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62 Cards in this Set
- Front
- Back
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WHEELCHAIRS
parts Brakes (locks)- |
lever/cam system or slot/locking mechanism, can have extensions on brakes to decrease amount of force needed 195-197
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WHEELCHAIRS
parts seat belts: |
velcro, latching, push button
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WHEELCHAIRS
parts caster wheels: |
wheels- small front wheels of wc, standard rubber of pneumatic-shock absorbing, easier on soft ground or uneven surfaces
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WHEELCHAIRS
parts drive (push) wheels: |
solid rubber or pneumatic
outer rim for propulsion (may have projections-pegs) Mag vs. standard steel spokes, mag is easier to maintain |
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WHEELCHAIRS
parts armrests: |
full length or desk length -easier to roll under tables
removable or fixed |
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WHEELCHAIRS
parts front rigging: |
foot plate or foot rest or elevating leg rests, can have heel loops or toe loops, removable or fixed
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are fixed item wheelchairs heavier or lighter than other wheelchairs?
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Fixed item wheelchairs are lighter and more stable.
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when are elevating leg rests necessary?
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Elevating legrests are needed when pt is unable to flex knee, had LE edema or is in a reclining wheelchair.
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what is the purpose of anti-tipping devices on wheelchairs?
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Anti tipping devices are used to keep the wc from falling over backwards.
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Special chairs:
amputee frame: key differences? |
brings wheels back to increase stability, changes in wt distribution and COG
Seat plates to support residum |
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Special Wheelchairs
Reclining: key features? |
reclining- back of chair lays back, with release levers
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Special Wheelchairs
Tilt in space: key features |
has a fixed seat-to -back angle, even when reclined. Used for pressure relief or other activity without compromising posture control
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Special Wheelchairs
one arm drive key features |
the two outer rims can be driven with one hand or has a pump lever for propulsion
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Special Wheelchairs
Hemi chair: key features |
shorter than other chairs for leg propulsion
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Measuring Wheelchairs
most important measurement? |
width and depth most important measurements
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Measuring Wheelchairs
how to meausre seat depth... |
measure from end of buttocks to post knee and subtract 2-3 inches
poor fit results in sacral sitting, poor thigh support, skin breakdown and less efficient propulsion |
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Measuring Wheelchairs
seat width... |
measure across hips and add 2 inches
too wide causes propulsion problems; too narrow discomfort and skin breakdown |
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Measuring Wheelchairs
back height... |
top of seat to inferior angle of scapula. If using cushion, add its height
Sport wheelchairs have a much shorter back rest. |
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Measuring Wheelchairs
arm rest... |
seat to bent elbow. If using cushion, add its height.
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Measuring Wheelchairs
seat to footplate... |
popliteal fossa to sole of foot.
too long causes sacral sitting too short forces pressure to ischia and coccyx. if using cushion, subtract its height. Need to have at least 2" clearance between floor and foot plate |
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Measuring Wheelchairs
foot plate size... |
calcaneous to heads of metatarsals
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TRANSFERS
what should be done prior to the transfer? |
Before initiating a transfer the therapist should get as much info about the pts abilities as possible to determine the best transfer.
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best course of action if you are in doubt about the level of assistance you may need in a transfer?
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If you are in doubt about the level of assistance you need, always have a second person available
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Dependent transfer
how much assistance from patient? |
minimal or no active participation by the pt.
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Types of Dependent Transfers
4 |
sliding - draw sheet or transfer board
3 person carry dependent stand pivot hydraulic lift |
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Assisted transfers
how much assistance from the patient? |
require some pt participation
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Assisted transfers
types...3 |
2 person lift
sliding board assisted stand pivot |
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max assist of 1-3
what % of work does therapist do? |
therapist does 75% or more of transfer
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mod assist of 1-3
what % of work does therapist do? |
therapist does 50% of the transfer
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min assist of 1-3
what % of work does therapist do? |
therapist does 25% of the transfer
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Stand By Assist (SBA) or Contact Guard Assist (CGA)
what % of work does therapist do? |
therapist does less than 25% of the transfer
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"assisting" can include what types of additional techniques?
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Assist can be verbal cueing, balance control and lifting/ supporting
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what are two major reasons to have direct contact with a patient during a transfer?
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1. allows the therapist to maintain the best biomechanical posture while working with the patient
2. manual contacts provide input to the pt concerning direction of movement |
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Transfer belts are extremely important when used properly for what reasons?
