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.

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.

5.  Parts
of wheelchair-

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.