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WHEELCHAIRS. MANUAL WHEELCHAIR COMPONENTS FRAME AND AXLE WHEELS AND TIRES HAND RIMS/ WHEEL LOCKS GRADE AIDS CASTERS/ARMRESTS/LEGRESTS SEAT AND BACK. FRAME AND AXLE. FRAME MATERIAL MAY DETERMINE THE WEIGHT AND DURABILITY OF THE WHEELCHAIR
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WHEELCHAIRS • MANUAL WHEELCHAIR COMPONENTS • FRAME AND AXLE • WHEELS AND TIRES • HAND RIMS/ WHEEL LOCKS • GRADE AIDS • CASTERS/ARMRESTS/LEGRESTS • SEAT AND BACK
FRAME AND AXLE • FRAME MATERIAL MAY DETERMINE THE WEIGHT AND DURABILITY OF THE WHEELCHAIR • WEIGHT IS IMPORTANT IN TERMS OF LOADING WC INTO THE CAR
FRAME TYPE • RIGID FRAME IS MORE STABLE FOR ACTIVE USER • MAKE SURE PATIENT CAN LOAD THIS INTO THE CAR
FOLDING FRAME • FOLDING FRAME IS EASIER TO STORE AND TRANSPORT • NEWER LOCKING SYSTEM FOR FOLDING FRAME IMPROVES RIGIDITY AND MAINTAINS BALANCE • SOME FRAMES HAVE FLEXIBILITY IN PLACEMENT OF REAR WHEELS WITH AN ADJUSTABLE AXLE PLATE
WHEEL AND TIRES • WHEEL SIZE AFFECTS • OVERALL HEIGHT • ROLLING EASE • TRANSFERRING IN AND OUT OF CHAIR • UE MECHANICS OF PUSHING
WHEEL TYPE • SOLID SMOOTH WHEELS • BEST ON • SMOOTH • HARD • INDOOR SURFACES
WHEEL TYPE • THREADED PNEUMATIC TIRES • GIVES SMOOTHER RIDE • EASIER MANUEVERABILITY ON ROUGH TERRAIN,WET OR ICY SURFACES
WHEEL TYPE • FLAT TIRES CAN BE MINIMIZED • WITH THORN RESISTANT TUBES • OR ADDITION OF LATEX GEL
HAND RIMS • VERY SMALL DIAMETER • SMOOTH RIMS FOR HIGH SPEED RACING • LARGE • TO MAXIMIZE MANEUVERABILITY AND POWER
HAND RIMS • MODIFICATIONS • IMPROVE GRIPPING • BY ADDING COATING • INCREASE TUBE SIZE • CHANGING SHAPE • ADDING RIM PROJECTIONS
WHEEL LOCKS • WHEEL LOCKS= BRAKES • POSITION HANDLES TO PROVIDE EASY ACCESS • BUT NOT INTERFERE WITH WC PROPULSION
WHEEL LOCKS • BRAKE EXTENSIONS FOR PATIENTS • WITH U.E. DYSFUNCTION • OR POOR BALANCE
WHEEL LOCKS • FOR ACTIVE USER • WITH LONG PUSHING STROKE • POSITION BRAKES LOWER DOWN • TO PREVENT INJURY TO FINGERS AND THUMBS
GRADE AIDS • SPRINGLOADED TEETH THAT KEEP THE CHAIR FROM ROLLING BACKWARD • CAN BE SELECTIVELY ACTIVATED WHEN GOING UPHILL
GRADE AIDS • FOR PATIENTS WHO HAVE DIFFICULTY GOING UP INCLINES • DON’T USE GRADE AIDS IN STRONG PUSHERS • MAY BE ACTIVATED IN WHEELIES
CASTER • THE SMALL WHEELS FOUND USUALLY IN FRONT OF THE CHAIR
CASTER • HARD SMALL CASTERS ALLOW EASIEST TURNING • SMALLEST 4” CASTORS GOOD FOR SPORTS BUT CAN’T BE USED WELL OUTDOORS
CASTER • LARGE PNEUMATIC CASTERS ARE LESS LIKELY TO GET STUCK ON UNEVEN OR SOFT GROUND • MAKE SURE THEY DON’T HIT FOOT OR FOOT PLATE
CASTERS • PLACING THE CASTER TO REAR OF CHAIR • DECREASES TURNING RADIUS • INCREASES THE TENDENCY TO TIP FORWARD
CASTER • CASTER LOCKS • NECESSARY FOR ABSOLUTE STABILITY OF CHAIR IN TRANSFERS
ARMRESTS • AID IN TRANSFERS • WEIGHT SHIFTS • REDUCE ISCHIAL PRESSURE • BY CARRYING THE WEIGHT OF THE ARMS AND MAINTAINING TRUNK BALANCE
ARM RESTS • NEED STURDY SUPPORTIVE ARMREST FOR THOSE WITH MARGINAL PRESSURE MANAGEMENT • PATIENTS WITH T6 OR ABOVE INJURY NEED THEM FOR STABILITY IN SITTING
ARMRESTS • NEEDED IF PATIENT HAS • LAPBOARD • ARM TROUGH • BALANCED FOREARM ARTHOSIS • ATHLETIC WC USERS MAY WANT TO ELIMINATE ARM RESTS
ARM RESTS • TYPES • FIXED • ADJUSTABLE • REMOVABLE • SWING AWAY
