The document discusses the importance of wheelchairs as mobility aids for individuals with disabilities, emphasizing proper prescription and fit for maximizing functional mobility. It details various factors influencing wheelchair selection, including user needs, environmental considerations, and specific features for comfort and utility. Additionally, it highlights the importance of training in wheelchair use and management for optimized independence and safety.

1. PRESENTED BY
GUNUKULA SAI SANGEETHA
MPT 2NDYEAR
SRM COLLEGE OF PHYSIOTHERAPY
SRM UNIVERSITY

2. Wheelchair is truly is mobility orthosis.
A properly prescribed wheelchair can be
useful device in reintegrating a person with a
disability into the community.

3. Sufficient support.
Deter the effect of deforming forces.
Allow for maximum functional mobility.

4. EXAMINATION. PLAN OF CARE.

5. PLAN OF
CARE.
SEATING
SYSTEM.
MOBILITY
BASE.

6.  Those who need wheelchairs are those who
either should not or cannot walk, walking is
either Inadvisable or Impossible.

7. Inadvisability of ambulation may be because of
 Contraindications to weight-bearing.
 Interference with wound healing.
 Prior to ambulation.
 Inadequate safety in walking . or
 Deficiency of the patient’s judgment.
In all of these conditions, the restriction against
walking may be temporary.

8. Deficiency in ambulation
results usually from the involvement of both
lower limbs by one or more of such conditions
as:
Absence of an essential part.
Paralysis.
Deformity,
Pain on weight bearing.
Incoordination.
In all of these conditions, the use of wheel
chair may be permanent.

10. Fit correctly.
Cosmetic to the user.
Light weight.
Yet strong as possible.
Modified based on needs.

11. Age, size & weight.
Disability & prognosis.
Functional skills.
Indoor / outdoor use.
Portability / accessibility.

12.  Reliability / durability.
 Cosmetic features.
 Options available.
 Service.
 Cost.
 Level of acceptance (Environment).

13. WHEELCHAIR USER
THERAPIST
FAMILY MENBERS
NURSES
PHYSICIANS
QUALIFIED
REHABILITATIVE
TECHNOLOGY SUPPLIER
VOCATIONAL
COUNSELORS
EDUCATORS

14. Contacts the body directly.
Seat.
Back.
Foot supports.
Head support.
Lateral supports for LE.
Medial supports for knee.
Straps or bands for UE.

16. Tubular
frame.
Arm rest.
Foot
supports.
Wheels.

17. Examination
of the patient.
Evaluation of
the data.
Determining
the
diagnosis.
Planning
interventio
Anticipated
goals and
expected
outcomes.
the
n.
Prognosis.

18. History of the patient.
Interview.
Medical and surgical history.
Tests and measures.
Neurological status.
Postural control.
Musculoskeletal status.

19. Sensory status.
Functional skills level.
Cognitive perceptual behavioural status.
Communication level.

20. Patients work, home environment should be
considered.
KITCHEN.
BATHROOMS.
DOORS AND RAMPS.

21. PHYSICAL EXAMINATION
EXAMINATION OF FUNCTION
USING EXISTING EQUIPMENT.
SUPINE EXAMINATION.
SEATED EXAMINATION.

22. Examined in gravity minimized
position (supine or side lying).
Gravity dependent
position(sitting).

23. Under thigh length.
Leg length.
Distance from seat to the
lower scapula.
Midscapula.
Shoulder.

24. Distance from hanging elbow to seat surface.
Width across the hips.
Outside the knee to outside the opposite
knee.

25. Good measurements has to be considered to
avoid many problems:
Too narrow seat:
Uncomfortable.
Difficult access.
Developing pressure sores.
Too wide seat:
Leaning to one side.
Promoting scoliosis.
Difficult propulsion.

26. Too shallow seat:
Less area of contact
More pressures over soft tissues
Less support to feet & legs
Poor balance
Too deep seat:
Restricted leg circulations
Extended leg / forward slide in the chair
Difficult propulsion.

27. ROM for LE is determined.
Pelvic tilt should be neutralized.
Knee flexed to 90 to 100 to eliminate effect of
hamstrings.

