At Exam 1

Front 1

Assistive technology

Back 1

Any item, piece of equipment, or product system whether acquried commercially off the shelf, modified, or customized that's used to increase, maintain, or improve functional capabilities of individuals w/ disabilities.

Front 2

Potential outcomes of proper seating and positioning:

Back 2

Improved movement
Neutral skeletal alignment
Prevent tissue breakdown
Improved comfort
Decreased fatigue
Improved respiration
Improved swallowing and digestion
Improved stability thus improved function

Front 3

3 categories of seating intervention (may overlap):

Back 3

Seating for postural control and deformity management
Seating for pressure management
Seating for comfort and postural accommodation (elderly often).

Front 4

Seating and positioning team members:

Back 4

Student/consumer (school)
Family/caregiver
School/work caregiver
Teacher
Physician
PT/OT/SLP
Equipment supplier
Rehab engineer
Funding source

Front 5

Force-

Back 5

anything that acts on a body to change its rate of acceleration or alter its momentum. Occurs in equal and opposite reaction pairs. Applied internally and externally.

Front 6

External force-

Back 6

wheel chair, head rest, gravity, etc.

Front 7

Internal force-

Back 7

mm, bones, ligaments.

Front 8

3 types of force:

Back 8

tension, compression, and shearing

Front 9

tension-

Back 9

force acting in same line, but away from each other.
Ex: antagonist and agonist muscles.

Front 10

Compression-

Back 10

pushing together
Ex: compression on cushion when seated.

Front 11

shearing

Back 11

forces that are parallel.
Ex: head of femur against acetabulum (internal), sliding transfer (external.

Front 12

Stress

Back 12

resulting molecular change inside biological or non-biological materials.

Front 13

Pressure-

Back 13

every force is applied over a surface area- defined as force/unit area.
Smaller area, greater F/pressure

Front 14

Newton's 1st law

Back 14

body at rest maintains at rest. Body in motion in a straight line tends to remain in motion unless external force acts to change either of these static, inertia.

Front 15

Newton's 2nd law-

Back 15

Greater F, greater the acccelleration. The greater the mass, the less the acceleration.

Front 16

Newton's 3rd law-

Back 16

One body exerts a F on another, there's an equal and opposite F called a reaction exerted on the body by the second.

Front 17

Static friction-

Back 17

force that mst be overcome to start a body in motion

Front 18

Dynamic friction-

Back 18

friction that occurs during the motion.

Front 19

A __ relationship exists between muscle required to maintain a posture in the presence of gravity and teh efficiency of that posture.

Back 19

direct

Front 20

What helps maintain balance?

Back 20

Keeping the COG directly above the BOS.

Front 21

Lower COG...

Back 21

increases stability

Front 22

Larger BOS...

Back 22

larger the movement w/o instability.

Front 23

In standing, what provides BOS?

Back 23

feet

Front 24

In standing, where's the COG

Back 24

upper sacral region

Front 25

BOS in sitting..

Back 25

buttocks, back of thighs, feet, and back

Front 26

COG in sitting...

Back 26

lowered

Front 27

Why is pelvic stability reduced in sitting?

Back 27

Passive locking mechanism at the hip joints provides ligamentous support when the hips are fully extended. Lose this when seated.

Front 28

Outcome of needs identification:

Back 28

ID contexts and related concerns: setting, caregiver support, physical contexts, accessibility, transportation.
ID previously used seating system
ID and prioritize goas

Front 29

Outcome of skills eval: Physical skills-

Back 29

Ortho factors
Neuromotor factors
Respiratory and circulatory factors

Front 30

Outcome of skills eval: sensory skills-

Back 30

vision
perception
tactile sensation

Front 31

Outcome of skills eval: cognitive/behavior skills:

Back 31

safety awareness
Motivation

Front 32

Functional skills:

Back 32

Transfers
Self-care
Mobility, propulsion
Communication
Bowel and bladder function
Other equipment used.

Front 33

Match technologies to what three factors?

Back 33

Postural control
Pressure management
Comfort (elderly)

Front 34

Critical Qs for evaluation:

Back 34

Does it meet consumer's goals and needs?
Does it provide stability and allow function?
Is it comfortable?
Is it durable?
Are there resources for maintenance?
Who will finance the system?

Front 35

What is the key point of control?

Back 35

the pelvis

Front 36

What is the first area addressed?

