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WC - Measurements - Back rest
Axilla -4
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WC - Measurements - Depth of seat
Popliteal to IT -2
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WC - Measurements - With of chair
(+) 2
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WC - Measurements - Height of seat
Heel to popliteal (+)2
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WC - door - inside door & exterior door
- Inside door - 2'8 X 6'8
- Exterior door - 3 X 6'8
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WC - small casters - size; better for what? (3)
- 3”
- Speed
- Turning
- Less resistance
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WC - large casters - size; better for what? (2)
- 8”
- Uneven terrain
- Bumpy roads
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WC - Rear wheel — larger - resistance; better for what terrain?
- Less resistance
- Better for uneven terrain
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WC - Rear wheel — smaller - maneuverability
Better maneuverability
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PF contracture - do what w/WC?
INC angle of footplate
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To DEC hip flex do what w/WC?
INC back angle
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WC - kyphosis & balance issues - do what w/WC?
Rearward shift in system tilt of WC
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WC - kyphosis & good balance - what is needed? support what?
- Slouch needed for stability
- Support @ PSIS
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WC - Mobile Arm Support - what mms are needed? @ what strength?
- Shoulder flexors, ER
- Elbow flexors
- ALL between trace (1/5) & fair plus (3+/5)
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WC - head or mouth stick - lesion at what level?
C3, C4, sometimes C5
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WC - high cervical lesion (C1-4) - what type of WC? - 3
- Electric WC w/tilt-in space seating or reclining seat back
- Microswitch or puff-and-sip controls
- Portable respirator may be attached
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WC - C5 - shoulder function + elbow flexion
- Manual WC w/propulsion aids
- Ex: projections
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WC - C5 - IND w/WC when?
Short distances on smooth flat surfaces
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WC - C6 - radial wrist extensors
Manual WC w/friction surface hand rims - IND
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WC - C7 - same as C6 w/+ what?
- Manual WC w/friction surface hand rims - IND
- (+) INC propulsion
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WC - C8-T1 - hand function
- Manual WC
- Standard hand rims
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Manual WC w/propulsion aids - @ what level?
C5
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IND Manual WC w/friction surface hand rims - @ what level?
C6
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IND Manual WC w/friction surface hand rims + INC propulsion - @ what level?
C7
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Manual WC w/standard hand rims - @ what level?
C8-T1
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WC - what is needed for power WC? - 2
- Good head control - to use head rest control system
- Good fine motor skills - to use joy stick
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WC - standard seat height; hemi or low-seat seat height; used by who & why
- Standard - 20”
- Hemi/low-seat - 17.5”
- Used by hemiparetics to use sound LE to help propel WC
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WC - Bathroom - toilet seat height; horizontal bars
- Toilet seat height - 17-19”
- Horizontal bars - 34"
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WC - Clearance for doorway - min and ideal
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WC - Low or high density gel or foam cushions - to relieve ischial P?
High
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Ascending Ramps in WC - 3
- Forward lean of head & trunk
- Use shorter strokes
- Move hands quickly for propulsion
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Descending ramps in WC - 2
- Grip hand rims loosely, control chair's descent
- Descend in wheelie position (steep ramp)
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WC wheelie position - hot to get there (3); balancing - wheels pushed forward vs. pulled back
- Pt places hands well back on hand rims
- Then pulls (moves) them forward abruptly & forcefully
- Head & trunk are moved forward to keep from going over backward
- Wheels are pushed forward - chair tips further back
- Wheels are pulled back - chair tips toward upright
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WC curb descent - backward vs. forward
- Descending backward w/forward head & trunk lean
- Descending forward in wheelie position
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WC - Kitchen - Height of countertops; counter depth
- Height - no higher than 31"
- Depth - at least 24"
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WC Ramps - Recommended ratio of slope to rise; width; handrails
Slope - 1:12 (for 1 in of vertical rise, 12 in of ramp is required)
Width - 36"
- Handrails:
- Waist high for ambulators (34-38 in)
- Should extend 12 in beyond top/bottom of runs
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WC - Elevating leg rests - indicated for what? (2); CONTRA (1)
- LE edema control
- Postural support
- CONTRA:
- Pts w/knee flexor (hamstring) hypertonicity or tightness
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WC Sling seat - standard; what happens to hips & thighs? Reinforces what?
- Hips tend to slide forward, thighs tend to ADD & IR
- Reinforces poor pelvic position (posterior pelvic tilt)
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WC Insert/contour seat - creates what?
- Stable, firm sitting surface
- Improves pelvic position (neutral pelvic position)
- Reduces tendency for pt to slide forward or sit w/posterior pelvic tilt (sacral sitting)
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WC - Pressure-relieving cushions - fluid/gel or combination cushion (fluid/gel plus foam) & air cushion
- Accommodates moderate to severe postural deformity
- P relief push-ups are required, typically every 15-20 minutes
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WC Insert or contour backs - does what?
Improve trunk extension & overall upright alignment
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WC - Tilt-in-space - indicated for what pts?
Extensor spasms that may throw pt out of chair
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WC environmental access - Width; height; 90 deg turning space; 180 deg turning space; high forward reach; low forward reach; side reach
- Width - 24-26" from rim to rim
- Length - 42-43"
- 90 deg turning space - min 36"
- 180 deg turning space - 60" x 60"
- High forward reach - max 48" from floor
- Low forward reach - min 15" from floor
- Side reach - max 24"
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