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Wheelchair And Seating Flashcards

(48 cards)

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1
Q

Non wheelchair mobility devices

A

Hemiwalker, four wheeled walker, two wheeled walkers, canes, scooters, crutches, lofstrand cutch, trekking stick

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2
Q

Rollator

A

4 wheeled walker
Not appropriate for pts who need alot of stability or cognitive deficits impacting ability to lock brakes

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3
Q

Front wheeled/2 wheel walker

A

Used for balance deficits, front wheels can be turned inside to clear doorways, grip at wrist height

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4
Q

Cane

A

Walking aid, provide postural stability, maintaining good posture

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5
Q

Durable medical equipment

A

Withstands repeated use and primarily/customarily used to serve a medical purpose and not useful to a person in absence of illness/injury

Can be rented

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6
Q

Custom/complex rehab tech

A

Products and associated services including medically necessary, individually configured devices that require eval, configuration, fitting, adjustment, programming

Custom manual wheelchair, power wheelchair, adaptive seating, alternative positioning devices

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7
Q

Role of OT in seating and mobility

A

Holistic evals to assess skills, patterns of daily living and mobility

Identify needs, interest, goals, supports, and barriers

Assess/recommend environmental settings to understand type of mobility device

Assess/align equipment and specific features with client, needs, goals, and environment

Assist clients/caregiver education of device use

Remain current about policy/reimbursement

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8
Q

Assistive technology practitioner

A

Credential required for many type
Of systems and funding sources offered by rehab and assistive technology association of north america

rehab tech supplier ensures consumers best interest

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9
Q

Certified Rehab Technology specialist

A

Credential through national registry of rehab tech suppliers

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10
Q

Role of Rehab Technology supplier

A

Equipment vendor/distributor, access to various manufacturers, knowledge of equipment, equipment limitations, working knowledge of equipment applications, provider of equipment details for funding, helps get trial equipment

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11
Q

Seating evaluation

A

Assess all client factors to determine needs match equipment, medical information determines needs
1) primary dx that lead to mobility limitations
2) secondary dx comorbidities
3) past/future sx, hold off until after surgery posture
4) height/weight, instability need for alternative feeding
5) pertinent medical status prosthesis ventilators o2 tanke
6) environment
7) transportation
8)pain
9) functional sensory ability
10) skin integrity
11) current mobility base
12) seating system on mobility base
13) posture in current equipment
14) motor/mobility skills

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12
Q

Medicare mobility device algorithm

A

Cane/crutch to walker to manual wheelchair to manual wheelchair with power assist to scooter to power chair with joy stick to power wheelchair with alternative controls to dependent

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13
Q

Postural assessments

A

Complete on firm surface such as mat or armchair, bed will sag, wheelchair surface will hammock

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14
Q

Measurements

A

LE length=foot plate placemebt
Hip width = width of seat
Buttock to upper leg=depth of seat
Shoulder height= back support
Measure with yard stick or metal, soft measuring tape bends

If hips are abducted measure hip to hip
Seat depth measure pelvis to popliteal fossa

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15
Q

Back supports

A

Depends on need
-if you need alot of support want it to go to shoulders
-ultra low for access to wheels

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16
Q

Wheelchair angles

A

Pelvis to thigh = seat to back angle
Trunk to thigh = seat to back angle
Thigh to calf = seat to leg rest angle
Calf to foot = leg rest to foot angle

Make note of flexibility of spine against gravity, change gravitational pull for posture/head position

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17
Q

Posture assessment: anterior pelvic tilt

A

Lordosis, center of gravity forward, pressure on pubis

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18
Q

Posture assessment: posterior pelvic tilt

A

Kyphosis, sacral pressure, shoulder girdle moves forward, sliding

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19
Q

Posture assessment: pelvic obliquity

A

Pressure on ischial tuberosity, concavity at ribcage, may lead to scoliosis, lateral leaning/instability

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20
Q

Posture assessment: pelvic rotation

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A

Leg length discrepancy vs rotation, R vs L, seat depth, may be equal but appear as discrepancy due to rotation

21
Q

Mobility base

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A

Dependent= smaller wheels
Tilt: anterior, posterior, lateral
Weight of base
Wheel size
Caster size
Armrest
Leg rest
Wheelchair lock placement
Propulsion technology

22
Q

Transport wheelchair

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A

Momentary use, considered
DME not CRT

23
Q

Seating options

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A

Ready made
Custom made
Custom molded (pressure mapping)
Accommodate asymmetries by providing external support for alignment

