Wheelchair and Walking Aids PDF

Wheel chair and walking aids  eelcha W h ir  Wheelchair ▪It is a mobility orthosis, providing appropriate support to allow maximum functional mobility. It is a combination of a postural support system and a mobility base, that are joined to create a d...

Wheel chair and walking aids  eelcha W h ir  Wheelchair ▪It is a mobility orthosis, providing appropriate support to allow maximum functional mobility. It is a combination of a postural support system and a mobility base, that are joined to create a dynamic seated environment.  Wheelchair functions: It is a functional aid which can ▪ Provide protection ▪ Support and stabilize the body, ▪ Stimulate activities ▪ Afford locomotion while maintaining immobilized one or another part of the body to perform ADL. ▪ It enables many patients to move about without undue effort. ▪ Psychological value ▪ Stimulating greater interest in one’s surroundings and a greater desire to keep moving.  Common cases that could need wheel chairs: Those who need wheelchairs are those who either should not or cannot walk, walking is either Inadvisable or Impossible. ▪ Inadvisability of ambulation may be because of ▪ Contraindications to weight-bearing ▪ Interference with wound healing ▪ Prior to ambulation, ▪ Inadequate safety in walking ▪ Deficiency of the patient’s judgment. ▪ In all of these conditions, the restriction against walking may be temporary. Deficiency in ambulation ▪ results usually from the involvement of both lower limbs by one or more of such conditions as: ▪ Absence of an essential part, ▪ Paralysis. ▪ Deformity, ▪ In coordination. ▪ In all of these conditions, the use of wheel chair may be permanent. Wheelchair prescription depend upon many factors: Age, size & weight Disability & prognosis Functional skills Indoor / outdoor use Portability / accessibility Reliability / durability Cosmetic features Options available Service Coast Level of acceptance (Environment).  Types of Wheelchair 1. Standard wheelchair 2. Standard light weight wheelchair. 3. Ultra lightweight transport wheelchair. 4. Reclining back rigid frame wheel chair. 5. sport chair. 6. Heavy duty pediatric wheelchair. 7. Power wheelchair  Ultra lightweight transport Reclining back rigid frame wheelchair. wheel chair Standard light weight wheelchair. Heavy duty pediatric wheelchair. Power wheelchair sport chair.  Components of the wheelchair: ❖ Wheelchair frame: stationary or foldable. ❖ Seat and cushion Wheelchair seat cushions should provide a high-level of comfort, prevent bruising or sores that result from pressure points ❖ Arm rests: fixed or adjustable. Stationary or removable. ❖ Leg rests: adjustable or removable ❖ Foot rests: ❖ Restraints: chest belts  Wheelchair frame foldable. Foot rest Swing-away Foot rest  Wheel chair options and accessories ▪ Caster wheel : ▪ Casters vary in size from 4 to 8 inches and increase the maneuverability of the wheelchair. The smaller the caster the greater the mobility. The larger the caster the greater the stability. ▪ Tire materials vary from solid plastic to pneumatic. The firmer the material the greater the maneuverability, the softer the material the more cushioned the ride. ▪ Crutch / cane holder: ▪ It is a small cup at the base of the wheelchair with a strap at the top to allow transportation of these ambulatory aids. ▪ Anti-tipping device: ▪ Placed on the back tipping lever, these devices prevent the patient from tipping backwards in the chairs, but also limit going up curbs. ▪ Hill-holder device: ▪ A mechanical brake that allows the chair to go forward, but automatically brakes when the chair goes in reverse. It is useful for patients who are not able to ascend a ramp or hill without a rest. ▪ Lock extensions: ▪ Metal tubes placed over the standard lock to make it easier to lock the rear wheels appropriate for someone with upper extremity weakness. ▪ Wheel / rim covers: ▪ Using covers made of plastic or other material for increasing grip friction. It is common for patients who have a spinal cord injury or arthritis. ▪ Rim projections: ▪ Pegs placed vertically, obliquely or horizontally that allow patients with poor hand function to propel the chair. Horizontal or oblique pegs can widen the chair and may limit maneuvering in the home. ▪ Detachable footrest: ▪ Needed for stand / pivot transfers. ▪ Elevating leg rest: ▪ Raise the lower legs to assist with lower extremity circulation, ▪ edema prevention and orthostatic hypotension. ▪ Removable arm rests: ▪ Needed for side transfers. ▪ Adductor cushion or pommel: ▪ A cushion placed between the knees to try and control for adductor spasticity or contractures. Sometimes the entire seat unit is tilted backward 10-15 degrees to help control for extensor spasticity or thrusting. Importance of good measurements ▪Good measurements has to be considered to avoid many problems: Too narrow seat: ▪Uncomfortable. ▪Difficult access. ▪Developing pressure sores. Too wide seat: ▪Leaning to one side. ▪Promoting scoliosis. ▪Difficult propulsion. Too shallow seat: ▪ Less area of contact ▪ More pressures over soft tissues ▪ Less support to feet & legs ▪ Poor balance Too deep seat: ▪ Restricted leg circulations ▪ Extended leg / forward slide in the chair ▪ Difficult propulsion.  Steps to measure wheelchair 1. Measure the width of the person who will use the wheelchair. Take the measurement with the person in the seated position, on a fairly firm surface. This will determine the width of the seat. Add approximately 1 to 2 inches (2.5 to 5 cm) for slight movement and comfort when sitting. Allow for the thickness of bulky clothing, which could be worn in the winter 2. Measure the widest part of the subject's chest. This will usually be from directly under one armpit to the other. This will influence the width of the seat back 3-Measure from the back of the heel to the back of the knee. This will determine the length of the leg rest extension and influence the seat height. Add a minimum of 2 inches (5 cm) to this measurement to determine seat height. Unless the wheelchair is going to be foot propelled, the footrest needs that much room for clearance.. 4-Measure from the back of the hips to the back of the subject's knee. Add approximately 1 to 2 inches (2.5 to 5 cm) to determine the ideal seat depth. For an adult, there should be that much space from the edge of the seat to the back of the knee. 5-Measure from the tip of the elbow to the top of the hips. Again, the person should be in a sitting position with both arms at a 90 degree angle. This will determine the height of the armrest in relation to the seat. 6-Measure from the hips to the shoulders. This will determine the height of the seat back. 7-Measure from the hips to the top of the head. This will determine the necessary height of the headrest.