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PTA 201 REHAB > Wheelchairs chap7 big red 33 > Flashcards

Wheelchairs chap7 big red 33 Flashcards

1
Q

Wheelchairs
Objectives

By the end of the class, the student will be able to:
Identify and describe the purpose of key components and features of wheelchairs

A

fyi

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2
Q

“a device used to provide support or to straighten or to correct a deformity.”

A

Orthosis-

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3
Q

A wheelchair is a?

A

mobility orthosis

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4
Q

an artificial device to replace a part of the body

A

Prothesis

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5
Q
  • Postural support + mobility base (p1288- Phys Rehab)
  • PT will examine patient to determine appropriate wheelchair
  • Insight from all team members is important
  • Goal is to help patient achieve maximal function
  • Goals must be discussed with patient to ensure realistic expectations are shared
A

The Prescriptive Wheelchair

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6
Q

Information Gathered to choose a wheelchair for a pt

A
  • ROM
  • Anthropometric measures
  • Strength
  • Current/existing wheelchair
  • Postural alignment- big deal
  • Caregiver’s attitude
  • Caregiver’s comfort with technology
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7
Q

which wheels turn the wheelchair?

A

the caster wheels

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8
Q

Locks of wheelchair

A
  • ALWAYS HAVE THE W/C IN A LOCKED MODE WHEN HAVING THE PATIENT TRANSFER OR SITTING AT REST
    • Toggle- most typically seen
  • Has an extension option (p143- P & T of Patient Care)
  • Z or scissors lock
  • Auxillary lock
    • Reclining wheelchairs
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9
Q

Leg Rests

A
  • Elevating-
  • Great to accommodate for a patient’s ROM ability
  • Calf panel for leg support
  • Caution: when lowering the leg rest- support the patient’s lower extremity
  • Leg rests can typically pivot outward to clear space for transfers
  • Footrests (footplates) p144
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10
Q

When lowering the leg from a leg rest what should you do?

A

brace or hold the leg so it doesn’t swing down

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11
Q

Choosing a Wheelchair

Selecting the appropriate w/c (P&T, p134, Box 7-1)
Types of w/c (p134, Table 7-1)

A
  • standard adult
  • heavy-duty adult
  • ultralight
  • intermediate or junior
    • growing child or youth
    • indoor
  • hemiplegic
  • amputee
  • one-hand drive
  • externally powererd
  • sports
  • reclining
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12
Q

Measurements for Proper W/C Fit

Standard Wheelchair

Seat height/leg length

A

heel to popliteal fold (+ 2 inches)

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13
Q

Measurements for Proper W/C Fit-Standard Wheelchair

Seat depth

A

heel to popliteal fold (+ 2 inches)

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14
Q

Measurements for Proper W/C Fit-Standard Wheelchair

Seat width

A

widest aspect of buttocks, hips, or thighs (+ 2 inches)

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15
Q

Measurements for Proper W/C Fit-Standard Wheelchair

Back height

A

seat of chair to axilla (- 4 inches)

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16
Q

Measurements for Proper W/C Fit-Standard Wheelchair

Armrest height

A

seat of chair to olecranon process (+ 1 inch)

17
Q

fyi

confirmation of fit of wheelchairs (p136 & 137)- KNOW

A

fyi

18
Q

What if the armrests are too high? What difficulties might that pose for the patient?

Too low?

A
  • too high- tightness in shoulders, postural stability off
  • Too low? no support, may not be as functional
19
Q

Folding Wheelchairs instructions

A
  • Move heel loops forward and raise footrests
  • Pull up on seat rails or on the front and back of the seat upholstery (p149)
  • Reclining chair- back support bar is removed first
  • To unfold- lift rear wheels using push handles and move handles away from each other.
20
Q

Wheelchair Propulsion- Forward and Backward

A
  • Hands positioned on handrims at top of the wheel
  • Hands positioned at 2 o-clock position for forceful forward propulsion; hands in 10 o-clock position for forceful backward
21
Q

Wheelchair Propulsion- Turning

A

Hold one handrim and pull/push the other handrim

22
Q

Elevation of caster wheels

A

Use the tipping lever and push handles (p150)

23
Q

Ascending a curb forward (p150)

A
  • Tip up caster wheels
  • W/C propelled forward until drive wheels touch curb
  • Slow lowering of caster wheels
  • Assistance getting drive wheels up and over the curb
24
Q

Ascending a curb backward

A
  • W/C propelled backward until drive wheels touch curb
  • Tip up caster wheels
  • Pull on push handles so chair ascends the curb on the rear drive wheels
  • Turn chair
  • Slow lowering of caster wheels
25
Q

Descending a curb forward

A
  • Get to edge of the area (close to curb)
  • Tip caster wheels up
  • Carefully and slowly push w/c forward and allow drive wheels to go over the curb
  • Lower caster wheels using the tipping lever
26
Q

Descending a curb backward

A
  • Drive wheels to curb; caster wheels on sidewalk (area)
  • Assist drive wheels down off the curb
  • Elevate caster wheels to clear the curb; back up or turn w/c
  • Lower caster wheels
27
Q

Ascending and Descending Steps

A
  • Ascending- drive wheels up first (p151)
  • Descending- caster wheels will be tipped up and chair remains in reclined positioned as drive wheels are taken down each step.
28
Q

Ramps and Inclines

Ascending

A
  • Elevate caster wheels and pull up backward or push up forward
  • Pulling up backward on all four wheels is not recommended (if assisting patient)
  • What can a patient do to optimize ascending an incline if performing independently?
29
Q

Ramps and Inclines-Descending

A
  • Elevate caster wheels to slow down descending motion
  • Descend backward with all four wheels on the ground
  • What can a patient do to optimize descending if performing independently?
30
Q

Independent Function-Wheelie or Pop-up

A
  • Takes practice and continued practice
  • Patient must have B UE strength, coordination and balance
  • Instruct patient to pull back quickly and evenly on both handrims and then abruptly stop the rearward motion of the wheels
  • Backward movement should be an attempt to create a momentum, not propel the chair backward
  • Once casters are elevated a small forward movements cause rearward movements of the chair and small backward movements cause forward chair movement
31
Q

Considerations for Doors and Elevators (Procedure 7-8 & 7-12)

Positioning for entering

A

Doors

  • Open to
  • Open away

Elevators

  • Look at any differences in floor height versus elevator floor
32
Q

Considerations for Doors and Elevators (Procedure 7-8 & 7-12)

Entering backward

A
  • Will need assist
  • Watch legs
33
Q

Reaching Forward-P165 & 166

Note the position of the caster wheels

A
  • Caster wheels are positioned forward
  • Examine the picture in the text to visually understand what is considered a “forward facing caster wheel”
34
Q

Protected Fall-Procedure 7-14

Hopefully seldom required by the patient; however, it does occur?

A

DrW will go over it in lab

35
Q
A

PTA 201 REHAB (7 decks)

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