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AY BMSc Lectures > Wheelchairs & Posture > Flashcards

Wheelchairs & Posture Flashcards

1
Q

What are the 4 main types of wheelchair?

A

Manual attendant propelled wheelchairs
Manual occupant propelled wheelchairs
Powered attendant controlled wheelchairs
Powered occupant controlled wheelchairs

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2
Q

What are the 4 manual wheelchair categories?

A

Occupant propelled
Attendant propelled
Seating wheelbases
Bariatric

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3
Q

What is the brand name of the lighter weight wheelchair?

A

Dash Lite

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4
Q

Name 2 standard semi-modular NHS wheelchairs?

A

Lomax Uni

Remploy Access

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5
Q

What are the 2 active user wheelchairs?

A 
Sunrise Neon (folding frame) 
Sunrise Helium (rigid frame)
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6
Q

What are the 3 positions of seating wheelbases?

A

Tilt-in-Space
Recline
Recline and Tilt-in-Space

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7
Q

Name 7 propulsion systems

A 
Levers 
Cranks 
Feet
Somebody else 
Handrims 
Electricity 
Engine
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8
Q

What are the disadvantages of an engine as a propulsion system?

A

Noisy

Smelly

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9
Q

What factors should be considered in a foot propelled wheelchair?

A

Seat height
Castor size
Cross braces

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10
Q

What s the preferred elbow angle for able bodied patients in Dundee?

A

107-118 degrees

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11
Q

What is the preferred elbow angle for MS patients in Dundee?

A

90-110 degrees

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12
Q

What is the preferred elbow angle for SCI patients in Dundee?

A

128-135 degrees

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13
Q

What are cambered wheels?

A

Bottom of wheel angles out away from wheelchair

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14
Q

What factors determine the manoeuvrability of a wheelchair?

A

Castor rake
Castor diameter
Wheel position

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15
Q

What are the basic features of an Electric Powered Indoor Chair (EPIC)?

A

Compact
Small turning circle
Small drive wheels
Low power

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16
Q

What are the basic features of an Electric Powered Indoor/Outdoor Chair (EPIOC)?

A 
Larger drive wheels 
Greater power 
Greater torque 
Greater range 
Ability to climb kerbs
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17
Q

What are the 3 drive wheel positions of an EPIOC?

A

Rear-wheel drive
Mid-wheel drive
Front-wheel drive

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18
Q

What factors affect the stability of a wheelchair?

A 
Wheelbase
Position of centre of gravity 
User wight 
Anti-tippers 
Castor orientation 
Camber
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19
Q

What is the EPIOC kerb climber?

A

Device which enables the wheelchair to ascend kerbs of up to 4” high (contacts kerb first and lifts castors up to pavement)

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20
Q

What are the 2 types of EPIOC kerb climber?

A

Central

Bilateral

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21
Q

What are the advantages/disadvantages of a central kerb climber?

A

Adv

  • simpler
  • direction less critical

Disadv

  • impede transfer
  • impede foot position
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22
Q

What are the advantages/disadvantages of a bilateral kerb climber?

A

Adv
- swing out of way for transfers

Disadv

  • more complex
  • direction more critical
23
Q

What are the 2 options for flexibility of an EPIOC?

A

Folding frame

  • remove batteries
  • fold up as per manual wheelchair
  • still significant weight due to motors

Folding or removable backrest
- makes powerchair more compact for hoisting into a car

24
Q

What is stage I of development of a pressure sore?

A

Nonblanchable erythema: heralding lesion of skin ulceration

25
Q

How can stage I of a pressure sore present in individuals with darker skin?

A 
Discolouration of the skin 
Warmth 
Oedema 
Induration 
Hardness
26
Q

What is stage II of development of a pressure sore?

A

Partial thickness skin loss involving epidermis or dermis or both

27
Q

How does a stage II pressure sore present clinically?

A

As an abrasion, blister or shallow crater

28
Q

What is stage II of the development of a pressure sore?

A

Full-thickness skin loss involving damage or necrosis of subcut tissue which may extend down to but not through underlying fascia

29
Q

How does a stage III pressure sore present clinically?

