This document provides an overview of wheelchairs. It discusses the history and types of manual and powered wheelchairs. Key details include the various components of wheelchairs like frames, seats, armrests and how to properly measure and set them up. Indications for wheelchair usage and factors to consider when prescribing one are also outlined. Complications from long-term usage are mentioned.
Mobility aids are the appliances or devices, which or useful for the mobility as well as stability purpose of an individual who cannot walk independently, these are also referred as walking aids, or Ambulatory assistive devices. There are different types of assistive devices - crutches/ canes/ walkers/ wheel chairs
Wheelchair is truly is mobility orthosis.
A properly prescribed wheelchair can be useful device in reintegrating a person with a disability into the community.
A complete description of the lower limb orthosis is available in the following presentation with an in depth understanding of the same.It covers the ankle foot orthosis,Knee orthosis the knee ankle foot orthosis and hip orthosis.
Mobility aids are the appliances or devices, which or useful for the mobility as well as stability purpose of an individual who cannot walk independently, these are also referred as walking aids, or Ambulatory assistive devices. There are different types of assistive devices - crutches/ canes/ walkers/ wheel chairs
Wheelchair is truly is mobility orthosis.
A properly prescribed wheelchair can be useful device in reintegrating a person with a disability into the community.
A complete description of the lower limb orthosis is available in the following presentation with an in depth understanding of the same.It covers the ankle foot orthosis,Knee orthosis the knee ankle foot orthosis and hip orthosis.
this PPT contains all the detailed information about walking aids including types, measurements, advantages & disadvantages, gait training with specific aid, etc.
Traction: a basic physiotherapy modality used for inducing space between the joints. this slideshow deals with various types of traction and its application to cervical, thoracic and lumbar spine.
Gait training Physiotherapy perspective.pptxSusan Jose
do you know what is gait?
lets know more this presentation.
can physiotherapist help you with your walking abilities. click on the above slide to know more.
Wheelchairs and seating systems allow individuals with mobility impairments to actively participate at home, work, school, and the community. The quality of life of an individual is reflective of the overall effectiveness of the wheelchair and seating system when considering activities of daily living (ADLs). Therefore it is imperative that the multidisciplinary team of rehabilitation professionals
considers not only the individual and the wheelchair but also the
activities, context, policies, and personal assistance associated with the technology. Historically, rehabilitation professionals have
focused on functional mobility at the time of implementation of
the wheelchair and seating system. Now, as a result of changes in the overall health care environment, driven by a need for increased value, rehabilitation professionals must integrate a more holistic
approach to manage costs while improving outcomes at the time
of implementation and throughout the life of the wheelchair and seating systems.To better understand the long-term effects of the wheelchair and seating system and to maximize the functional
outcomes of the individual, rehabilitation professionals across the multidisciplinary health care team must understand the advances in current technology as well as best practices in the service delivery.
process. The value of the wheelchair and seating system within
the context of health care now extends beyond the four walls of a
traditional clinic to the community in which the individual uses
the wheelchair and seating system.
this PPT contains all the detailed information about walking aids including types, measurements, advantages & disadvantages, gait training with specific aid, etc.
Traction: a basic physiotherapy modality used for inducing space between the joints. this slideshow deals with various types of traction and its application to cervical, thoracic and lumbar spine.
Gait training Physiotherapy perspective.pptxSusan Jose
do you know what is gait?
lets know more this presentation.
can physiotherapist help you with your walking abilities. click on the above slide to know more.
Wheelchairs and seating systems allow individuals with mobility impairments to actively participate at home, work, school, and the community. The quality of life of an individual is reflective of the overall effectiveness of the wheelchair and seating system when considering activities of daily living (ADLs). Therefore it is imperative that the multidisciplinary team of rehabilitation professionals
considers not only the individual and the wheelchair but also the
activities, context, policies, and personal assistance associated with the technology. Historically, rehabilitation professionals have
focused on functional mobility at the time of implementation of
the wheelchair and seating system. Now, as a result of changes in the overall health care environment, driven by a need for increased value, rehabilitation professionals must integrate a more holistic
approach to manage costs while improving outcomes at the time
of implementation and throughout the life of the wheelchair and seating systems.To better understand the long-term effects of the wheelchair and seating system and to maximize the functional
outcomes of the individual, rehabilitation professionals across the multidisciplinary health care team must understand the advances in current technology as well as best practices in the service delivery.
process. The value of the wheelchair and seating system within
the context of health care now extends beyond the four walls of a
traditional clinic to the community in which the individual uses
the wheelchair and seating system.
