Flashcards in Wheelchairs Deck (28):
How often should a patient do pressure relief push ups?
How far up should the back of a wheelchair go?
mid scap height
- for standard sling back chairs, that is
- for sportier chairs, may go lower to afford more movement
What type of w/c frame improves the stroke efficiency?
rigid frame increases distance per stroke
If your patient has difficulty ascending a ramp without taking a break, what additional attachment might you want for their w/c?
hill holder device: mechanical brake that allows the chair to go forward, but brakes when the chair goes in reverse
What adaptations can be made to a bariatric wheelchair to allow a more efficient push as well as stability in the chair?
- rear axle is displaced forward for increased stability
- positions center of body mass forward and allows for arm push that requires less wrist ext
What kind of tires should be used for increased durability for a bariatric w/c?
hard tires, vs pneumatic tires
T/F: A reclining wheelchair back might be a good idea for bariatric patients.
true to allow for increased girth
How should you measure for seat width?
measure hip to hip, then add two inches
Why don't you want the width of a w/c seat too big, nor too small, but just right?
too big = difficulty getting to push wheels, proper propelling
too small = discomfort on pelvis/thighs
When measuring the seat width for a patient who's obese with a pear shape, what needs to be taken into consideration?
they'll have more width with gluteal/femoral area when sitting, so consider widest portion of seated position
- aka forward edge of seated position
How do you measure for seat depth?
posterior buttock to posterior aspect of lower leg in the popliteal fossa: subtract 2-3in from this measurement
Your patient demonstrates sacral sitting in his w/c. What might you look to see regarding the seat depth?
too long of a seat depth can cause sacral sitting
What are the results of improper leg length measurement for a w/c?
leg length = bottom of shoe to popliteal fossa
- too long = sacral sitting to help reach the foot plates, sliding forward in chair
- too short = uneven weight distribution onto thighs and ischium
How do you measure for seat height for a w/c?
add two inches to pt's leg length measurement
- footplates should be 2in above floor
What are the standard w/c seat measurements for width, depth, and height for an adult?
seat width: 18in
seat depth: 16in
seat height: 20in
How do you instruct your patient learning w/c mobility to complete a sharp turn?
yank back on one side, push forward on the other
- compared to just pushing forward on one side for a sloping turn
How do you instruct your patient learning w/c mobility to ascend a ramp?
forward lean of head and trunk, use short quick strokes
How do you instruct your patient learning w/c mobility to descend a steep ramp?
- if it's too steep to just loosely grip hand rims and coast your way down, then you do wheelie
T/F: When popping a wheelie, instruct your patient to keep their head and trunk backward to assist with attaining the position.
false, you throw the wheels forward while keeping your body forward so that you don't tip all the way back
- bringing your head and body back would make you tip all the way back... ow
Pushing the wheels forward in a wheelie makes the chair tip further.... forward? or back?
- and opposite: pulling wheels back makes chair tip to upright
How do you instruct your patient learning w/c mobility to descend a curb?
can do it backwards with forward head/trunk lean, OR descend forward with a wheelie
How do you instruct your patient learning w/c mobility to ascend a curb?
wheelie the castors up, then use momentum to really push yourself up
T/F: Pts with complete C6 SCI can be independent with transfer board on level surfaces.
T/F: Head/hips move in opposite directions.
true (head hips relationship)
Why might a patient need elevating leg rests?
for edema control
For your patient with extensor spasms, what can you do with your w/c to control for this?
- higher back support
- pelvic strap to keep hips in flexion
- tilt in space design to keep pt from coming out of chair during active spasms
What is an appropriate seat height for a patient that's a hemi?
- standard is 20in, but want them to be lower to have better control with unilateral leg pulling/pushing