Wheelchair

Question 1

means of transportation or mobility, but they also provide support, safety, and stability to enable the user to perform functional activities

Answer 1

wheelchair

Question 2

Factors Associated with the Selection of a Wheelchair Type and Components

Answer 2

• Patient’s impairment, activity limitations, and participation restrictions
• Patient’s age, size, stature, and weight
• User’s functional skills or preference
• Portability/accessibility
• Reliability/durability
• Expected use or patient needs of the wheelchair (e.g., indoors, outdoors, recreation, transfer needs, ability to transport the chair)
• Temporary versus permanent use of the wheelchair
• Potential or prognosis for change in the patient’s
  condition, especially as it affects mobility
• Mental and physical condition or capacity of the
  patient
• Cosmetic features
• Options available
• Service
• Cost

Question 3

Designed for persons who weigh less than 200 lb and for limited use on rough surfaces; not designed for vigorous functional activities

Answer 3

standard adult

Question 4

Constructed for persons who weigh more than 200 lb or for those who perform vigorous functional activities

Answer 4

heavy duty adult

Question 5

Designed to be lightweight, may have a rigid or folding frame, and can be made with titanium in a rigid or folding frame; weighs from 12 to 30 lb; benefit is efficiency in propulsion and reduction in cumulative trauma in the upper extremities; weight capacity to 300 lb

Answer 5

ultralight wheelchair

Question 6

Designed for persons with a body build smaller than that of an adult but larger than that of a child

Answer 6

intermediate or junior

Question 7

Designed to permit adjustments in the frame to accommodate the growth of the user

Answer 7

growing

Question 8

Designed for persons up to the approximate age of 6 y

Answer 8

child or youth

Question 9

Constructed for use indoors, with the larger drive wheels placed at the front of the chair and the caster wheels at the rear; it functions better in confined areas but is more difficult to propel and makes it more difficult for the user to perform many functional activities

Answer 9

indoor

Question 10

The seat is lowered approximately 2 inches to allow better use of the user’s lower extremities to propel the chair; however, the lower seat may make it more difficult for the user to perform a standing transfer

Answer 10

hemiplegic

Question 11

The rear wheel axles are positioned approximately 2 inches posterior to their normal position to widen the base of support of the chair and compensate for the loss of the weight of the user’s lower extremities

Answer 11

amputee

Question 12

Two hand rims are fabricated on one drive wheel, and the two drive wheels are connected by a linkage bar; the smaller hand rim propels the near drive wheel, the large hand rim propels the far drive wheel, and when both rims are moved simultaneously, both wheels are propelled

Answer 12

one-hand drive

Question 13

The chair is propelled by a deep-cycle battery system, and various types of controls are used to operate the chair (e.g., a joystick, a chin piece, or a mouth stick)

Answer 13

externally powered

Question 14

A low-profile, fixed frame, lightweight (15-24 lb) chair with features such as a low back, canted rear wheels, fixed or adjustable axles, and fixed or adjustable seat and backrest; it can be bought or customized for various sports activities

Answer 14

sports

Question 15

Used for persons who need to partially or fully recline at some time when they are in the chair; the chair may be a semireclining or fully reclining chair; semireclining chairs recline to approximately 30 degrees from vertical, and fully reclining chairs can recline to a horizontal position; elevating leg rests and headrest extensions are necessary components for these chairs

Answer 15

reclining

Question 16

• Measure from the user’s heel to the popliteal fold, and add 2 inches to allow clearance of the footrest
• 19.5 to 20.5 inches

Answer 16

seat height/leg length

Question 17

• Measure from the user’s posterior buttock, along the lateral thigh, to the popliteal fold; then subtract approximately 2 inches to avoid pressure from the front edge of the seat against the popliteal space
• 16 inches

Answer 17

seat depth

Question 18

• Measure the widest aspect of the user’s buttocks, hips, or thighs, and add approximately 1.5 inches; this will provide space for bulky clothing, orthoses, or clearance of the trochanters from the armrest side panel
• 18 inches

Answer 18

seat width

Question 19

• Measure from the seat of the chair to the floor of the axilla with the user’s shoulder flexed to 90 degrees, and then subtract approximately 4 inches; this will allow the final back height to be below the inferior angles of the scapulae (Note: This measurement will be affected if a seat cushion is to be used; the person should be measured while seated on the cushion, or the thickness of the cushion must be considered by adding that value to the actual measurement)
• 16 to 16.5 inches

Answer 19

back height

Question 20

• Measure from the seat of the chair to the olecranon process with the user’s elbow flexed to 90 degrees, and then add approximately 1 inch (Note: This measurement will be affected if a seat cushion is to be used; the person should be measured while seated on the cushion, or the thickness of the cushion must be considered by adding that value to the actual measurement)
• 9 inches above the chair seat

Answer 20

armrest height

Question 21

A proper fit will allow you to place two or three fingers easily under the thigh, with your hand held parallel to the floor, from the front edge of the seat to a depth of approximately 2 inches

Answer 21

seat height/leg length

Question 22

Proper fit will allow two or three fingers to be placed between the front edge of the seat and the user’s popliteal fold with your palm horizontal to the seat (C) with your hand held parallel to the floor.

