Review of workshop on wheelchair assessment and prescription.
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1) The document discusses wheelchair assessment, prescription, and mobility training. It outlines the different types of wheelchairs and their purposes as well as measurements needed for proper fitting. 2) Wheelchair assessment involves observation, interview, examination, measurements, and recording to determine what type of wheelchair and accessories are needed. 3) Mobility training teaches skills from basic maneuvering to advanced transfers to maximize independence. Safety is emphasized.
Review of workshop on wheelchair assessment and prescription.
- 1. --Shrikant -Ist S. Sant yr. M.P.Th (Community Physiotherapy) -COPT, PIMS, Loni.
- 3. In most of us always consider option of wheelchair in many orthopedic and neurological conditions where individual‟s mobility is impaired or challenged. Wheelchair is and or ambulation to disabled individual. According to WHO, of wheelchair assessment and prescription services. According to WHO, there are three levels of wheelchair assessment and prescription services Basic, Intermediate and Advanced.
- 4. WHO definition- A wheelchair is “an assistive device which enhances personal mobility and facilitates participation, for a person with walking limitation” Main functions of wheelchair are; Mobility Comfort Posture Protection Self esteem and confidence to the user.
- 6. 4-wheeler This is wheelchair with two rear wheels and two castor wheels in front. It is of basically two types1. Folding type If the user needs to fold the wheelchair for storage. For folding up on transport. If flip up foot rests are needed. For indoor use. 2. Non-folding type If a strong frame is needed. If the wheelchair needs to lasts a long time.
- 7. 3-wheeler Good for sand, mud and rough ground. For rural life. Good on sand, mud and rough ground. Good for hilly areas. Good for going over small obstacles and going down small steps.
- 8. Orthopaedic If the user needs a wheelchair for transportation purposes. For hospital use.
- 9. Child‟s three wheeler wheelchair Small size to fit children properly. Easy push. Easy to use in transportation for children by parents. Comfortable cushion and enough padding for safety and support. Attractive look and colors.
- 10. Sports wheelchair- Lightweight and stable. Increased „camber.‟ Easy to move for sports. Sporty look. Advanced safety measures like seat belts, additional calf straps.
- 11. Tricycle Only for outdoors. Excellent for travelling long distances Hand paddles for propulsion. Advanced and more convenient braking system.
- 12. Supportive seatGives good support and posture to children or adults who cannot sit by themselves. Head support with chin support for specific conditions like quadriplegia or where neck support is lost. Additional support measures for limbs with calf pads and elbow padding. Modified push handles with brakes for assistant.
- 13. Why is assessment is necessary? Does the person need a wheelchair? What type of wheelchair is required? What wheelchair parts are required? What instructions does the user need? Five 1. 2. 3. 4. 5. stages of wheelchair assessment- Observation Interview Physical examination Measuring Recording the information
- 14. Sitting balance test: Can balance with hands resting on knees Yes? No? Not good Can balance with one hand on knee when raising other arm Yes? No? Average Can balance when raising both arms Yes? No? Average Can reach with one arm away from the upright posture without losing balance Yes? No? Good Can easily reach with both arms away from and back into an upright posture without losing balance Yes? No? Good
- 15. In order to get correct size of wheelchair, there are three body measurements that need to be taken: 1. Hip width: Distance between two cardboards placed on lateral surfaces of pelvic region which relates with seat width of wheelchair. It is equal to measured seat depth.
- 16. 2.Base of back to back of knee: Distance between upper surface of finger placed in popliteal fossa of person sitting in 90-9090 position and cardboard placed attached to posterior surface of waist of person. Which relates with seat depth. It is measured seat depth in mm-30mm.
- 17. 3.Base of shoe/foot to back of knee: Distance from base of heel to underneath to user‟s knee. Which relates to height of footrest on the wheelchair. The measurement should be done with or without shoe and should be mentioned during recording. It is measured calf length (mm)+100mm.
- 18. Standard 4. Measuring height of backrest. backresta) For standard backrest: Distance between base of seat to inferior angle of scapula. Judged on both side and added with 100 mm for wheelchair measurement of the same. b) For low backrest: Distance between base of seat to bottom of ribcage. Added with 100 mm for wheelchair measurement for the same. Low Backrest
- 19. Prescription means finding the best possible match for user‟s need from availability. Wheelchair prescription is done based upon necessity and disorder severity and also availability. Includes Selection of right wheelchair. Selecting right wheelchair parts. Selecting the right wheelchair. Agreement with user for training, maintaining & caring of their wheelchair. Gathering information about locally available wheelchairs, is equally important after assessment before discussion with user.
- 20. Mobility skills are taught to users for providing maximum outcome from use of it. They should be directed towards making patient independent and not assistantdependent. Appropriate level according to duration of use capabilities. For first time user basic level should started and old wheelchair user may be trained with advanced skill level. Safety and precautions should be explained before starting actual skills training.
- 21. Basic 1. 2. 3. 4. 5. 6. levelSitting and balancing of wheelchair Wheelchair propulsion. Pushing wheelchair. Controlling speed of wheelchair. Stopping wheelchair. Basic transfer skills- a. b. From wheelchair to bed and vice versa, with and without assistant. In standing, sitting and non-standing. From wheelchair to bed and vice versa with help of transfer board.
- 22. Advanced 1. 2. 3. skillsDriving wheelchair on slope and on steep. Single and multiple step climbing through wheelchair. Advanced transfer skills: a. From floor to wheelchair and vice versa with or without assistant.
- 23. LEVO C3 One of modern standing wheelchair. First company to make such WC. Former Valutec from Sweden. iBOT® 4000 Founded by engineer Dean Kamen from Great Britain. User can stand, climb stairs and even drive over kerbs/slope or up onto a footpath. Not for all.
- 24. Proper padding. Insulated warm clothing's. Alarm system. Strong break system. Choosing appropriate transfer techniques.