24
Q

Cushion material

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A

Foam, gel, air, combo

Cover- breathable (maintain temp) vs incontinent proofs

25
criteria for selection in power mobility
1) impairment impairs 1+ MRADLs, inability to complete, increased risk of injury, complete in reasonable time 2) r/o less expensive dme 3) document decrease UE strength endurance ROM coordination presence of deformity/pain
26
Power mobility device categories
1) scooters/POV 2) power wheelchairs
27
Category 1 scooters/POV
3-4 wheels, uses tiller for stearing, limited seating options Funding limited in how much they pay for scooters Used outside, part time assistance to replace ambulation, effective over some terrains Require decreased exertion than manual w/c Typical user: decreased strength/balance to ambulate with cane, RW, manual wheelchair, has trunk control and UE for steering MS, CHF, arthritis, COPD
28
Category 1 scooter criteria
Safety in transferring to/from Power operated vehicle Operate tiller systems (BUE skills) Posture, maintaining position Access to rooms, maneuvering spaces scooter has large turning radius Demonstrate willingness to use equipment Utilize judgement/vision for safe mobility
29
Cons to power operated vehicles/scooters
Need a-lot of space Decreased stability on uneven terrain Difficulty use while seated at a variety of settings Need UE strength to operate
30
Category 2 power wheelchairs
Used for fulltime mobility assistance Lack sufficient strength/postural stability for manual wheelchair or power operated vehicle, used inside and outside, typically controlled with 1 hand, greater maneuverability compared to POV No frontal obstruction for access to work surfaces allows for greater access, maneuverability, and stability
31
Types of drive systems
Rear wheel drive Midwheel/center wheel drive Front wheel drive
32
Rear wheel drive
Motor in back, larger casters, provides stability, improved comfort secondary to suspension, can handle higher speeds, wider turning radius, decreased maneuverability, larger may not fit in certain environments Have to push, least one provided
33
Midwheel/center wheel drive
Motor in middle, 4 casters 2 in front/back, can pivot smaller turning radius, increased maneuverability, more intuitive to drive, increased stability up/down inclines, difficulty navigating terrain/obstacles due to casters Needs ramp or running start, looses contact casters get hung up
34
Front wheel drive
Motor is in the front, larger wheels in front, casters in back, decreased turning radius, better over terrain, navigating hills/curbs, feel like it fishtailing due to back casters Pulls base over obstacle, grab and go, snow, curbs, grass
35
Optional functions of power chairs
Power recline Tilt Seat elevation Height adjustability Power standing Power leg rst
36
Power recline justification
Pressure distribution, decreased hop flexion, maintaining muscle length/joint ROM, BP management, respiratory abilities, catheter care, edema management
37
Power rear tilt justification
Pressure relief, increased chewing/swallowing, head uptight, visual field orientation, BP management, respiratory distress, increased sitting tolerance, helps with transfer, manage tone/soasticity, manage autonomic dysreflexia
38
Power anterior tilt justification
Increase (I) with transfers, increase (I) with ADLs, decrease pain, minimize eliciting STNR, pressure distribution away from scapula, sacrum, coccyx, ischial tuberosity, “work ready”, accommodate hip contracture
39
Power lateral tilt justification
Reorient trunk for functional posture
40
Power seat height justification
Increase (I) with transfers, decrease fall risk, increased functional reach, decrease over shoulder reaching, decrease overuse injury, decreased hyperextension when conversing with someone in standing, decrease pain
41
Power standing justification
Supported stand, can move wheelchair in standing, lower speed for safety, increased functional reach, increased (I) with ADLs, decrease risk of overreaching/overuse injury, decrease hyperlordotic neck, decreased stnr, decrease pain, facilitate eye positioning for communication, increased weight bearing, decreased contracture, increased elimination/digestion, difficult to get funding
42
Power leg rest justification
LE edema management, increased circulation, maintain LE muscle length, joint ROM, prolong stretch, increase clearance threshold
43
Power Assist wheelchair
Motorized wheels for decreased UE strength and decreased effort to propel Assistive manual power Smart Drive powers wheel while user uses wheel to steer, increase terrain Power add-ons system attaches to front of wheelchair and lift casters to turn manual to 3 wheel power mobility device, more stable than scooter, need UE to steer
44
Power assist wheelchair justification
Can’t fully operate manual wheelchair ie shoulder pain Less expensive than power wheelchair, ECT, decrease repetitive strain, assist navigating ramps/curbs
45
Group 1 power wheelchair
Basic joy stick, captain chair, needs to be initiated by consumer or physician Does not need specialist evaluation Characteristics: 5 mile range on battery/3 mph Manual elevating leg rest 6* incline Non expandable joy stick, nonpowered recline, cant have ventilator, intermittent use less than 2 hours/days, 3/4” obstacle
46
Group 2 power wheelchair
Captains chair or sling seat/back Can accommodate back support cushion and add on seating, no power or power options Characteristics: 7 mile battery range/3 mph 4 wt capacities 6* incline 1.5” obstacle Standard or remote joy stick Single/multi-power seat function Full time use Power option accommodates ventilator, alternative switches/controls Justification: skin integrity, chronic/progressive disease processes, irreversible condition, use of ventilator
47
Group 3 power wheelchair
Mobility limitations must be neurological, myopathy, or congenital skeletal deformities Requires specialty evaluation performed by license/certified professional, supplier must be ATP certified 12 mile range, 4.5 mph, 7.5* incline, 72” obstacle, single/multifxn power seat, full time use, accommodates ventilator/seating, suspension Suspension decreases vibration of wheelchair, smoother ride, decreased tipping on uneven terrain
48
Group 4 wheelchair
Offers features not needed for in home use, 16 miles/charge, 6 mph, 9* incline, 3” curb climb

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