A

Deep crater with or without undermining of adjacent tissue

30
Q

What is stage IV of development of a pressure sore?

A

Full thickness skin loss with extensive destruction, tissue necrosis or damage to muscle, bone or supporting structures (such as tendon and joint capsule)
Undermining and sinus tracts may also be asssociated

31
Q

Name 6 extrinsic factors that can result in a pressure ulcer

A 
Excessive uniaxial pressure 
Friction and shear forces
Impact injury 
Heat 
Moisture
Posture
32
Q

Name 8 intrinsic factors that can result in a pressure ulcer

A 
Immobility 
Sensory loss
Age 
Disease
Body type 
Poor nutriiton 
Infection 
Incontinence
33
Q

Equation for pressure

A

P = F/A

34
Q

What are the 5 at risk pressure areas when sitting?

A 
Head
Shoulder
Sacrum 
Buttock
Heel
35
Q

What are the objectives of cushion design?

A 
Even pressure distribution 
Low temperature at skin surface
Low humidity at skin surface 
Pelvic stability 
Practicality of usage
36
Q

When considering cushion design what is the ‘clinic effect’?

A

When the patient adopts a different posture when monitored

37
Q

In a neutral pelvis how are the ASIS and PSIS related?

A

Neutral pelvis: ASIS and PSIS are level

38
Q

Describe the ‘ideal’ pelvic posture

A

Neutral alignment (head balanced over spine, sine balanced over pelvis)
Neutral pelvis (ASIS and PSIS are level)
Shoulders slightly posterior to pelvis
Head in neutral position with eyes (gaze) forward
Equal weight bearing through ischial tubersoties

39
Q

What is the most common pelvic tendency?

A

Posterior pelvic tilt

40
Q

Describe posterior pelvic tilt

A 
ASIS higher than PSIS
Flexed lumbar spine 
Thoracic kyphosis 
Shoulder protraction 
Increased cervical extension 
C-type posture ("slumped")
41
Q

What wheelchair factors can cause posterior pelvic tilt?

A 
Seat depth too long 
Back support too short 
Sling back upholstery 
Elevating leg rests 
Lower extremities are not supported well
42
Q

What physical conditions can cause posterior pelvic tilt?

A 
Tight hamstrings (knee extension) 
Reposition themselves by sliding 
Cannot maintain 90 degrees of hip flexion
43
Q

Describe anterior pelvic tilt

A

ASIS lower than PSIS
Increased lumbar lordosis
Thoracic kyhosis is reversed or reduced
Shoulder retraction

44
Q

What causes an anterior pelvic tilt?

A

Weak muscles/low tone
Weak hamstrings
Weak abdominals
Tight hip flexors (ilipsoas and rectus femorus)

45
Q

Describe pelvic obliquity

A

One ASIS is higher than the other
Compensatory C-shaped curve in the lumbar and thoracic spine
The shoulder on the side of obliquity tends to be elevated

46
Q

How is a pelvic obliquity named?

A

Named for the side that is lower

47
Q

What wheelchair facotrs cause a pelvic obliquity?

A

Sling back upholstery

Wheelchair too wide

48
Q

Whta physical conditions cause pelvic bliquity?

A

Muscle imbalance

Irregular muscle tone (high or low tone on one side of the trunk)

49
Q

Describe pelvic rotation

A

One side of the pelvis is more forward than the other side (some level of rotation is usually found in those who have a pelvic obliquity)

50
Q

What are the 3 points for pelvic stabilizatoin?

A

Seat, back and anterior support

51
Q

Describe the lower body ‘ideal’ posture?

A

Feet flat on footplate in neutral position
Ankles 90 dgerees
Knees 105 and neutral abduction
Femurs parallel to seat
Footplate position allows 2” clearance from floor
1” space from back of knee to front of seat

52
Q

Why is lower body positioning important?

A

Directly affects position of pelvis
Helps sustain the position of th ehips and knees
Correct positioning assist in the prevention of deformities and distributes pressure
Do not over position

53
Q

What affect can footplate height have?

A

Too low = increase pressure under thigh

Too high = increase sacral area pressure

AY BMSc Lectures (8 decks)

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