mobility aids are really helpful for those who have problems in moving around independently. There are many kinds of mobility aids eg canes, crutches,wheelchair.It can be beneficial for those people who are affected by certain types of conditions like: cerebral palsy,developmental disabilities,arthritis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
2. INTRODUCTION
• Any chair on wheels that can
be propelled either manually
or by power
• A properly prescribed
wheelchair-useful in
reintegrating a person with a
disability into the community
27-11-2017 2
3. HISTORY
• The first folding manual WC - US by Herbert Everest and
Harry Jennings in 1933
• In late 1970s and early 1980s, Marilyn Hamilton led way
in development of manual WC with custom fitting
• Today a plethora of powered and manual WC technology
• Challenge is matching client need to specific WC
technologies and components
27-11-2017 3
4. GOALS OF PRESCRIBING WC
• Maximize functional independence with ADL
• Minimize risk of secondary injuries
• Accommodate or correct skeletal deformities
• Ensure proper comfort
• Promote positive and unobtrusive self image
27-11-2017 4
5. INDICATIONS
• INADVISABILITY OF AMBULATION
Contraindications to weight-bearing
Interference with wound healing
Prior to ambulation
Inadequate safety in walking
Deficiency of the patient’s judgment
**In all of these conditions, the restriction against walking may be
temporary
27-11-2017 5
6. INDICATIONS contd
• IMPOSSIBLE FOR AMBULATION
Congenital or traumatic LL amputees
Paralysis
Deformity
Pain on weight bearing
Incoordination
**In all of these conditions, the use of wheel chair may be permanent
27-11-2017 6
8. ADULT MANUAL WHEELCHAIR
• Standard
• Standard Hemi
• Lightweight
• High strength lightweight
• Ultra lightweight
• Heavy duty
• Extra heavy duty
27-11-2017 8
12. TIRES
• Solid rubber
• Pneumatic
• All terrain
• Kevlar
Outdoor-wider tire with a medium knobby treads
Indoor-smooth and lightly tread tire skin
27-11-2017 12
13. CASTER WHEELS
• Solid(polyurethane) and
pneumatic
• 2-8 inches in diameter
• Small- greater foot clearance and
agility
stuck crack and bumps
• Large- more security, easy roll
over rough surface
27-11-2017 13
14. PUSHRIMS
• Allow propulsion
• Control safety without
touching the tire
• Types
oStandard
oOne hand drive
oNatural fit
• ½ inch diameter
27-11-2017 14
15. BACK REST
• Basic upholstery fabric sling
• Fabric back with tension ties
• Firm back, minimum contour
• Contour-molded foam over hard back
• Hard back with softer foam/gel central region
27-11-2017 15
16. LATERALS
• Frame mounted pads
• Stabilises the trunk
• Accommodate or correct
deformities
Caution- Avoid undue pressure or
tissue compression
27-11-2017 16
17. ARMREST
• Standard WC: narrowest armrest
• Long term WC: removable &
height adjustable
• Provide GH joint support
• Perform push up for pressure relief
• Promote transfer
27-11-2017 17
18. ARM TROUGH
• Unable to lift/self stabilise arm
• Hollow cavity
• Protects arm from drifting into
wheels
• Made of polyurethane foam
• Improve joystick control
27-11-2017 18
19. FRONT RIGGING
• Includes footrests, leg rests & footplates
• Provide support to legs & feet
• May be removed on one or both sides
• Various types available
• Consider hamstring tightness
27-11-2017 19
20. HEAD REST
• Unstable neck posture
• Tilt & recline seat function
Foundation for head array
May restrict rear vision
Adds extra weight
↑perception of frailty
27-11-2017 20
22. SETTING UP OF MANUAL WC
• Can be adjusted together/separately
• Seat dump—sloping downward of seat
• Too much seat dump:
Pelvis will rotate backward
Loss of lumbar-lordosis
Increase pressure on sacrum
Problem in transferring in and out
• Increase back angle- for stiffness of hip, trunk support
27-11-2017 22
SEAT & BACK ANGLE MEASUREMENT
23. REAR WHEEL CAMBER
• Angle of rear wheel tilt
• 8 degrees is the normal
• Increases access to pushrims
• Increases width of wc
• Wearing of inner side of tire
27-11-2017 23
24. HORIZONTAL AXLE POSITION
• Moving the axle forward moves the seat back
• Shift of COG over or slightly behind rear axles
• Forward axle position
- requires less muscle effort
- facilitates “popping a wheelie”
• Make WC more “tippy” and difficult push up ramp
• Delivered with the axle in the most rearward position
• Needs to be changed
27-11-2017 24
25. VERTICAL AXLE POSITION
• Raising the axle has the effect of lowering the seat, while
lowering the axle raises the seat
oBetter propulsion biomechanics by lowering the seat
height
oGreater stability in low position
oToo low - lead to shoulder impingement syndrome
oIdeal position - elbow angle 100- 120⁰
27-11-2017 25
26. SEATING & POSITIONING