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allows safety if used properly but does decrease manual contact to pt
some hosp/ rehab centers require them, part of protocol and helps in legal situations some facilities prohibit use, as would rather contact pt. |
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what is the purpose of "transfers"?
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Purpose of transfers is to permit pts to function in different environments or use different pieces of equipment.
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what is the GOAL of transfer training?
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Goal of transfer training is to increase the level of independence of a pt.
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will transfer technique always be "by the book"?
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You can generalize your transfer technique to multiple situations with slight modifications
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Key points to remember when teaching and performing transfers...
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always inform your pt about what you are doing and what the pt is expected to do
use commands and contacts to synchronize the actions of all involved |
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who is "in charge" during a transfer?
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the person at the head of the pt usually gives the commands
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when is a transfer complete?
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the transfer is not complete until the pt is safely in a new position
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Draw sheet/sliding transfer.
3 people required basic technique? |
put stretcher, if possible, next to unaffected side. grasp draw sheet with supinated arms. 2 people toward movement, one on the opposite side. watch body mechanics, bring knees up onto bed if necessary. move 1/2 way, reposition, and then complete
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when should a 3 person carry (lift) be used?
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used only if a sliding transfer can not be used
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3 person carry/lift
basic technique? |
position stretcher at a right angle to the pt. remove your jewelry to avoid scratching. tallest therapist at head, strongest in the middle, one at legs. move pt close to you, edge of mat. curl and lift. move as a unit to new surface. lower and uncurl
scoot toward middle of new surface |
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Stand/Swing Pivot
basic technique? |
put wheelchair as close to surface as possible, parallel. lock and remove all extra appliances, parts
move pt forward, hip walk or push back/ hips forward ( if required) place gait belt around pts waist snuggly. block pts feet and knees with yours bilaterally ( or one LE or none as required). put your arms around pts waist either inside or outside pts arms depending on pts control and hold gait belt securely DO NOT allow pts to put arms around your neck. |
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Stand/Swing Pivot
when used? |
pt can bear LE weight, but can't stand independently
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Stand/Swing Pivot
purpose of generating momentum? |
Use momentum, rocking forward and backward, and counting so that all effort is given at same time ( if required)
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Hoyer Lift
Key points? |
basically a sling seat. has a weight limit. works on a hydraulic pump unit. can be used to lift very heavy or totally dependent people from the floor/bed into bed/chair
can also be used a bathing aid, to get to perineal parts for thorough cleaning |
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2 person lift-wc to floor, mat to wc,etc
basic technique? |
lock wc and remove all extra appliances
cross pts arms and grasp the wrists, or may use gait belt straddle wheel second person holds under thighs and lower legs, and faces direction of transfer lift, clear and lower |
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sliding board- no LE use or NWB bilateral LE
basic technique? |
place sliding board under bottom and on surface sliding to
make sure LE are positioned non skid shoes push and slide body careful of fingers remove board from under bottom |
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side to side wt shift- to scoot toward edge of seated surface
basic technique? |
one arm around neck /shoulder of pt
opposite arm at opposite hip or post knee of pt |
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Pelvic Slide
basic technique? |
pt pushes upper body back into chair, therapist assists pulling bottom forward
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sitting push up-
basic technique? |
pt pushes up on armrests, therapist assists hips forward
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push up transfer-
basic technique? |
paras, no sliding board used
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Floor to wc
basic technique? |
therapist lowers handles of wc to floor, assist pt out; slide pt forward and lift
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forward out of wc independently forward
basic idea? |
scoot forward to edge of seat
lower hand to casters lower bottom to floor |
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power lift floor to wc (backwards)
basic technique? |
back up to wc
hands on casters or foot rests lift bottom to edge of chair hands on handrails scoot bottom back |
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turn and lower
basic technique? |
slide legs out and twist body on the way down
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turn and lift
basic idea? |
forward and twist body until seated
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forward fall
basic technique? |
fall to knees and then hands car, bath tub bench, bs commode
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why teach transfer to both side of patient?
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Pt must be safe and able to transfer to either side to be independent.
Teach transfer to both sides, not just the strong side |
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Guarding- involved vs uninvolved.
key points to remember? |
Keep your feet out of the line of movement
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Changing your hand position will facilitate different movements
such as... |
under buttocks - lifts pt
side of pelvis- guides movement ant pelvis- apply resistance for strengthening and movement facilitation |
