Tmt:w/c.trans

Front 1

Prior to Bringing a Patient into a Treatment Area (2)

Back 1

1. Remove unnecessary items
2. Prepare needed equipment

Front 2

Body Mechanics (6)

Back 2

1. Proper posture
2. Cardinal rules of correct body mechanics
- Keep the load close
- Center of gravity (@ level of S2) within base of support
3. Create an appropriate base of support-avoid crossing extremities
4. Use isometric muscle contractions of trunk muscles prior to lift-trunk erect
5. Lift with the legs
6. Do not twist to turn
- Move the feet to change direction
- Avoid twisting feet or crossing as decreases BOS and can interfere with balance

Front 3

Instructions to Patients when Transferring (4)

Back 3

1. Inform patient of what is to be done
2. Provide information as part of teaching process
3. Instructions
- Include oral and written descriptions
- Include visual demonstrations
- Are given prior to and provided during activity
- Consist of patient-friendly language and terms
- Describe the general sequence of events
4. Verbal cues
- Focus patient’s attention during performance
- Specific and brief
- Properly timed
- Appropriate in tone and volume

Front 4

Patient Preparation for Transfers (5)

Back 4

1. Properly dressed for
- Modesty
- Safety/protection of wounds, scars, residual limbs
- Effective treatment
2. Draping-expose body parts for Rx
3. Gait belts used for transfers/ambulation
4. Awareness of lines, tubes, and electrodes
5. Transporting
- Engage wheel locks
- Adjust lines, tubes, equipment
- Protect patient’s arms and legs
- Pillows and padding for comfort/protection

Front 5

Components of Wheelchairs (6)

Back 5

1. Anti-tipping components
2. Armrests
3. Front rigging
4. Pelvic positioners
5. Wheels
6. Wheel locks

Front 6

Types of Wheelchairs (7)

Back 6

1. Amputee-frame
2. Fixed frame
3. Folding
4. One-arm drive
5. Reclining-back
6. Standard
7. Tilt-in-space

Front 7

Wheelchair Components: Wheel Locks (2)

Back 7

1. Purpose-
- to stabilize wheels of WC after WC is stopped
- for safety, engage whenever moving into/out of WC
2. Types
- Rear- prevents fwd/bwd
- Castor- prevents side-side (not typically used)

Front 8

Wheelchair Components: Pelvic Stabilizer (2)

Back 8

1. Purpose
- Stabilize pelvis for proper position
2. NOT for prevention of falls or as a restraint!
- Appears to be a seat belt

Front 9

Wheelchair Components: Caster Wheels (2)

Back 9

1. Types
- Pneumatic
- Solid rubber
- Roller blade
2. Indications
- Shock absorption
- Smoother ride
- Small, durable

Front 10

Wheelchair Components: Drive Wheels (3)

Back 10

1. Solid rubber
2. Pneumatic
3. With or without tread

Front 11

Wheelchair Components: Armrests (3)

Back 11

1. Full
2. Desk length
3. Removable or fixed

Front 12

Wheelchair Components: Front Rigging (2)

Back 12

1. Purpose
- Support for LE
2. Components
- Footrest-foot plate only
- Leg rest-foot plate and calf pad
- Fixed (cheaper & lighter) or removable (convenient for transportation and storage)

Front 13

Wheelchair Components: Leg Rests (2)

Back 13

1. Purpose
- Support calf and cushion
- Allows elevation when needed
2. Components
- Foot plate and calf pad

Front 14

Wheelchair Types: Tilt-In–Space (1)

Back 14

- Entire seat tilts back rather than just back of wheelchair as in a reclining back wheelchair

Front 15

Wheelchair Types: One-arm drive (1)

Back 15

- For those who can only manoever with one hand

Front 16

Wheelchair Types: Amputee (1)

Back 16

- Weighted chair to accomodate shifted center of gravity

Front 17

Wheelchair Types: Companion (3)

Back 17

1. Used for transport only
2. Must be pushed by an assistant
3. No drive wheel

Front 18

Wheelchair Types: Power Scooters (2)

Back 18

1. Description
- alternative to powered WC
2. Indications
- For those who can ambulate short distances

Front 19

Measuring Seat Depth (4)

Back 19

1. Most important measurement for wheel chair fiting
2. Patient proper posture
- aligned 90° hip/knees
- back in contact with flat back support
- no pelvic tilt
3. Measure horizontal distance from flat back to post. aspect lower leg. Subtract 2-3 inches
4. Potential problem when too short
- thighs not supported properly
- affects weight distribution and comfort
5. Potential problems when too long
- circulation compromise
- can lead to sacral sitting
- poor posture and possible skin breakdown
- inefficient propulsion

Front 20

Measuring Seat Width (5)

Back 20

1. 2nd most important measurement, results in:
- proper upright posture
- proper positioned drive wheels and armrests!
2. How to measure
- pt properly aligned
- measure widest aspect of hips or thighs (whichever is wider), // to solid flat seat & add 2 inches
3. Too wide
- Difficult to reach drive wheels
- may lean to 1 side
4. Too short
- excess pressure on pelvis and thighs
- discomfort
- possible skin breakdown
5. Include enough space for
- extra clothing
- prosthetic/orthotic devices
- ease of movement

Front 21

Measuring Back Height (3)

Back 21

1. Amount of back support needed
2. Potential problems:
- Too high: restricts mvmt
- Too low: not enough support
3. How to measure:
- pt sitting properly aligned on solid flat seat
- measure vertical distance // to back support from top of seat to inf. angle of scapula. Add height of any seat cushion

Front 22

Measuring Armrest Height (2)

Back 22

1. Benefits: promotes proper positioning and posture
2. Potential problems if wrong height:
- causes discomfort and doesn’t allow proper alignment
- can possibly cause unequal pressure on forearms, ischia
- spinal curvature
2. How to measure
-proper sitting with upper arm against chest wall elbow 90° flexion.
- Measure vertical distance from solid seat surface to pt. forearm, // to back support. Add height of seat cushion.

Front 23

Measuring Footplate Length (2)

Back 23

1. Benefits: proper alignment and support of LE’s
- used to determine type of foot/leg rest
2. Too much:
- sacral sit
3. Too little:
- wt distribution on thigh uneven
- more wt on ischia and coccyx
- possible breakdown
4. How to measure
- minimum of 2” between floor and lowest point of under surface for clearance
- Msr. Length of pt lower leg and height of foot from posterior aspect of thigh at popliteal fossa to sole of foot at heel. Subtract height of seat cushion.

Front 24

Measuring Footplate Size (2)

Back 24

1. Benefits:
- proper support of LE
- prevents deformity of foot/ankle
2. How to measure
-keep size to a minimum to avoid interference with WC maneuverability
- Measure from calcaneus to met heads while foot is supported and ankle in neutral