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Wheelchairs and Wheelchair Seating

Wheelchairs and seating are an important part of how your client functions. Therapy First has experts who can help!

What is a Wheelchair Seating Assessment?

Wheelchair seating and mobility is a technical and specialized area of Occupational Therapy. The therapist must have a good understanding of not only the physical and functional needs of their client but also of the current technology in order to choose the equipment that is best suited to their client's needs. Wheelchairs and cushions available in the market are always changing and improving and Therapy First keeps up to date with the newest products.

We, at Therapy First believe that a thorough seating assessment is a crucial part of determining which equipment is most suitable. From this assessment, we set goals with the client and a plan for how to meet these goals. Goals may include facilitation of mobility, improving positioning, preventing pressure sores, and maximizing function.

Interview: A seating assessment will begin with collecting basic background information which might include but not be limited to your client's medical diagnosis and any other related conditions, past or planned surgeries, problems with pain or pressure sores, and a discussion about your client's concerns and goals for a new wheelchair and/or seating system. Caregivers are involved with the assessment when appropriate. The assessment will also include discussions around your client's activities of daily living, their work or school, their leisure activities and the physical environments that they use their wheelchair in such as home and work.

Physical Assessment: We will then do an assessment of your client's physical posture and function in their current wheelchair and make note of how straight (or crooked!) they sit and what their overall posture looks like. From there we will help them transfer to a mat table where we can assess the physical movements and range of motion they have from their head all the way down to their feet. We will then sit them up on the mat table with support, if needed. This helps us to understand how properly positioned supports can maximize their seated posture and therefore improve their function.

Report: We will produce a thorough written evaluation of the assessment, complete with recommendations and a follow-up plan that will include your client's personal goals. This report can be sent to you and their physician. We will also work in collaboration with their existing community therapists, home care and physicians.

Once the assessment is completed and recommendations are determined we will work together with your client and a vendor of their choice to select the most appropriate equipment for your client to try. They will have time to trial the equipment to see if it is meeting their goals prior to ordering it.

We recommend that individuals using a wheelchair for the majority of their day receive a complete review of their seating and mobility assessment at least every five years.

Powered Wheelchair Assessments

Safety in a powered mobility device such as a power wheelchair or a scooter is of utmost importance. The therapists at Therapy First can evaluate your client to ensure that they are able to function safely and independently in their existing powered mobility device or help to assist them in finding the most appropriate device for them. Improved postural support may be recommended so that the user is better positioned to drive, or programming of the device may be recommended to ensure the parameters such as speed, acceleration and turning speed for example are set to a level that the user can safely control. It may be that your client needs an alternative method of controlling the powered mobility device. There are options besides the traditional joystick that can be used for controlling the powered mobility device. This can be in the form of a head control a foot control or a sip and puff control. Our therapists can determine which is the most appropriate for your client. Sometimes customization of the powered mobility device in the form of joystick modifications may be recommended in order to offer your client and we can assist you in finding the resources to get this done!

Wheelchairs

Not all wheelchairs are created equally!

The wheelchairs of today are not like the heavy old chrome ones of days gone by. Gone are the days where your clients had to wheel around or be pushed around in wheelchairs weighing 50 plus pounds! Manual wheelchairs can be designed to be used for independent or dependent mobility and are available in either folding frame or rigid frame styles.

Folding frame wheelchairs have the benefit of being easily transportable but are often heavier in weight and have more moving parts. Rigid wheelchairs typically are lighter weight and more efficient to propel because the energy your client puts into pushing the chair goes into moving it and is not lost in the many moving parts of a folding frame wheelchair. Tilt in space wheelchairs are wheelchairs in which the entire seat and back tilt back in space to offer support and positioning to clients who often cannot move on their own.

Aircraft aluminum and titanium are two products that can reduce the weight of a wheelchair to close to 15 lbs! These materials are most often found in rigid frame wheelchairs. Reducing the overall weight of a wheelchair and ensuring the wheelchair is configured to your clients needs can ensure they are more efficient in their push stroke and help to reduce overuse injuries of shoulders and elbows. Wheelchair technology is improving every year and there are many options and features that can help your client reach their maximum level of functioning. The therapists at Therapy First are experts when it comes to wheelchair prescription.

Did you know that not having proper back support in a manual wheelchair can reduce the efficiency of your client's push stroke?

Did you know that for efficient propulsion in a manual wheelchair the user's elbows should be bent to an angle of approximately 120 degrees (when their hands are resting at the top of the pushing surface)?

Did you know that energy expenditure increases when wheelchair tire pressure falls below recommended pressures?

Did you know that overall weight of the wheelchair is not the single most important factor for how easy it is to wheel? Ensuring the proper set up of the wheelchair for example center of gravity adjustability can greatly effect how difficult or easy a wheelchair is to propel.

Therapy First therapists can help you with all of these questions and can help to ensure your client to receive the wheelchair that is best suited to their needs.

http://www.wheelchairnet.org/wcn_wcu/SlideLectures/McKeough/McKeoughWCAnat.pdf

Cushions

Cushion properties are very important in providing support and pressure reduction. Each cushion should be chosen for the individual's specific needs.

Please refer to the article below for a better idea of cushions and their properties.


Cushion Presentation

How do I know if my client needs a seating assessment?

Click on this link to the following article: Wheelchair Seating...Is it Time you were Reassessed?

For more information or to book an appointment contact us by phone at 204-612-0399 or by email at ot@therapyfirst.ca