluid/Gel or Fluid/Gel/Plus Foam: Custom Molded
Air Cushion

Question 24

What does ATP stand for?

Answer 24

Assistive Technology Professional

Question 25

What does SMS stand for?

Answer 25

Seating and Mobility Specialist

Question 26

ATP and SMS certifications are overseen by who?

Answer 26

Rehabilitation Engineering and Assistive Technology Society of North America (RESNA)

Question 27

How are wheelchairs altered for amputees?

Answer 27

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.

Question 28

How are wheelchairs altered for hemiplegia?

Answer 28

Seat is lowered approx. 2 inches for better use of LEs to propel chair

Question 29

How can a pt drive with one hand?

Answer 29

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

Question 30

How often does a pt need to shift in a chair?

Answer 30

Every 15-20 minutes

*Cushions do not increase the amount of time you can go in between pressure relief

Question 31

What are some other signs/symptoms to watch for with patients in w/c’s

Answer 31

• 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

Question 32

When ascending and descending curbs what way is easiest and why?

Answer 32

Facing forward because the pt is able to help

Question 33

When ascending/descending stairs what is required?

Answer 33

At least 2 people to assist the patient

Question 34

What are 2 potential problems when entering and exiting elevators?

Answer 34

• 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

Question 35

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?

Answer 35

This will increase the BOS

Question 36

When falling forward out of the wheelchair how should the patient position their pelvis?

Answer 36

pivot pelvis to land on one hip; or if knees hit first, then pivot to land on one hip