• Comfortable, healthy, functional sitting posture
• Pelvis stabilization
• Cushion should be mounted onto a hard surface
• Secondary injuries can occur
• Pressure relieving seating system require in certain
27-11-2017 26
27. SEAT CUSHIONS
27-11-2017 27
Plain Rectangular foam
Contoured foam with skin Matrix of air filled
elastic capsules
Alternating air cell
inflation
Contour molded with gel
filled inserts
28. WHEELCHAIR PROPULSION
• Depends on weight of wheelchair
• Quality & set up, strength of patient
• Propulsion technique: 2 phases - Push phase & Recovery phase
o arc
o semicircular
o single looping over
o double looping over
27-11-2017 28
29. HEMIPLEGIC CHAIR
• Low seat height
• Arm trough
Keeps forearm in level position
• No foot plate for non affected side
• Double push rims on non affected
side
27-11-2017 29
31. POWER ASSISTED WC
Mobility assistance
Help weakness, muscle paralysis,
overuse, fatigue
Decrease - upper limb risk of
injuries
Difficult to transport-↑weight
Types - stand alone power unit
power add on devices
27-11-2017 31
32. POWER WHEELCHAIR
• Ideal for those who do not have the strength/stamina to propel
a manual wc
• Grouped into four broad categories:
Conventional power wheelchairs
Folding and transport power wheelchairs
Combination indoor-outdoor power wheelchairs
Heavy-duty indoor-outdoor power wheelchairs
27-11-2017 32
33. CONVENTIONAL POWER WC
• Not programmable
• Have very basic seating with
limited sizes available
• Appropriate for limited
indoor use
27-11-2017 33
34. FOLDING & TRANSPORT POWER WC
• Designed for easy disassembling to
facilitate transport
• Usually compact for indoor use
• Less stability or power to negotiate
obstacles outdoors
• Good trunk and upper body control
27-11-2017 34
35. Combination Indoor-outdoor Power WC
• For mobility indoors (home, school,
work) and in community with finished
surfaces
• Equipped with standard proportional
joysticks and standard programmable
electronics
• Standard or rehabilitation seating
27-11-2017 35
36. HEAVY DUTY INDOOR-OUTDOOR POWER WC
• Large-diameter drive wheels with
heavily treaded tires
• Four drive wheels to climb obstacles
and rough terrain
• Can support weight >250 lb
• Power seating options
27-11-2017 36
38. Scooters
• Provide intermittent mobility
• Requires good arm strength, trunk
balance & ability to transfer
• Steered with a tiller
• Thumb levers used to drive
• Three or four wheeled scooter
• Cost less & easy to disassemble
• Wide turning radius
27-11-2017 38
39. Stand up Wheelchair
• Advantages:
Physiologic, practical & psychological
• Complex mechanism
• High COG so increased chance of fall
• Safe only on perfectly flat and smooth
flooring
• Properly strapped and secured to the
seat and seat back
27-11-2017 39
40. Sports wheelchair
• Designed for racing, rugby, tennis ,basketball
• Lightweight materials, very aggressive axle position and
camber
• Only one wheel in front for quick turns and maneuver
enhancement
27-11-2017 40
41. Paediatric wheelchair
• Similar to adult WC but smaller
• Seat width/ depth < 14 inches
• Adjustable frames or kits to accommodate growth
27-11-2017 41
42. Prerequisites
Good upper limb strength
Able to lift buttock 2” from bed surface
Stable trunk balance
Hand eye coordination
Good cognition
27-11-2017 42
43. Factors in wheelchair selection
Age & weight
Disability & prognosis
Functional skills
Indoor / outdoor use
Portability / accessibility
Reliability / durability
Cosmetic features
Options available
Service
Cost
Level of acceptance
27-11-2017 43
44. Wheelchair prescription
• Particulars of patients
• Size : adult, intermediate,
small
• Types: fixed back, semi
reclining
• Brakes: lever, toggle
• Foot rest: detachable, non
detachable
• Foot plates: regular, large
• Heel loops: right, left
• Armrest: padded, removable
• Wheels size: 22-26 “, spokes,
mag-wheel
• Tires: regular, pneumatic
• Axle: regular, heavy duty
• Hand rims: regular, vertical
• Front caster: 2-8 ” regular,
pneumatic
• Cushion
• Back rest
• Color
27-11-2017 44
45. COMPLICATIONS
• Pressure ulcer
• Nerve compression at wrist
• Overuse injury to muscles , tendons and ligaments
• Shoulder impingement syndrome
27-11-2017 45
46. PRESSURE ULCER ISSUE
• Coccyx, ischial tuberosity, greater
trochanter
• Push up and leaning to side or
forward periodically
• Tilt - rotating entire body in
sagittal plane - Redistribute
effects of gravity away from
buttock on to the back
• Reclining - angle between back
and seat
27-11-2017 46
47. PRESSURE MAPPING TOOL
Thin mat with pressure sensor
connected to computer
producing topography of
pressures
Helpful in comparing
pressure relieving qualities of
various cushions
Biofeedback for effective
weight-shifting technique
27-11-2017 47