Back 36

the pelvis: alignment and stabilization
Neutral or slight anterior tilt
Support provided under, behind, anterior, or from sides

Front 37

Ways to support pelvic control:

Back 37

Cushion (may be modified/molded), back wall on cushion, back rest, laterally to help align hips, anterior by belt (can also correct w/ belt).

Front 38

Ideal pelvic posture:

Back 38

Neutral alignment (or slight anterior tilt)
Head balanced over spine
Spine balanced over pelvis
ASIS/PSIS level
Natural spinal curves
Shoulders slightly posterior to pelvis.
Head in neutral position w/ eyes looking forward
Equal WB through both ischial tuberosities

Front 39

Assymetrical pelvic postures:

Back 39

pelvic obliquity
Rotation
Severe anterior or posterior tilt
Windswept legs

Front 40

Pelvic obliquity-

Back 40

one side higher than other. Name by lower side. May have irregular tone.

Front 41

Pelvic rotation-

Back 41

one side forward of the other. "Forward rotation w/ R ASIS forward of L"

Front 42

Positional reasons for PPT

Back 42

Seat cap too long, too much hamstring stretch, or elevated leg rests.

Front 43

Reasons for APT

Back 43

weak abs/tight hip flexors

Front 44

How is the seating intervention of a person in a wheelchair generally described?

Back 44

In terms of support provided.

Front 45

Support-

Back 45

To carry the weight of, especially from below... or to maintain in position so as to keep from falling, sinking, or slipping.

Front 46

What do supports provide?

Back 46

contact against the body, stable surface, distribute weight, maintain desired position, reduce extraneous movement, limit tone influences, improve function

Front 47

Types of support systems:

Back 47

Planar (linear)- add on supports
Contoured (off the shelf)
Custom contoured (molded)

Front 48

Ideal angle of the pelvic positioning application:

Back 48

45-90 degrees

Front 49

Want to increase pelvic stabilization w/ the goal of...

Back 49

enhancing upper body function

Front 50

Hip grip-

Back 50

Helps bring pelvis back in place, increase ability to forward reach and increase comfort.

Front 51

__% of people w/ SCI will encounter tissue breakdown.

Back 51

50

Front 52

Social costs of poor pressure management-

Back 52

loss from work and social, self worth

Front 53

Origins of ulcers:

Back 53

WB bony prominences most commonly develop ulcers.
Duration of pressure is a significant variable.

Front 54

Factors contributing to ulcer development:

Back 54

Mobility
SCI- lack of BF and loss of mm mass
Body type- heavy may not be positioned as much, skinny may have issues too.
Nutrition- anemic, decreased protein, vitamin C
Infection
Age- lose elasticity
Sitting posture
Microclimate- air cushion is cooler than foam
Transfers- shearing

Front 55

Mobility scales used to consider ulcer development:

Back 55

Norton scale and Braden scale

Front 56

In patients w/ SCI, buttock tissue needs ___ minutes to allow the tissue perfusion return to the uncompressed level.

Back 56

3

Front 57

Weight shift for patients w/ SCI ever ___

Back 57

15-30 minutes.

Front 58

Wheeled mobility historical perspective: 20000 years ago:

Back 58

Used wheels under sleds

Front 59

Early 1500s:

Back 59

carts

Front 60

1588:

Back 60

Mid-European times

Front 61

1700s:

Back 61

King Philip of Spain used a WC w/ reclining back rest, leg rest, etc. Used through Civil War.

Front 62

Civil war:

Back 62

also used cane seats/backs

Front 63

1870s:

Back 63

Bike industry created technology transfer

Front 64

1932:

Back 64

Biggest change; First saw cross braced frame. Everest was injured and sustained an SCI and w/ Jennings developed cross frame tech that allowed chair to be folded.

Front 65

1952:

Back 65

WC sports

Front 66

1957:

Back 66

Power introduced into industry

Front 67

1960s:

Back 67

Olympic athletes

Front 68

1970s:

Back 68

Higher end WC, more sporty (box type) frame; lighter equipment

Front 69

65 Y/O and older make up more than __% of population by 2030.

Back 69

20

Front 70

Age related changes ___ use of mobility devices.

Back 70

Increases.

Front 71

Currently 57.5% of manueal WC users and 69.7% of power WC users are __.