28.  Wheelchair frame: stationary or foldable.
 Seat and cushion
 Arm rests: fixed or adjustable. Stationary or
removable.
 Leg rests: adjustable or removable
 Foot rests:
 Restraints: chest belts

29. 1. Push handle bracket tube
2. Backrest
3. Swing-away, padded armrest
4. Pneumatic tire
5. Aluminum handrim

30. 6. Aluminum wheel rim
7. Spokes
8. Rear wheel hub
9. Release axel
10. Axel plate

31. 11. Frame
12. High wheel lock
13. Swing-away release
14. Caster housing cover
15. Caster plate
16. Caster housing
17. Seat cushion
18. Seat sling

32. 19. X-Hinge
20. Swing-away foot rest
21. Cross brace
22. Caster fork
23. Caster wheel
24. Caster tire
25. Flip-up foot rest
26. Heel loop

34. Wheelchair seat cushions should provide a
high-level of comfort, prevent bruising or
sores that result from pressure points, keep
you cool, and wick away moisture.

35. Foam cushions.
Gel cushion.
Air cushion.
Honey comb cushion.
Honeycomb cushions are made from
thermoplastic urethane, a material that
provides excellent shock absorption and
prevents users from bottoming out.

36. v

37. Caster locks:
CRUTHCH OR CANE HOLDER.
ANTI-TIPPING DEVICES.
HILL HOLDER DEVICE.
Lock extensions.
Wheel / rim covers.
Rim projections.
Detachable footrest.

38. Elevating leg rest:
Removable arm rests:
Adductor cushion or pommel
Custom moulded cushion.
Pelvic positioners.

39. 1. Standard wheelchair
2. Standard light weight wheelchair.
3. Ultra lightweight transport wheelchair.
4. Bathroom wheelchair.
5. Reclining back rigid frame sports chair.
6. Tennis chair.
7. Rugby wheelchair.
8. Heavy duty pediatric wheelchair.
9. Power wheelchair.

40. A chair that is designed to be low the ground,
allowing propulsion with the non involved
upper and lower extremity. Use low seat
measurements. Some therapists do not
choose to use these chairs since they feel it
reinforces abnormal reflexes. The patient
must have good perceptual motor skills.

42. For patients who have bilateral lower
extremity amputation, the wheelchair has to
be modified by placing the axis of the rear
wheels back approximately 2 inches to
increases the base of support in this direction.
Without the change, the seated amputee has
a high and posterior center of gravity
compared to a non amputee and the chair
could tip backwards more easily.

44. SPORTS WHEELCHAIR

45. People active in recreational and competitive
sports.
Some people need more than one
wheelchair.
Street or everday wheelchair
Competitive chair.

46. Archery.
discus.
Shot put.
Precision javelin.
Basket ball.
Tennis.
Dancing the chair.

50. Because their bodies are growing and
changing, chairs for children and adolescents
must be changed or replaced more often than
an adult chair.

51. Add-on Power devices provide motorised
power to the standard manual wheelchair
Rear wheel, Mid wheel and Front wheel drive
versions
Indoor and outdoor
Typically controlled by a joystick but there
are various other inputs
Tilt-in-space and reclining systems are
available

52. POV/scooter
Transportable power
Basic power (non-adjustable)
Power assist
Power Base
Off Road

53. Tilt
Recline
Standing
Seat Elevation
Power Elevating Leg Rest

56. Increased functional ability
Greater social inclusion
Access to education and employment
Reduced dependence on carers
Reduced fatigue
Better performance & efficiency

57. Access adaptations such as wheelchair spaces
on public transport and wheelchair lifts are
frequently designed around a typical manual
wheelchairs
Because of the weight and size they typically
cannot be self propelled by the user

58. Require daily charging
Generally non-foldable and requiring tie-downs
in a van for transportation
Expensive

59. Modern power chairs now have the options to
control a PC, mobile phone or aspects of the
environment

60. TONGUE OPERATED WHEELCHAIR.
VOICE OPERATED WHEELCHAIR.
HAND GESTURE BASED WHEELCHAIR
MOVEMENT CONTROL FOR DISABLE.
Smart wheel chair based on voice recognition
for handicapped

