Wheelchair prescription

Question 1

Seating principles

Answer 1

stabilize proximally to promote improved distal mobility and function

achieve and maintain pelvic alignment
-neutral to slight anterior tilt-no oblique or rotated

facilitate optimal postural alignment in all body segments accomodating for loss of ROM

prevent asymmetry and skin breakdown

limit abnormal movement and improve function

provide the minimum support necessary to achieve anticipated goals and expected outcomes

provide comfort

Question 2

postural support system

Answer 2

seat surface
back surface
pelvic postioner
UE supports
LE supports
secondary support surfaces

Question 3

seat support

Answer 3

surface under buttocks
firm to create good LE alignment, pressure distribution, comfort
sling upholstery for more than simple trasnportation is not effective
-creates poor pelvic postioning

foam/air/gel/combos

MOST CRITICAL DIMENSIONS:

• seat depth
• seat width

Question 4

back support

Answer 4

surface behind trunk
contributes to posture
height can vary
-short or tall backs

Question 5

pelvic positioner

Answer 5

maintain good pelvic position

angle of pull: 40-60 degrees

Question 6

upper extremity supports

Answer 6

provide support surface for arms: surface to use to pushup

support trays, communication devices and arm troughs

Question 7

lower extremity supports

Answer 7

placement of feet affect position of entire lower body

affect tone and posture in trunk/head/arms

elevating leg rests

foot positions/straps

Question 8

secondary support surfaces

Answer 8

trunk alignment/LE alignment/head position

lateral trunk supports

medial/lateral knee supports

adductor wedges

headrest

chest supports

Question 9

manual mobility systems

Answer 9

self propellers

need to prevent repetitive strain injuries

position UE for most effecient stroke during propulsion

reduce force needed per stroke and amount of strokes to move chair

Question 10

manual W/C considerations

Answer 10

lightest weight possible

stable frame for efficiency

high quality bearings

optimal wheel size

ease of proulsion and stability

Question 11

Methods of self-propulsion

Answer 11

total
one-arm drive
feet only
one arm/one foot

Question 12

power mobility

Answer 12

pt. unable to mobilize manual w/c
cognitively aware
prevent postural problems, CV issues, joint issues

Question 13

sports and recreation

Answer 13

different W/C for different sports
rigid construction
strong light-weight materials
wheel/caster, wheel/bearings placements differ for different reasons