Back 71

65 or older

Front 72

Neuro disorders resulting in mobility impairments:

Back 72

CVA (11.1%)
CP
Guillian Barre syndrome
Huntington's chorrea
TBI
MD
Parkinson's
Polio
SCI
spina bifida
MS
May also have cognitive deficits

Front 73

Ortho and rheumatological disorders resulting in mobility impairments:

Back 73

AS
Osteogenesis imperfecta
Osteoporosis
Paget's disease
scoliosis
amputation

Front 74

Other chronic conditions resulting in mobility impairments:

Back 74

diabetes
cardiorespiratory problems
obesity
cognitive impairment

Front 75

Scope of mobility limitations:

Back 75

Fully ambulatory: no impairment
Marginal ambulatory: walks short distances. Needs chair at times.
Manual WC user: propels manual chair.
Marginal manual WC user: UE impairment. Manual is not most efficient
Totally/severely mobility impaired: power mobility is the only option

Front 76

Factors to consider when selecting a mobility device:

Back 76

Consumer profile- disability, date of onset, prognosis (length of need for chair), size and weight.
Consumer needs- do they need it easy to transport, reliability, durability
Physical and sensory skills- from MAT assessment- ROM motor control, strength, skills and understanding, depth perception
Functional skills- how do they transfer, does chair need to be certain height, can they propel chair independently

Front 77

Environmental factors to consider:

Back 77

Physical context- where will they use chair, method of chair transport
Social context- some don't want a power chair
Institutional context- funding

Front 78

3 broad categories of mobility:

Back 78

Dependent- need to be pushed; not cognitively aware, child, etc
Independent manual- can push self
Independent power- need power chair, but can use on their own

Front 79

Frame types:

Back 79

Standard/conventional
Lightweight
Ultra lightweight
Heavy duty
Hemi-height chair
Recline chair
Tilt in space
Power

Front 80

Standard/conventional frame-

Back 80

Cross frame, inexpensive, steel, not a lot of adjustability, limited choices, heavy- 40-65 lbs

Front 81

Lightweight frame-

Back 81

Stainless steel/aluminum, increased adjustability, 26-40 lbs

Front 82

Ultra lightweight frame-

Back 82

rigid frame, adjustability, quick release wheels, titanium or composite material, less than 25 lbs.

Front 83

Heavy duty-

Back 83

Someone who's heavy, someone who expends a lot of energy in chair, extra welds to frame so won't break as easily

Front 84

Hemi-height chair-

Back 84

sit low to ground, used often in CVA, can use uninvolved side to push chair, usually light or ultralight weight

Front 85

Recline chair-

Back 85

can open seat to back angle, may use for pressure relief.Tip back will get shearing. Laterals may end up under armpits.

Front 86

Tilt in space-

Back 86

seat and back stay together, but whole system tilts back. Good for pressure relief or has tight mm and unable to open seat to back angle

Front 87

Rigid and folding chairs:

Back 87

Rigid: back will typically fold down, typically light weight. Box, T or I frame.
Cross brace- traditional folding. Lower cost, easy to fold, heavier.

Front 88

Component options:

Back 88

Armrests
Front riggings
Wheel locks
Anti-tippers
Push handles
Wheels
Tires
Hand rims
Casters

Front 89

Armrests--

Back 89

desk or full length. can be flipped back or removable.

Front 90

Front riggings:

Back 90

leg rests- hangers- depend on HS length and turning radius, further out hangers- less turning radius; removable, swing away, solid (stronger).
Foot plates- limited PF/DF manufacturer can make them angle adjustable.

Front 91

Wheel locks-

Back 91

push to lock or pull to lock, extended handles

Front 92

Anti-tippers-

Back 92

front or back, usually back unless it's someone who rocks themselves forward

Front 93

Push handles-

Back 93

how the caregiver maneuvers the chair

Front 94

Wheels-

Back 94

spokes are lighter weight wheels

Front 95

Tires-

Back 95

airless inserts, air, or solid; dependent on environemnt and weight desired

Front 96

Hand rims-

Back 96

some have projections for someone w/ SCI to help them grip

Front 97

Casters-

Back 97

small tire in front; may need ot be bigger if go outside a lot. Affect turning radius.

Front 98

Power mobility can be rear, mid or front wheel drive:

Back 98

Rear- lots of poewr, easier to pop curbs, use for rough terrain
Mid- COG brought in; person can turn on a dime; good for tight corners in home, not in rough terrains.
Front- rare, front wheel pulls chair, fish tailing at high speeds

Front 99

Control interface-

Back 99

How the person drives the chair.
Proportional- like an automobile. Smaller the turn of the joystick, the smaller the turn of the chair.
Non-proportional- go or don't go, on or off like a light switch. Doesn't depend on how much you push it.
Most are proportional.
Sip and puff- type of non-proportional
Can have switches in headrest where they tap head to change direction. Typically non-proportional.