Answer 22

seat depth

Question 23

Proper fit will allow the placement of your hand, held vertically, between the user’s greater trochanter, hip, or thigh and the armrest panels with your hand positioned vertically to the seat.

Answer 23

seat width

Question 24

A proper fit for a standard seat back will allow you to place four fingers, with your hand held vertically, between the top of the back upholstery and the floor of the user’s axilla.

Answer 24

back height

Question 25

too high - insufficient trunk support because the back upholstery will be too low - difficulty positioning the knees beneath a table or desk - difficulty propelling the wheelchair because of the difficulty in reaching the hand rims on the drive wheels - poor posture when the forearms rest on the armrests

Answer 25

seat height

Question 26

too low - difficulty performing a standing or lateral swing transfer - improper weight distribution

Answer 26

seat height

Question 27

too low - increased pressure on the distal posterior aspect of the thigh, decreased function of the upper extremities when propelling the chair, and unsafe mobility

Answer 27

leg length

Question 28

too high - increased pressure to the ischial tuberosities, difficulty positioning the chair beneath a table or desk, or decreased trunk stability caused by a lack of support by the posterior area of the thighs

Answer 28

leg length

Question 29

too short - decreased trunk stability because less support will be provided under the thighs - increased weight bearing on the ischial tuberosities because the body weight will be shifted posteriorly as a result of the lack of support to the thighs - poor balance

Answer 29

seat depth

Question 30

too long - increased pressure in the popliteal area, leading to skin discomfort or compromise of circulation

Answer 30

seat depth

Question 31

too wide - difficulty propelling the chair when using the upper extremities because the distance to the hand rims is increased - difficulty performing a standing or lateral swing type of transfer - difficulty moving through narrow hallways or doorways - postural deviations

Answer 31

seat width

Question 32

too narrow - difficulty changing position because insufficient space - excessive pressure to the greater trochanters - difficulty wearing bulky outer garments, orthoses, or braces

Answer 32

seat width

Question 33

too high - difficulty propelling the chair

Answer 33

back height

Question 34

too low - decreased trunk stability or postural deviations

Answer 34

back height

Question 35

too high - problems propelling the chair because it will be difficult to reach over the high armrest to grasp the hand rims - difficulty performing a standing transfer - postural deviation as a result of elevated shoulders - limited use of the armrests

Answer 35

armrest height

Question 36

too low - poor posture or back discomfort - increased abdominal discomfort when leaning forward - inadequate balance - difficulty rising to a standing position from the chair because the armrests are too low to offer support when pushing to stand.

Answer 36

armrest height

Question 37

It is important to routinely inspect the skin that overlies bony prominences such as the

Answer 37

vertebral spinous processes, inferior angles of the scapulae, ischial tuberosities, greater trochanters, lateral femoral condyles, sacrum, and medial humeral epicondyles

Question 38

The patient and his or her family should be instructed to watch for the following signs or symptoms of decreased circulation in the lower extremities

Answer 38

* Ankle edema * Color changes in the toes, feet, or legs * Decreased sensory response to surface stimuli * Loss of hair follicles

Question 39

- permanently attached to the chair frame - recommended for users who will be performing standing transfers

Answer 39

fixed armrests

Question 40

recommended for users who will perform a lateral swinging or sliding transfer in a sitting posture

Answer 40

removable or reversible armrests

Question 41

position the wheelchair close to a permanent surface such as a desk, table, or countertop

Answer 41

desk or cutout armrests

Question 42

need to adjust the armrest height for different activities or when cushions with different thickness or bulky outer garments are used

Answer 42

adjustable armrests

Question 43

- located at the front of the chair to permit changes of direction and turns - 5 or 8 inches

Answer 43

caster wheels

Question 44

provide a smoother, more comfortable ride and function better on rough and soft surfaces such as sand, gravel, and grass, but they may require greater energy expenditure by the user to propel the chair

