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5 Neurological Dysfunction > L11 W/C > Flashcards

L11 W/C Flashcards

(48 cards)

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1
Q

steps to prescribing a w/c

A

1.determine the need
2. examine the pt
3. select a positioning device and pressure relief
4. Determine funding
5. Document medical necessity
6. Evaluate the pt with new w/c
7. Re-assess and follow-up

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2
Q

Team members for prescribing w/c

A

Patient
Caregivers
Referral source
Pt/OT
ATP
manufacturer reps
insurance reps

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3
Q

Equipment needed to prescribe w/c

A

high/low mat table
measuring tools
transfer equipment
camera
pressure mapping system

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4
Q

How long does a w/c eval take?

A

90 to 120 minutes

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5
Q

How long does a w/c fitting appointment take?

A

60 to 120 minutes

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6
Q

Subjective eval for w/c

A

Medical status and hx
living situation (w/c accessibility)
current functional level
transportation
cognitive issues
visual/perceptual deficits
time spent in current w/c, current measurements

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7
Q

Mat evaluation

A
  1. posture
  2. sitting balance
  3. ROM
  4. Strength
  5. Tone
  6. Measurements
  7. Skin check
  8. Functional Eval
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8
Q

Posture eval

A

measure in the 3 following situations:
1. In current w/c
2. Edge of mat
3. Supine

helps you to see with gravity, gravity eliminated, and how equipment impacts it

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9
Q

In all 3 positions of posture, look at

A

balance
pelvic tilt, rotation, obliquity
lego position
lumbar lordosis
thoracic kyphosis
scoliosis
shoulder position
head position

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10
Q

Windswept deformity

A

describes the appearance of abnormal valgus deformity in one knee in association with varus deformity in the other

named for the lower ASIS

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11
Q

Pelvic obliquity

A

frontal plane deformity and is always named for the lower ASIS

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12
Q

Posterior pelvic tilt is associated with

A

thoracic kyphosis

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13
Q

ROM that should be measured for w/c

A

Hip
Knee w/hips flexed
Ankle w/knees flexed
Hamstring length
UE

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14
Q

Strength eval

A

necessary to note grip strength, UE, and LE

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15
Q

Functional Eval includes

A

transfer ability
balance assessment
gait
pressure relief
manual w/c propulsion
power w/c driving

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16
Q

Types of manual w/c

A

Standard weight
Bariatric
High Strength Lightweight
Ultralight
Tilt in space

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17
Q

Standard weight

A

least expensive
designed for infrequent, short duration use
little adjustability

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18
Q

Bariatric w/c

A

accommodate users over 250 lbs
accessibility is an issue because of wider seat widths

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19
Q

High strength light weight wheelchair

A

justified for a full time user of w/c
height is adjustable
flip back armrests
limited vertical axle adjustability

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20
Q

Ultralight w/c

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A

fully customizable
typically under 25 lbs
must have features that match anatomical dimesions of individual and functional ability

21
Q

Customizable features of ultralight w/c

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A
  1. seat surface height at front and rear edge
  2. seat plane angle
  3. seat width and depth
  4. back support height
  5. seat to back support angle
  6. foot support to seat height
  7. leg to seat surface angle
  8. horizontal and vertical position of rear axle
  9. rear wheel camber
  10. wheel and caster type/size
22
Q

More forward axle on ultralight w/c

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A

decreases overall rolling resistance, allows easier negotiation of variable terrain, limits the risk of UE strain or injury over time

ideal set up is to have fingertips reach the hub, with the hub directly behind the shoulder

23
Q

Too far forward axle on ultralight

Study These Flashcards
A

injury from tipping backwards

24
Q

Tilt in space manual w/c

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A

dependent user who typically does not self-propel
needs pressure relief with tilt in space

can tilt from 0-50°
pediatric ones can adjust for growth changes

25
Power assist systems
with the first stroke, the motor engages and keeps the chair going until the user decides to stop or needs to stop medicare requires at least 1 year in a manual chair prior to this good for patients that wants a manual w/c, but has power w/c needs
26
Power w/c types
Scooters Group 2 power Group 3 power
27
Scooters
typically used for outdoor use only, houses don't have enough room for them difficult to get covered by medicare
28
Group 2 power w/c
rental medicare rents these for 13 months lower end power, used mostly for mobility for little need for specialty seating
29
Group 3 power w/c
most common of power w/c can be set up with speciality seating, custom seating, power seat functions, specialty controls
30
When will medicare cover a Group 3 power w/c?
if mobility limitation is due to a neurological condition, myopathy, or congenital skeletal deformity
31
Power drive wheel configurations
rear wheel front wheel mid wheel
32
Rear wheel drive configuration
used to be most available have large turning radius and accessibility issues
33
Mid-wheel drive configuration
majority of current w/c are this is most maneuverable, tightest turning radius, and smallest turning circumference
34
Front wheel drive configuration
navigate tight corners better due to small front end. difficult to turn 360° due to long back end large drive wheels at front let you traverse obstacles, can do variable terrains
35
Things to help with safety for power w/c
improved suspension systems tracking tech lights charging ports bluetooth
36
Power seat functions
1. power tilt in space 2. power recline 3. power elevating leg rests 4. power seat elevators
37
What are power tilt in space used for?
at least 45° of tilt for pressure relief anterior tilt for transfers
38
What are power recline capabilities used for?
cathether
39
Uses of power elevating leg rests
edema
40
power seat elevators use
transferring
41
Recline vs Tilt
42
Medicare requirements for power seat functions
1. user meets all coverage criteria 2. speciality evaluation was performed by licensed professional 3. a RESNA certified ATP had direct in person involvement with w/c selection
43
Seat elevators
allows for seat to rise up to 14 inches
44
Alternative Drive controls
head array sip/puff speciality joysticks chin control
45
Cushion types
general use pressure relieving positioning positioning/pressure relieving positioning/pressure relieving/adjustable custom
46
Other positioning needs
backrests head rests armrests hip guides abductor wedges side guards footrest configuration
47
Plan AFTER w/c eval
trial at home follow up clinic appointments for custom seating home health or outpatient therapy to work on driving fitting at home or in clinic
48
Letter of medical necessity
speciality letter versus through eval documentation that includes medical justification of w/c includes summary, measurements, recommendations

5 Neurological Dysfunction (16 decks)

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