Wheelchair Flashcards

(37 cards)

1
Q

types of chairs

A

manual
power
PAPAW

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2
Q

Type of chair power vs manual

A

power- bulky, heavy, expensive, specialized transport, maintenance issues
manual- smaller, lighter, less expensive, transport by car, improves fitness, overuse issues
delay decision until rehab underway for return

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3
Q

when to pick power chair

A

insufficient strength to propel a manual WC
need to cover long distances- uneven terrain
certain medical or orthopedic problems (SH)
high risk for overuse injury (older obese)

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4
Q

Manual chair levels of function

A
C4= unable to propel
C5= limited distance indoors
C6= may be too slow or tiring to use; power may be more suitable for lifestyle or priorities
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5
Q

Selecting a manual chair

A
lightest wt possible
stable frame for efficient use
quality
optimal wheel size
best combo of ease of propulsion and stability
fitted to prevent overuse injury
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6
Q

Rigid characteristics

A

+ easier to propel, fewer components, stronger, lighter, seat to back angle adjustable
- bumpier on uneven surfaces, harder to store

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7
Q

Seat depth

A

measure butt to popliteal fossa and subtract 1-2”
important for good posture
too short, less body contact to distribute weight, pressure; excessive pressure, fear of falling off
too long, slide out and cause kyphotic posture

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8
Q

seat width

A

as narrow as possible

measure widest part and add t go through doors

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9
Q

seat height

A

seat rail to floor; take cushion into account
finished height considerations- propelling chair with foot needs to be lower to ground, height of transfer surface, work surface height (desk)

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10
Q

Seat height can be altered by

A

altering frame construction
changing wheel size
thickness of seat insert/cushion
removing upholstery and add seat board

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11
Q

seat surfaces

A

firm more stable and comfortable
can be sling, taut fabric, solid metal/plastic base, solid hook on seat
sling seat leads to slump sacral sitting

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12
Q

wheelchair back

A
affects seat depth, may impede SH mvt
can be fixed or adjustable
upholstery or solid
if too high, impedes SH ROM
if too low, not enough posture support
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13
Q

Pelvic positioner

A

seat belt, helps spasticity
45-60 deg from chair, depending on problem
fastened with buckle, velcro

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14
Q

arm rests

A

consider height and length of arm rests
too high, poor SH position
too low, lean over to use, poor posture
consider any additional att needed

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15
Q

footrest/legrest

A

swing away/elevating, several styles
if too long- slide out to reach, slumped, sacral sitting
if too short- too much weight on sacrum
angle of front rigging increases length chair
calf straps for FL tone, heel loops

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16
Q

casters/hangers

A

4-8” standard, larger- smoother ride
smaller= tighter turn, more maneuverable
hangers- where leg rest att to WC- 60-90 deg

17
Q

tires

A

standard or solid- no traction, easier to roll, bumpier ride
pneumatic- smoother, air, can have a flat
airless inserts- hybrid, softer ride without maintenance, expensive
grade aids

18
Q

wheel position

A

affects seat height and overall stability
moving wheel back- COM moves forward, more energy to roll, more SH ext, stress on UE
move wheel forward- COM moves back, easier to steer, less stress on UE but chair less stable
can have quick release wheels or camber which puts at an angle to increase width and stability

19
Q

wheel design

A

mag wheel- light weight, no maintenance, less efficient

spoke- high performance, maintenance

20
Q

wheel rims

A

coated rims for more friction
oval rim, increases surface
pegs or projections
can use gloves, tap around rim for friction

21
Q

Locks

A
push vs pull- hand function
high vs low
front vs back, convenience of care giver
extensions- if weak, increase lever arm; use strong arm to reach over
anti-tip bars
22
Q

Gradeaid

A

att to WC locks

prevents chair from rolling backwards

23
Q

UE supports

A

BFO balanced forearm orthosis

MAS mobile arm support

24
Q

Power chair options

A
mobility base
seating system
control options
access devices
controller
battery
25
front wheel drive
intermediate turning radius good for traversing curbs, uneven terrain tends to fishtail at higher speeds
26
rear wheel drive
largest turning radius better shock absorption and foot clearance better control at higher speeds
27
Mid wheel drive
smallest turning radius most stable on slopes good indoor chairs
28
Seating System
stationary- less expensive, pt independent with pressure relief recline- backrest reclines, may elicit spasticity, good for intermittent caths, requires long wheel base tilt- constant angle between seat and back, less likely to elicit spasticity or alter sitting position, requires long wheel base tilt/recline- allows either elevator- increase chair height, reach countertops
29
power recline
if pt self catheterizes likely to elicit spasticity longer base
30
control options
proportional- gas pedal like non-proportional- off or on, set speed, puff chair momentary- stops as soon as take hand off, joystick latched- move until tell stop, sip
31
devices used to control WC
``` chin sip puff head rest joystick controller is "brain" of WC can adjust max speed and rate of accel/decel ```
32
Battery
rechargeable good for about a year charge every day
33
Supporters/positioners
chest straps lateral trunk supports pelvic positioners
34
Wheelchair cushion
``` pressure relief postural support weight maintenance expense $400-500 decisions- give and take Foam air-filled= like water bed, good pressure relief, heavy gel or fluid= heavy, gel distribution ```
35
Evaluating pt
examine in GE position (supine/ SL) sitting goal: neutral posture with good lumbar/trunk alignment
36
wheelchair skills
practice in "real world" propelling without full hand function- pegs, wrapping rim hard surface/open space practice builds skill and stamina
37
overuse injuries
manual WC propulsion major contributor risk factors prevention strategies