The document discusses various types of wheelchairs, including attendant propelled chairs, manual chairs, power mobility devices, mobility scooters, single-arm drive wheelchairs, reclining wheelchairs, standing wheelchairs, and smart wheelchairs. It covers the characteristics and uses of each type. Guidelines for wheelchair measurements, components, skills training, and assessments are also presented. Laws regarding accessibility for people with disabilities are summarized.

1. PRESENTED BY: SHIKHA MAMGAIN
MOT(MUSCULOSKELETAL)
GUIDED BY: Ms. ONA P DESAI
ASSOCIATE PROFESSOR
MS. RUCHI NAGAR BUCKSHEE
ASSISTANT PROFESSOR

3. 1. Attendant – propelled chairs
2. Manual chairs
3. Power mobility device
4. Mobility scooters
5. Single – arm drive wheelchair
6. Reclining wheelchair
7. Standing wheelchair
8. Sports wheelchair
9. iBOT
10. Smart wheelchair

4.  Designed to be pushed by another
individual because of user’s
inability to propel or operate
manual wheelchair in a functional
or safe manner

5.  For those who can propel and
brake using the upper limb.
 Have variety of frame types,
weights and transport feature.

6. Used by individuals-
 Who cannot propel a chair either
using hand or feet
 For whom the energy expenditure
required to walk or propel a
manual chair is contraindicated
 Who are prone to repetitive stress
injuries
 Who have neuromuscular
dysfunction

7.  Share some features with power
chairs but primarily addressed for
people with a limited abiity to
walk, but who might not otherwise
consider themselves disabled.
 Typically 3 weheeled with a base
on which is mounted a basic seat
at the rear, with a control tiller at
the front.

8.  Enables a user to self propel a
manual wheelchair using only a
single arm
 Large wheel on the same side as
the arm to be used is fitted with
two concentric handrims, one of
smaller diameter than the other.
 The outer smaller rim is connected
to the wheel on the opposite side
by an inner concentric aisle

9.  Have seating system which can be
tilted to various angles
 Good for person who are unable to
sit upright for extended periods
because of pain or other reasons
 Various designs are available and
wheelchair with the feature may
either tilt the seat back and
legrests in relation to seat or may
tilt the entire back, seat and legrest
as one depending on the need of
user.

10.  Can be used as both a
wheelchair and a
standing frame
 Benefits-
1. Aids independence and
productivity
2. Extending access
3. Relief of pressure/
reduction of pressure
sores
4. Reduction in abnormal
muscle tone/ spasticity
and skeletal
deformities
5. Raising self- esteem
and psychological well
being

11.  Developed for athletes for –
1. Basketball
2. Rugby
3. Tennis
4. Racing
5. Dancing
 Cambered wheelchair

12.  Developed by Dean Kamen that
incorporates gyroscopic and active
control technology enabling the
chair to balance and run on only 2
of its four wheels on some surface

14.  Use control system to augment or
replace user control.
 Purpose is to reduce or eliminate
the user’s task of driving a
wheelchair
 Controlled via computer has a suit
of sensors and applies techniques
in mobile robotics
 Interface may consist of a
conventional wheelchair joystick.

16.  Main problem of wheelchair users
are about moving and working
from a sitting position
 Many requirements are associated
with the dimensions and other
aspect of wheelchair
 Length of wheelchair- 1100-
1200mm. User’s feet add
approximately 50 mm to the
overall length
 Width varies between – 600-700
mm. To propel a chair manually by
operating the rims of the main
wheels, a clearance of not less
than 50mm and preferably 100
mm is needed
 Space requirements for
maneuvering are always related to
the activities to be performed.

17.  Different users act in different
ways depending on individual
performance and the type of chair
used
 When planning spaces in building
to cater for wheelchair turning, a
guide is to impose on the plan to
provide a circle of 1800mm
diameter

18.  SEAT WIDTH- across the widest
parts of either the thighs or hips
while patient is sitting in a chair
comparable to that expected. Add
½ to 1 inch on each side of the hip
or thigh measurement taken.
 SEAT DEPTH- from the rear of
buttocks to inside of bent knee.
Check the clearance behind the
knee to prevent contact of front
edge of seat with popliteal space.
 SEAT HEIGHT- popliteal fossa to
heel.
 BACK HEIGHT- for full trunk
support, measure from top of the
seat to top of shoulder. For
minimum trunk support , top of
back to inferior angle of scapula

19.  ARM HEIGHT- with patient in
comfortable position, measure
from seat post to bottom of bent
of elbow.

20.  Prevention of deformity-
 Tone normalization
 Pressure management
 Promotion of function
 Maximum sitting tolerance
 Optimal respiratory function
 Provision for proper body
alignment

21.  Spotter’s strap- a simple webbing
strap that can be attached to the
wheelchair at one end and held by a
spotter at the other.
 Benefits-
 Reduces the likelihood of injury due
to rear-tipping accidents.
 Reduces the likelihood of injury due
to the wheelchair “running away” on
downhill grades.
 Provides confidence when learning
new skills (e.g., wheelies) or
attempting to use the wheelchair in
risky environments.
 Allows a spotter to stand farther
away from the wheelchair than
would be appropriate without the
spotter strap.
 Eliminates the need for the spotter
to bend forward to catch a tipping
wheelchair.
 Allows effective spotting even for
wheelchairs without push handles.