64. directional stability (tracks in a straight line)
Largest turning radius
Pivot point behind the user
Excellent traction up inclines, poor down
inclines
Fastest speeds

66. Slightly slower
Good traction down hill
Best climbing ability
Smoothest on rough terrain because of long
wheel base.
Shorter turning radius than rear wheel drive

68.  Smallest turning radius
 Slower than rear wheel drive for safe control
 Traction about equal for up and down inclines
 Pivot point under the driver
 Additional casters for stability.
 May experience a more significant rocking
motion over obstacles

70. Wheelchair Tyres for Racing, Activity and
Day Chairs
Pneumatic Wheelchair Tyres
Airless Wheelchair Tyres

71. Semi-pneumatic tires for wheelchairs – made
of solid rubber or plastic with a ring of air
running through the centre.
Foam tyres for wheelchairs – constructed
from pneumatic tire inserts filled with
polyurethane foam instead of air.
Solid tyres for wheelchairs – moulded from
rubber or plastic, these are the heaviest and
most durable.

72. Using for first time requires training.
Learns how to propel in all directions.
Operating the wheelchair assesories.
Wheel locks.
Foot supports.
Arm rests.

73. Mechanisms safely without tipping.
Tranferring.
Benefits from learning to do wheelies.

74. Driving skills and safety.
Hand control with joy stick.
Head control with individual switches.
User awareness.
Responding in vareity of situation and
obstacles.

75. Pushrim biomechanical changes with progressive increases
in slope during motorized treadmill manual wheelchair
propulsion in individuals with spinal cord injury.
Gagnon DH, BabineauAC, Champagne A, Desroches G,
Aissaoui R.J Rehabil Res Dev. 2014;51(5):789-802. doi:
10.1682/JRRD.2013.07.0168.
Feasibility of closed-loop controller for righting seated
posture after spinal cord injury.
Murphy JO; BSE, Audu ML, Lombardo LM, Foglyano KM;
BSE, Triolo RJ.J Rehabil Res Dev. 2014;51(5):747-60. doi:
10.1682/JRRD.2013.09.0200.

76. Wheelchair Tilt-in-Space and Recline Does Not Reduce
Sacral Skin Perfusion as Changing From the Upright to the
Tilted and Reclined Position in People With Spinal Cord Injury
Yih-Kuen Jan, Barbara A. Crane DOI:
http://dx.doi.org/10.1016/j.apmr.2013.01.004
Archives of Physical Medicine and Rehabilitation, Vol.
94, Issue 6
The manual wheelchair wheelie: a review of our current
understanding of an important motor skill.
Kirby RL1, Smith C, Seaman R, Macleod DA, Parker K.

77. Barriers, facilitators, and access for wheelchair users:
substantive and methodologic lessons from a pilot study
of environmental effects.
Meyers AR1, Anderson JJ, Miller DR, Shipp K, Hoenig H.
2002 Oct;55(8):1435-46.

78. 1. Albert M. Cook, Susan M. Hussey 2002 Assistive technologies: principles
and practice
2. Learner J, Beverly J, 2008, Learning Disabilities and Related Mild
Disabilities
3. Chan J, Davey C, Bath Institute of Medical Engineer, Buyers Guide Add on
power devices for manual wheelchairs Aug 2008
4. D.A. Hobson,September 1999, viewed 10th May 2010
http://www.wheelchairnet.org/
5. DX System Manual, Dynamic Controls,
http://www.dynamiccontrols.com/index.cfm/1,81,html
6. Wikipedia, Mobility scooter, viewed 10th May 2010
 http://en.wikipedia.org/wiki/Mobility_scooter
 May fish tail at higher speeds

79. http://www.mobility-advisor.com/wheelchair-seat-
cushions.html#sthash.niOhDZyn.dpuf
Physical Rehabilitation (O'Sullivan, Physical Rehabilitation)
2006. by Susan B. O'Sullivan (Author)5th edition.

80. THANK YOU