Wheelchair Mobility

Variety of WC are available (see page 147)

Purpose of WC Can be described as an orthotic mobility device b/c it can correct and straighten a deformity Can be compared to a brace that increases or maintains a patient’s level of function Can provide adequate support to allow the patient max function

A PT may recommend a WC after gather data on the initial eval. This decision is based on patient’s ROM, muscular tone, motor control, stability, balance, coordination, ability of pt. to maintain upright posture and patient comfort. PT will also consider the desired wheelchair function, need to transport chair and funding sources.

The following patient info must also be taken into consideration: Patient size Weight & stature Functional limitations Functional abilities Cognitive status Psychosocial status Expected use of WC Patient prognosis

Prescribing a WC is usually collaborative effort of the healthcare team: PT makes recommendation MD writes Rx PTA/PT take measurements MSW and family determine funding sources PT/PTA instruct family & patient with use and care for WC

Patient should be measured and fitted for WC. Measurements are required for the following: Thigh length Leg Length Distance from the seat to lower scapula, midscapula, and shoulder Distance from hanging elbow to the seat surface Width across the hips, shoulders, and from outside of knee to outside of opposite knee These procedures will be covered in lab (pp 155-158)

Goals of proper WC seating and positioning: Prevention of deformities and pressure ulcers Normalization of tone Promotion of function Optimization of Respiratory function Proper body alignment Increased sitting comfort and tolerance

Wheelchair Components (pp 136-147)

A WC has 2 main components: Postural support system seat back armrests leg rests footrests

2. Wheeled mobility base frame caster wheels drive wheels tires brakes

Push handle bracket tubes

Back rest

Arm Rests

Tires

Push Rim

Spokes

Frame

Locks

Swing away release lever

Caster Plate and Wheels

Seat

Swing away foot rest

Cross braces

Foot rest

Pictures in the previous slides were retrieved from http://www

Wheelchair Measurements

Factors to consider when measuring a patient for a WC: WC size should be proportional to the patient’s size Patients personal needs including environment Take measurements with patient on a firm surface while in supine or lying

Seat Width standard adult WC = 18 inches narrow or junior WC = 16 inches Extra wide = 22 inches

SEAT DEPTH 16 inches

Footrests 2 inches from floor

Wheelchair Training Wheelchair Training = patient instruction and practice with WC mobility, WC safety and WC maintenance.

Documentation