22.  ARMRESTS- fixed, flip-up,
detachable, desk, standard,
reclining and tubular style.
 FOOTRESTS- standard, swinging
detachable, solid cradle, elevating.
 FOOTPLATES- may have heel loops
and toe straps
 Calf strap
 Seat belts
 Various brake styles
 Antitip device
 Caster locks
 Arm supports
 Head supports

25.  Forward propulsions
 Backward propulsion
 Turning
 Wheelie
 Up the ramp
 Down the ramp

30.  OVERALL PRINCIPLES OF THE
WHEELCHAIR FITTING PROCESS –
Functional capacity and mobility-
the more base of support the more
will be the mobility. Rolling
resistance has to be overcome.
Activity and participation – able
perform ADL and participate in
society
Environment – could be hindrance
as well as support.
Complications of wheelchair-
deformities and restricted range of
motion together with pressure
sores and discomfort.

31. Seating – key to seating posture is
pelvis. A close to neutral pelvic
rotation and no lateral tilt supports
the natural spine curvature and
reduces the risk for high local
under-seat pressure. Hip and knee
angles affect pelvic rotation, and it
is important to know and
understand this relationship
(Engström, 2002)
Training - Training should be
carried out both indoors and
outdoors (Lois, 2004 ;Royston,
1995) .

32. Follow up and evaluation - A
simple general follow-up could
include the Quebec User
Evaluation of Satisfaction with
Assistive Technology (QUEST) 2.0
questionnaire (Demers et al., 1997)
. Evaluation of the effect of
wheelchair interventions requires
more specific assessment tools.

34.  Wheelchair Propulsion Test Form
 Wheelchair/scooter/stroller
seating assessment form
 Power mobility indoor driving
assessment
 Power mobility community driving
assessment
 Quebac user evaluation of
satisfaction with assistive
technology.

35. OUTCOME
MEASURE
GOAL TARGET
CLIENTELE
TASKS ASSESSMENT
METHOD
Power
mobility
indoor
driving
assessment
Describe and
evaluate
competency
and safety
People with
diverse
impairments and
disabilities, using
powered mobility
devices and living
in an extended
care residence
30 tasks grouped
into 7 categories:
Bedroom(4),
bathroom(4), doors
(4), elevator (3),
parking (4), access
ramps (2) driving
abilities (9)
4 Point ordinal
scale (1-4)
Power
mobility
community
driving
assessment
Evaluate
performance
(interaction
between
abilities and
environment
)
People wit
diverse
impairments and
disabilities, using
powered mobility
device and
moving around
outside of their
extended care
residece
6 task categories:
general driving skills,
w/c accessible
private transit, w/c
public transit,
driving with controls
in different
positions, driving in
varied surfaces,
accessing public
places
4 Point ordinal
scale (1-4)

36.  Wheelchair skill training program
manual
 The WSTP is a standardized training
method that addresses a set of
representative wheelchair skills.
Research evidence regarding the
safety and efficacy of the WSTP in
general (as well as some specific
skills) can be found on the web-site.
There are also some excellent
resources available in manuals,
textbooks and websites about
various ways to perform specific
wheelchair skills. Examples include
work by P. Axelson, I. Denison, L.
Harvey and M.F. Somers. Some on-
line resources can be found on the
Related Sites page of our WSP
website.
 However, despite good progress,
there has been relatively little
scientific study to date on the
optimum methods of either
performing or teaching most
wheelchair skills.

37.  The goals of the WSP are to
increase the likelihood that a
wheelchair user or caregiver who
needs and wants to improve
his/her ability to safely and
effectively use a wheelchair will
have an opportunity to do so, to
provide an evidence-based means
for wheelchair skills training to
occur and to provide learning
resources to those who wish to use
them.

41.  PROVISION OF ACCESS IN THE
PEOPLE WITH DISABILITIES ACT,
1995
Section 30 stipulates that the
appropriate government shall by
notification prepare a
comprehensive education scheme,
which shall make provision for, “the
removal of architectural barriers
from school, colleges or other
institution, imparting vocational and
professional training.”
Section 38 stipulates health and
safety measures and creation of a
non-handicapping environment in
places where persons with
disabilities are employed.

42.  Section 45 calls upon the
appropriate government to provide
for:
1. Installation of auditory signals at
red lights in the public roads for
the benefit of person with visual
handicap
2. Causing curb cuts and slopes to
be made in pavements for the
easy access of wheelchair users
3. Engraving on the surface of the
zebra crossing for the blind or for
low vision
4. Engraving on the edges of railway
platforms for the blind or for with
low vision
5. Devising appropriate symbol of
accessibility.

43.  Section 46 enjoins upon the
appropriate governments and local
authorities to provide:
1. Ramps in public building
2. Braille symbols and auditory
signals in elevators or lifts
3. Ramps in hospitals, primary
health centers and other medical
care and rehabilitation
institutions.
The architects of the Disability Act
were perhaps conscious of the fact
that for creation of barrier free
environment , special designs of
buildings and special technologies
would need to be developed.
Therefore, Section 48 calls upon the
appropriate governments and local
authorities to promote and sponsor
research in the on site modifications
in offices and factories.

44.  Planning a barrier free
environment, Ministry of Social
Justice And Empowerment
 Guidelines on the provision of
manual wheelchair on less
resourced settings, WHO 2008
 Inclusiveness and Accessibility
Index, Ministry of Social Justice
And Empowerment Govt Of India,
Accessible India Campaign 2015
 Lisbeth Nillson, The role of
powered wheelchair training in
rehabilitation
 Mark St. George et al, Computer-
aided design in wheelchair seating,
Journal of rehabilitation research
and development, 1989

45.  Edward D Lemaire et al, Critical
analysis of a CAD/CAM system for
custom seating: A comparison with
Hand – sculpting methods, Journal
of rehabilitation and research
development,1996
 Kristjan T Ragnarrson, Clinical
perspective on wheelchair
selection
 Ellen Bradey et al, A validity study
of guidelines for wheelchair
selection, CJOT,2000
 C E Brubaker, Wheelchair
prescription: An analysis of factors
that affect mobility and
performance, Journal of
rehabilitation research abd
development 2000