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wheelchair Cheat Sheet (DRAFT) by

types, population, fitting, attachments, cushions

This is a draft cheat sheet. It is a work in progress and is not finished yet.

types of wheelc­hairs

power w/c
-spinal cord injury, any level -multiple sclerosis -amyot­rophic lateral sclerosis (ALS) -muscular dystrophy -severe rheumatoid arthritis -cerebral palsy -systemic lupus erythe­matosus
manual w/c
person has enough upper body strength to push the wheelc­hair: -spinal cord injury, mid-th­oracic, lumbar, sacral -CVA -multiple sclerosis -muscular dystrophy -arthritis -lower extremity amputa­tions -other diagnoses affecting lower extrem­ities
Diagnoses where the person is unable to propel any type of wheelchair -severe quadri­plegic cerebral palsy -severe brain injury -multiple congenital conditions -advanced Alzhei­mer’s disease
lightw­eight w/c
Diagnoses that allow the person to drive and/or travel freque­ntly. -spinal cord injury -amput­ations -multiple sclerosis -arthritis -cerebral palsy -muscular dystrophy
standing w/c
Diagnoses that prevent the person from standing without total support. -cerebral palsy -spinal cord injury -multiple sclerosis -amyot­rophic lateral sclerosis -muscular dystrophy

positi­oning and support

contoured
posterior pelvic tilt
anti thrust
anterior pelvic tilt
wedge
preventing slumping and sliding forward
pommel
preventing sliding, reducing hip internal rotation, preventing knees from touching
sacral cut out
reducing the pressure on coccyx and helps prevent pressure sores
no lean
pelvic obliquity causing pt to lean to one side when seated
amputee
supporting left/r­ight/ or bilateral amputa­tions
 

wheelchair attach­ments

pelvic support strap
SCI any level, CP, alzhei­mers, MS, TBI, CVA, MD advanced
wheelchair tray
CVA, CP, congenital condit­ions, alzhei­mers, MS, MD SCI - mid cervical and below
lateral supports
severe kypohosis, severe scoliosis, post CVA, CP, MS, cervical or thoracic SCI
posey drop seat cushion
SCI C1-L1, Spastic CP, advanced alzhei­mers, severe TBI, severe seizure disorder, hip fracture
foot/ankle straps
CVA, TBI, MS and other neuro condit­ions, CP, seizure disorder, LE contra­ctures
arm trough
CVA with UE hemipa­resis
mobile arm support
C4-C7 SCI, MS, advanced MD, ALS
all terrain w/c wheels
any dx that requires w/c use

w/c cushions

type
advantages
disadv­antages
foam
low cost, lightw­eight, low mainte­nance
can bottom out quickly
gel
good pressure distri­bution, keeps you cool and can be used with a foam base
heavier, adds weight to the w/c, knead prior to each use to keep gel in place
air *roho
except­ional pressure relief, adjustable firmness
ait levels need to be checked daily for leaks, less stable
honeycomb
stable, keeps you cool
limited pressure distri­bution and positoning
altern­ating pressure
automatic pressure distri­bution to prevent pressure sores, ideal for those who cannot adjust their position
higher cost, battery needs to be recharged
 

wheelchair for specific dx

hip replac­ement
Reclining back, pommel cushion or hip abductor, pelvic positi­oning strap, elevating footrests.
After hip replac­ement surgery, the patient is not allowed to bend the affected hip past 90 degrees or to adduct the hip. The reclining back allows the patient to sit with the hip positioned at less than 90 degrees of flexion and the pommel cushion keeps the hip positioned in slight abduction. The pelvic strap prevents the patient from sliding forward in the chair and the elevating footrests help to control edema post surgery
SCI
Contoured solid seat and back inserts, pelvic and lower extremity positi­oning straps, lateral supports, chest support, lateral head support, may need power wheelc­hair, may need adapted switches to operate a power wheelc­hair. May use a standing wheelc­hair.
The solid seat and back are contoured to improve support and reduce the risk of pressure areas. The positi­oning straps hold the pelvis and lower extrem­ities in place in the chair. If the person has a cervical or high thoracic injury, a chest support and lateral supports keep the trunk aligned and prevent the person from slumping forward. For high cervical injuries, a lateral head support keeps the head and neck in midline.
spina bifida
Manual or power wheelchair with an adapted back, pressure relief cushions.
Children with spina bifida may need a custom back on a wheelchair to accomm­odate myelom­eni­ngocele (the portion of the spinal cord that protrudes from the spinal column). Pressure relief cushions are used to reduce risk of skin breakdown in areas with reduced sensation.
CVA
Hemi-w­hee­lchair with one arm drive, solid seat with gel for pressure relief, elevated armrest.
The hemi-w­hee­lchair is a lower height wheelchair that allows the person to propel the chair with the unaffected foot. A one arm drive allows the person to propel the wheelchair with the unaffected hand while keeping the wheelchair moving in a straight line. Gel or memory foam in the cushion helps to reduce the risk of pressure areas on the affected side. The elevated arm rest helps reduce edema in the affected arm.