Answer 44

pneumatic or semipneumatic tires

Question 45

used to propel the chair

Answer 45

Drive or Rear Wheels

Question 46

used for independent propulsion when the user has only one functional upper extremity and no functional lower extremities

Answer 46

one arm drive chair

Question 47

engaged either by pushing it forward or backward

Answer 47

toggle lock

Question 48

lock the caster wheels to prevent them from turning

Answer 48

caster locks

Question 49

- attached permanently to the chair frame - can be elevated or raised from a horizontal to a vertical position when the user rises, sits, or desires to place his or her feet on the floor - prevents the chair from being positioned close to and directly in front of most objects

Answer 49

fixed footrests

Question 50

release of a locking mechanism allows the front rigging to be pivoted outward, and lifting the leg rest removes the front rigging from the chair frame

Answer 50

swing-away or removable leg rests

Question 51

the entire front rigging can be elevated and maintained at different heights

Answer 51

elevating leg rest

Question 52

- located beneath the chair seat toward the front of the seat rail - wheelchair user must be able to reach under the seat to operate the lock

Answer 52

z or scissors lock

Question 53

necessary to release the back and to increase the wheelbase when the back is reclined

Answer 53

auxiliary lock for a reclining back chair

Question 54

lock the caster wheels to prevent them from turning

Answer 54

caster locks

Question 55

- footplate - It may have a toe or heel loop to help maintain the foot on the footrest

Answer 55

footrest

Question 56

prevents the foot from sliding backward

Answer 56

heel loop

Question 57

prevents the foot from moving forward

Answer 57

toe loop

Question 58

- attached to the frame of the chair, is designed to prevent the patient from falling out of the chair or sliding forward in the chair - crosses the wheelchair user’s lower abdomen or pelvis, similar to an airplane or automobile lap belt

Answer 58

lap belt (waist)

Question 59

- attached to the frame of the chair at the mid-chest level to increase trunk stability, prevent the wheelchair user from falling out of the chair and maintain the body upright - provided to protect patients who have inadequate balance or trunk stability while seated - not appropriate for use as a method to restrain a patient in the chair for a prolonged period

Answer 59

chest belt

Question 60

- allow the back of the chair to be adjusted to various positions from fully upright to 30 degrees of extension - The chair back usually is higher than that on a standard chair, and a removable head component is necessary to support the wheelchair user’s head when he or she is in a reclined position

Answer 60

semireclining

Question 61

- allow the back to be adjusted to various positions from vertical to fully horizontal - Adjustment knobs or levers located on either side of the back frame are used to adjust the position of the back - rear wheels will be located more posteriorly than on a standard chair - used for persons who must recline periodically while seated in the chair. Persons with lower extremity circulatory problems who cannot tolerate an upright position because of decreased circulation or who need to relieve skin pressure but cannot perform pressure relief independently

Answer 61

fully reclining

Question 62

- powered by one or more deep-cycle batteries that provide stored electrical energy to one or more belts that drive or propel the chair - available for persons with insufficient strength or motor control of the extremities to propel a standard chair

Answer 62

externally powered wheelchair

Question 63

cheapest battery, use a chemical reaction between lead and sulfur to create a charge

Answer 63

wet batteries

Question 64

contain a mixture of phosphoric acid, sulphuric acid, fumed silica, and pure water and tend to be heavier and more expensive

Answer 64

gel batteries

Question 65

costly, feature an absorbent glass mat between plates soaked with an acid electrolyte

Answer 65

AGM batteries

Question 66

- low backrests, solid, lightweight frames, canted (angled) rear wheels, low and narrow seats, and an overall low profile to make the chair more functional for the user - be tough, highly maneuverable, responsive, and stable - built to withstand the impact and jarring that occurs with different types of competitive and recreational sports - adjustable back and/or seat height

Answer 66

sport or recreational wheelchair

Question 67

- lighter than folding wheelchairs because they don’t feature the additional hardware and mechanisms that folding wheel- chairs require

Answer 67

rigid wheelchair

Question 68

made of aluminum, but titanium is the material of choice for lightweight mobility aids

Answer 68

lightweight wheel chairs

Question 69

- not only a lighter metal, but it is more durable and features built-in shock absorption - very durable, has higher quality wheel bearings, and has several adjustment features. It weighs from 12 to 30 lb

Answer 69

titanium

Question 70

Each wheelchair user should be taught to perform the following maneuvers

Answer 70

- operate the wheel locks and tighten them when necessary - remove and replace the armrests - swing away, remove, and replace the front rigging - elevate and lower the footplates before performing other activities