Front 100

Power mobility controllers:

Back 100

Toggle/knob- tells chair faster and slower by turning knob.
Torque- changes current, force, power; can give more or less power.
Acceleration- how quickly it picks up speed. Poor body control may want slower accel/decel.
Braking- fast or slow dependent on body control.
Momentary vs latched- seen w/ proportional joystick/sip and puff; keeps motor running until tell to stop.
Tremor dampening- joystick doesn't read shakiness, but responds when pushed hard.
Short throw- how far they push joystick to get chair to move
Attendat control- allow caregiver to help them drive
Auxilliary control- what you use to controll augmentative control device

Front 101

Batteries:

Back 101

Deep-cycle lead acid: wet cell-less expensive and longer lasting, higher maintenance (fluid evaporates), less safe. Gel cell (sealed) won't spill (some public transportation require gel cell)
Ventilators, humidifiers, and suction may hook into battery power

Front 102

Other power:

Back 102

Power assist- wheels have built in batteries. Go on manual chair; push wheel and cuts back on energy expenditure.
Smart WC- can tell where the chair is (ex: going down steps) and can adjust self.
Scooter (POV-Power operated vehicle)- 4 wheel drive is bigger but more stable or 3 wheel drive.
Sit to stand- need hip and knee extension ROM

Front 103

Wheelchair standards:

Back 103

ISO, ANSI, RESNA

Front 104

Parts of the wheel of best practice:

Back 104

Experience
Learning
Consumer
Follow-up
Resources
Technology
Skills
Technique

Front 105

Experience-

Back 105

moves practitioners from novice to expert.
Knowledge is more organized and efficient.
Utilize relevant info
Utilize previously stored info
Improved problem solving and clinical reasoning skills
Higher level of concept formation

Front 106

Hands on techniques-

Back 106

Ability to know when something feels right.
Not just a science, but an art.
Knowing-in-practice leads to reflection-in-action.

Front 107

Skills-

Back 107

Mat assessment
Trial of recommended equipment
Movement assessment- application of biomechanical and anatomical knowledge
Environmental assessment
Simulation
Thorough interview
Pressure mapping (contingent on situation)

Front 108

Technology-

Back 108

Understanding of strengths and weaknesses
Understanding of old and new technology
Combo of old and new

Front 109

Resources-

Back 109

Knowing resources
Utilizing resources
Finding resources
Learning how to learn
Networking

Front 110

Self-directed learning-

Back 110

Active learning skills
Methods- continuing education, peer mentoring, trial and error, reading, trade shows
Life long and self directed learning

Front 111

Follow-up-

Back 111

Formal- questionnaire, yearly appointment
Informal- repair appointment
Combo
Both useful

Front 112

Consumer relations-

Back 112

Embrace the consumer and their knowledge they best know their own needs and have their own experiences to draw from.

Front 113

Barriers-

Back 113

Barriers exist and must be identified.
Efforts should be made to overcome
Ex: time restraints, funding, lack of equipment
Methods to overcome- out of box thinking

Front 114

Researchers who have studied the effects of self-produced locomotion in typical children view it as...

Back 114

An organizer of psychological changes in infants and developmental changes in social understanding and spatial cognition.

Front 115

Studies suggest that spatial cognition and other functiosn are affected by...

Back 115

Experiences, including experiences afforded by self-produced locomotion, which have an influence on the structure of an infant's developing brain and related functions.

Front 116

Is mobility important to development?

Back 116

yes

Front 117

Children w/ limited mobility may be at risk for secondary impairments in:

Back 117

Spatial cognition
Communication
Social development
Other domains

Front 118

To promote independent mobility, what is advocated for young children w/ severe mobility limitations?

Back 118

Power mobility

Front 119

Dr. Jones' Power mobility study found significant differences in what factors due to use of power mobility at an early age?

Back 119

Receptive communication of BDI
Mobility functional skills of PEDI
Mobility caregiver assistance of PEDI
Self-care caregiver assistance of PEDI

Front 120

Conclusions of power mobility study:

Back 120

Children can learn to use power chair, may take longer time to master skills, but need intense training and lots of practice.
Power mobility promotes increase communication.

Front 121

Developing a funding strategy:

Back 121

Define and document the need
ID equipment/services needed.
Determine if an aternative device will meet the need.
Determine potential funding sources.
Gather all info needed for funding.
Submit for approval.
Appeal if needed.

