Wheelchair and Walking Aids Overview

Wheelchair and Walking Aids

• Wheelchairs are mobility orthoses providing support for maximum mobility.
• They combine postural support systems and mobility bases, creating a dynamic seated environment.
• Wheelchairs provide protection, stabilize the body, and stimulate activities.
• They allow locomotion for patients with immobilized body parts to perform daily activities (ADLs).
• Wheelchairs enable patients to move without much effort, offering psychological benefits and encouraging engagement with the surroundings.

Common Cases Requiring Wheelchairs

• People who cannot walk or for whom walking is inadvisable.
• Contraindications to weight-bearing.
• Interference with wound healing.
• Inadequate safety in walking.
• Deficiency in the patient's judgment.
• Restrictions against walking can be temporary.

Deficiency in Ambulation

• Involves both lower limbs due to conditions like:
  • Absence of an essential part.
  • Paralysis.
  • Deformity.
  • Lack of coordination.
• Wheelchair use may be permanent in these cases.

Wheelchair Prescription Factors

• Age, size, and weight.
• Disability and prognosis.
• Functional skills.
• Indoor/outdoor use.
• Portability/accessibility.
• Reliability/durability.
• Cosmetic features.
• Available options.
• Service.
• Cost.
• Level of acceptance (environment).

Types of Wheelchairs

• Standard wheelchair.
• Standard light-weight wheelchair.
• Ultra-light transport wheelchair.
• Reclining back rigid frame wheelchair.
• Sport wheelchair.
• Heavy-duty pediatric wheelchair.
• Power wheelchair.

Basic Manual Wheelchair Parts

• Push Handle.
• Armrest.
• Push Ring.
• Brake.
• Rear Wheel.
• Anti-tip Bar.
• Castor.
• Backrest.
• Cushion.
• Seat Frame.
• Calf Strap.
• Footplate.

Wheelchair Components

• Wheelchair frame: Stationary or foldable.
• Seat and cushion: Provide high comfort and prevent pressure sores.
• Armrests: Fixed or adjustable, stationary or removable.
• Leg rests: Adjustable or removable.
• Footrests.
• Restraints: Chest belts.

Wheelchair Options and Accessories

• Caster wheels: Vary in size (4-8 inches); smaller size increases maneuverability, larger size increases stability.
• Tire materials: Solid plastic or pneumatic; firmer material increases maneuverability, softer material cushions the ride.

Wheelchair Accessories

• Crutch/cane holder: Small cup at the base with strap for transporting ambulatory aids.
• Anti-tipping device: Placed on the back tipping lever to prevent backward tipping and curb limitations.
• Hill holder device: Mechanical brake allowing forward movement but automatically braking in reverse.

Wheelchair Measurements

• Seat width: Measure the person's seated width plus 1-2 inches (2.5-5 cm) for comfort and bulky clothing.
• Seat back width: Measure the widest part of the person's chest.
• Seat height: Measure from the heel to back of the knee plus 2 inches (5 cm).
• Seat depth: Measure from the back of the hips to the back of the knee plus 1-2 inches (2.5-5 cm).
• Armrest height: Measure from the elbow tip to the hip top with the person in a 90-degree arm position.
• Seat back height: Measure from the hips to the shoulders.
• Headrest height: Measure from the hips to the top of the head.

Importance of Good Measurements

• Too narrow seat: Uncomfortable, difficult access, pressure sores.

• Too wide seat: Leaning to one side, promoting scoliosis, difficult propulsion.

• Too shallow seat: Less contact area, more pressure on soft tissues, less support for feet and legs, poor balance.

• Too deep seat: Restricted leg circulation, extended leg/forward slide in the chair, difficult propulsion.

• Lock extensions: Metal tubes to improve rear wheel locking for those with upper limb weakness.

• Wheel/rim covers: Plastic covers to improve grip for patients with spinal cord injuries or arthritis.

• Rim projections: Pegs (vertical, oblique, or horizontal) to assist propulsion for patients with poor hand function.

• Detachable footrests: For stand/pivot transfers.

• Elevating leg rests: Assist lower extremity circulation, preventing edema and orthostatic hypotension.

• Removable armrests: Needed for side transfers.

• Adductor cushion/pommel: Placed between the knees to control adductor spasticity or contractures; seat tilting (10-15 degrees) may aid extensor spasticity or thrusting.

This quiz explores the use of wheelchairs and walking aids, highlighting their role in mobility and daily activities for patients. It covers common cases where wheelchairs are necessary and discusses the conditions leading to ambulation deficiencies. Gain insights into how these aids provide support and improve the quality of life.