LEG RESTS • TO PROVIDE PROTECTION • PROPER POSITIONING • MAXIMUM BALANCE • WEIGHT BEARING OF LE
LEG RESTS • SUPPORT THE FOOT TO MAINTAIN CIRCULATION • KEEP THE ANKLE IN NEUTRAL POSITION • SHOULD NOT BE SO HIGH IT FORCES WEIGHT BACK ON ISCHIAL TUBEROSITIES OR SACRUM
LEG RESTS • TYPES • STANDARD • SWING AWAY • REMOVABLE
LEG RESTS • ELEVATING • MAY HELP WITH EDEMA • ALTER ACCESSIBILITY • MAKES TURNING MORE DIFFICULT
ELEVATING LEG RESTS • NEED CALFPADS • MORE EXPENSIVE • NEED A SPECIFIC DIAGNOSIS TO JUSTIFY
LEG RESTS • PATIENTS WITH A LOT OF SPASTICITY • MAY NEED A LARGE FOOTPLATE • WITH PROPER FOOT RESTRAINT SYSTEM
SEAT AND BACK • BACK SUPPORT • WC BACK • SHOULD BE HIGH ENOUGH TO SUPPORT • LOW ENOUGH TO GIVE AS MUCH FREEDOM AS POSSIBLE
BACK SUPPORT • PATIENTS WITH ABNORMAL TRUNK CONTROL ABOVE T8-10 • BUT GOOD HEAD CONTROL • BACK SHOULD COME UP WITHIN 2” OF THE LOWER EDGE OF THE SCAPULA
BACK SUPPORT • IF BACK TOO LOW • IT CAN CAUSE INCREASED PRESSURE AT UPPER EDGE OF BACK • WHEELING EFFICIENCY IS DECREASED SECONDARY TO POOR STABILIZATION OF THE SHOULDER GIRDLE
SEAT TYPE • IF PATIENT HAS POOR MUSCLE CONTROL • SPASTICITY • DEFORMITY • THEY NEED A SOLID SEAT OR BACK OR BOTH
SEAT TYPE • A STABLE SEAT AND LUMBAR SURFACE • PREVENTS SACRAL SITTING
SACRAL SITTING • LEADS TO SACRAL AND ISCHIAL PRESSURE SORES • INCREASED KYPHOSIS • NECK AND UPPER BACK STRAIN
WHEELCHAIR STABILITY • DEPENDS ON REAR AXLE POSITION • IF REAR WHEELS ARE MOVED FORWARD • CHAIR MOVES EASIER • WEIGHT SHIFT FOR WHEELIES IS EASIER
WC STABILITY • IF REAR WHEELS ARE MOVED FORWARD • CHAIR TIPS BACKWARD MORE EASILY • ESPECIALLY WHEN GOING FAST OR UP RAMPS
WHEELCHAIR STABLILITY • ANTITIP DEVICES PREVENT BACKWARD TIPPING
WHEELCHAIR STABILITY • FOR LE AMPUTEES • MOVING REAR WHEEL POSTERIOR • KEEPS THE PATIENTS C.OF G. IN FRONT OF THE WHEEL • TO PREVENT TIPPING
WHEELCHAIR STABILITY • RAISING THE SEAT • WILL LESSEN THE OVERALL STABILITY OF THE CHAIR • MOST COMFORTABLE AND STABLE SEATING • WITH SEAT TILTED BACK BY 3-5’’
WHEELCHAIR STABILITY • CAMBER • THE ANGLE BETWEEN THE VERTICAL AXIS OF WHEELS AND A LINE PERPENDICULAR TO THE FLOOR
CAMBER • CAN BE ADJUSTED 7” TO MAXIMIZE LATERAL STABILITY • WITHOUT MAKING THE CHAIR TOO WIDE • CAMBER IS ADJUSTED FOR SPORTS TO ALLOW QUICK TURNS • OR LONG LATERAL REACHES
BIOMECHANICS OF SEATING • PELVIS • A KEY GOAL IN WC SEATING IS STABILIZING THE PELVIS • A LEVEL PELVIS IS NEEDED TO OPTIMIZE TRUNK CONTROL AND UE FUNCTION
PELVIS • EVALUATION • LOOK FOR • ANTERIOR PELVIC TILT • POSTERIOR PELVIC TILT • LATERAL SYMMETRY • ROTATION • RESTRICTION IN ANY DIRECTION
ANTERIOR PELVIC TILT • INCLINATION OF THE PELVIS IN THE SAGITTAL PLANE FORWARD OF ITS NEUTRAL POSITION • DUE TO THE HYPOTONICITY OF TRUNK MUSCULATURE
ANTERIOR PELVIC TILT • SHORTENING OF LOW BACK EXTENSORS • TIGHTENING OF ILIOTIBILA BAND • TIGHT HIP FLEXORS
POSTERIOR PELVIC TILT • DUE TO OVERACTIVITY OF HIP EXTENSORS • DUE TO TIGHT HAMSTRINGS • HYPOTONIC LOW BACK EXTENSORS
POSTERIOR PELVIC TILT • LOSS OF LUMBAR LORDOTIC CURVE • AFFECTS SPINAL ALIGNMENT • AFFECTS FUNCTION
POSTERIOR PELVIC TILT • TILTING OF PELVIS • MOVES C.OF G. POSTERIOR TO ISCHIAL TUBEROSITIES • INCREASES WT. BEARING THRU SACRUM