Front 122

Sources of funding:

Back 122

Public funding
Private funding
Other

Front 123

Public funding:

Back 123

Includes federal, state, and local government agencies.
In some cases, federal agency only oversees the program (Medicare).
3rd model extends federal presence to local levels of govt (IDEA).
Each program has a set of regulations that mandates teh services to be provided.

Front 124

Who authorizes in public funding?

Back 124

congress authorizes funding through a specific piece of legislation.

Front 125

Cooperative federalism:

Back 125

w/in each state an agency is designated to receive the federal funds and ensure compliance (medicaid).

Front 126

Which is billed first, medicare or medicaid?

Back 126

Medicare is billed first, Medicaid is always teh payer of last resort.

Front 127

Medicare was established...

Back 127

by congress in 1965

Front 128

Medicare covers whom?

Back 128

Individals 65+ and those under 65 who are blind, totally and permanently disabled, and have received SSDI (social security disability insurance) for at least 2 years.

Front 129

Who administers Medicare?

Back 129

Health Care Financing Administration (HCFA)

Front 130

2 types of medicare coverage:

Back 130

A and B

Front 131

Medicare part A:

Back 131

Covers IP hospitalization, SNF, home health, hospice care

Front 132

Medicare part B:

Back 132

Supplemental policy which individual pays a small premium to cover services such as OP and Durable medical equipment (DME) and Mobility Assistive Equipment (MAE).

Front 133

Mobility Assistive Equipment includes:

Back 133

Walkers
Canes
crutches
manual WC
power WC
POV (scooters)

Front 134

MAE defined by CMS-

Back 134

Equipment that's primarily used to serve a medical need, can w/stand repeated use, and is generally not useful to a person in absence of injury or illness.
Must be used in the home and deemed medically necessary.
Letter of medical necessity.

Front 135

Medicaid-

Back 135

Est 1965 by Title XIX of social security act.
Developed for people who are unable to pay the costs of their medical care.
Administered at state level.
Federal government mandates certain services, eligibility, and benefits requirements.

Front 136

AT w/ medicaid:

Back 136

Not an optional or mandatory service- state freedom of what they want to provide.
General criteria- medical necessity
Prior authorization required
Payer of last resort

Front 137

Medicaid- Early, Periodic, Screening, Diagnosis, and Treatment (EPSDT, soonercare)

Back 137

Most children go through screenings.
If dx is made through screenings, then all secondary treatments occur through this program.
Ages 0-21
Payer of last resort

Front 138

Medicaid community waiver:

Back 138

Requires a primary diagnosis of mental retardation
eligibility for medicaid.
Payer of last resort.

Front 139

Medicaid DDSD in-home supports waiver:

Back 139

To minimize waiting list.
Families receive a plan of care, in which they cash in for services, equipment etc.
Voucher for kids- 12,360/year
Voucher for adults- 18540/year
Payer of last resort

Front 140

Supplemental security disabled children's program:

Back 140

Covers non-medicaid covered items.
Federal/state match
Must be SSI eleigible- medical determination
Receive approx. 250/month for things like formula, diapers, etc.

Front 141

Tricare

Back 141

Federally funded
The Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)
Provides medical benefits to dependents of active duty members of armed forces and retired members.
Contracts w/ health insurance companies for AT.

Front 142

Education and AT:

Back 142

AT as written into IEP.
school doesn't have to provide things like WC, but purpose is for things that hellp a person educationally.
AT is IDed as being necessary for a "free and appropraite public education".

Front 143

Vocational rehabilitation

Back 143

Individual Written Rehab Plan outlines objectives related to vocational planning.
AT to complete training in vocational rehab program or to obtain employment (competitive, supported, or sheltered).

Front 144

OK Assistive Technology Center:

Back 144

Funded under Assistive Technology act of 1998.
Located on OSU campus.

Front 145

4 core programs of OK AT center:

Back 145

Demonstration centers
Short-term equipment loan
AT Reutilization
Low interest bank loans for AT purposes.

Front 146

Department of VA

Back 146

Provides AT services
Contracts w/ outside agencies to provide services.
For individuals who have service related injury.

Front 147

Worker's compensation:

Back 147

Work-related injuries are covered by benefits
Under certain conditions, AT may be covered
Workers comp benefits are financed jointly by employers and state.
Private companies typically administer policy.

Front 148

Private funding:

Back 148

Self-funding
Private health insurance

Front 149

Self-funding:

Back 149

Out of pocket cash
Private trust funds
Loans- Easter Seal Society- National loan fund

Front 150

Private health insurance:

Back 150

Some plans cover DME. Some don't.
Current Procedural Terminology (CPT) codes may be used.
May have an approved list of vendors.
Plan may be capped.
Based on diagnosis and medical necessity.

Front 151

Other funding sources:

Back 151

Civic organizations (Kiwanis club, rotary club, shriners)
Disability foundations (American foundation for the blind, MD association, UCP)
United Health Care children's foundation (pay up to 5000)

Front 152

Funding strategy:

Back 152

Gather all info needed for funding.
Submit for approval
Appeal if needed.

Front 153

General funding process:

Back 153

Intake referral
Funding is secured for eval
Eval completed
Recommendations are made w/ justification. Must be appropriate and cost effective.
Supplier pulls together paperwork
Funding is request
Consider resources for training, maintenance, and follow-up.

Front 154

Funding justification:

Back 154

Description of functional limitation that the device and service address.
Detailed description of the device including features, accessories, and customization.
How device will alleviate or ameliorate the functional limitation.
Description of eval process.
Explanation of why device is least costly
Description of the evaluator/team

Front 155

Two key questions to ask and address:

Back 155

What is this indiviudal's destructive postural tendencies?
What's the least costly alternative to address these tendencies?

Front 156

Diagnosis codes:

Back 156

describe a person's condition

Front 157

The Health Care Financing Administration (HCFA) Common Procedural Coding Sytstem (HCPCS)

Back 157

Used for DME coding

Front 158

CPT codes:

Back 158

pertain to medical services.
97755- AT assessment
97542- WC management and propulsion

Front 159

Appeals:

Back 159

Every funding source has an appeals process
Find out the procedure for appeal
Find out why the request was denied.
Make an appeal in writing, correcting the error.

Front 160

Why do we recommend assistive devices?

Back 160

Balance deficits
Pain
Weakness/fatigue
Joint instability
Provide sensory feedback
Excessive skeletal loading
Eliminate WB partially or all together from R or L LE

Front 161

What type of device categories to choose from>

Back 161

cane, crutches, walkers

Front 162

Cane:

Back 162

Poorest BOS
Not typically used w/ patients w/ WB restrictions
Reduces ened for greater force from contralateral hip adductors used for normal gait.

Front 163

Advantages of cane:

Back 163

Inexpensive
Adjustable most cases
Light weight and fits easily into most spaces

Front 164

Disadvantages of cane:

Back 164

Point of support is anterior to the hand and not beneath it

Front 165

Crutches:

Back 165

used for full or partial WB

Front 166

Advantages of crutches:

Back 166

Improve balance and lateral stability
Use w/ patients that have restricted WB
Easily adjustable

Front 167

Disadvantages of crutches:

Back 167

Can be awkward in small spaces secondary to larger BOS
Tendency of patients to lean on axillary bar
UE must be in good shape

Front 168

Walkers:

Back 168

Can help w/ decreased balance
Used w/ either full or partial WB
Wide BOS
Can allow UE to transfer bodcy weight to the floor.
2 wheel/4 wheel/ standard

Front 169

Advantages of walkers:

Back 169

Provide a high level of stability
Highly variable for different levels of mobility
Safest choice

Front 170

Disadvantages of walker:

Back 170

Difficult ambulating up and down stairs
Slower gait
Can be awkward in tight places, small rooms, restaurants

Front 171

Mildly impaired balance stability, use:

Back 171

single-point cane

Front 172

Unilateral LE pain/mild weakness

Back 172

Single point cane, hold w/ unaffected side

Front 173

Moderate impaired balance/stability-

Back 173

quad cane (narrow or wide base)

Front 174

Moderate to severe unilateral weak\ness/hemiplegia

Back 174

Walker cane/hemiwalker

Front 175

Bilateral LE weakness/paralysis

Back 175

Bilateral crutches or walker (pick up or front wheeled)

Front 176

Severely impaired stability

Back 176

walker (pick up or front wheeled)

Front 177

Impaired wrist/hand function

Back 177

Platform forearm walker

Front 178

Difficulty climbing stairs-

Back 178

stair climbing walker

Front 179

impaired bed mobility

Back 179

Bed rails, hospital bed

Front 180

Difficulty w/ transfer

Back 180

transfer sliding board

Front 181

Difficulty getting up from chair-

Back 181

seat lift or uplift seat assist