Wheelchairs are a very widely used tool for rehabilitation therapists to treat patients, and are very suitable for people with lower limb disabilities, hemiplegia, paraplegia below the chest, and people with limited mobility. As a rehabilitation therapist, it is very necessary to understand the characteristics of wheelchairs, choose a particularly suitable wheelchair and use it very correctly.
Do you have a thorough understanding of the selection and use of wheelchairs?
If a patient or family member asks you how to choose and use a wheelchair, can you give a reasonable wheelchair prescription?
First, let’s talk about what harm an inappropriate wheelchair will do to the user?
Excessive local pressure
develop bad posture
induced scoliosis
causing joint contracture
(What are the inappropriate wheelchairs: the seat is too shallow and the height is not enough; the seat is too wide and the height is not enough)
The main areas where wheelchair users bear pressure are the ischial tuberosity, thighs and fossa, and scapula area. Therefore, when choosing a wheelchair, pay attention to whether the size of these parts is appropriate to avoid skin abrasions, abrasions and pressure ulcers.
Let’s talk about the method of choosing a wheelchair. This is basic knowledge for rehabilitation therapists and must be kept in mind!
Ordinary wheelchair options
seat width
Measure the distance between the buttocks or the crotch when sitting down, and add 5cm, that is, there will be a 2.5cm gap on both sides after sitting down. The seat is too narrow, making it difficult to get in and out of the wheelchair, and the buttocks and thigh tissue are compressed; the seat is too wide, making it difficult to sit firmly, making it inconvenient to maneuver the wheelchair, causing fatigue in the upper limbs, and difficulty in entering and exiting the door.
seat length
Measure the horizontal distance from the back buttocks to the gastrocnemius muscle of the calf when sitting down, and subtract 6.5cm from the measurement result. If the seat is too short, the weight mainly falls on the ischium, and the local area is easily subject to excessive pressure; if the seat is too long, it will compress the fossa, affect local blood circulation, and easily irritate the skin of the area, which is very important for patients with extremely short thighs or hip and knee flexion contractures. , it is better to use short seats.
seat height
Measure the distance from the heel (or heel) to the chin when sitting down, and add 4cm. When placing the footrest, the board should be at least 5cm above the ground. The seat is too high and a wheelchair cannot fit in at the table; the seat is too low and the sitting bones bear too much weight.
seat cushion
For comfort and to prevent pressure sores, a seat cushion should be placed on the seat. Foam rubber (5~10cm thick) or gel cushion can be used. To prevent the seat from sagging, a 0.6cm thick plywood can be placed under the seat cushion.
Backrest height
The higher the backrest, the more stable it is, and the lower the backrest, the greater the range of movement of the upper body and upper limbs. The so-called low backrest is to measure the distance from the seat surface to the armpit (with one or both arms stretched forward), and subtract 10cm from this result. High backrest: Measure the actual height from the seat surface to the shoulders or backrest.
Armrest height
When sitting down, with your upper arms vertical and your forearms flat on the armrests, measure the height from the chair surface to the lower edge of your forearms, add 2.5cm. Proper armrest height helps maintain correct body posture and balance, and allows the upper limbs to be placed in a comfortable position. The armrests are too high and the upper arms are forced to rise, making them prone to fatigue. If the armrest is too low, you will need to lean your upper body forward to maintain balance, which is not only prone to fatigue but may also affect breathing.
Other accessories for wheelchairs
Designed to meet special patient needs, such as adding handle friction surfaces, brake extensions, anti-shock devices, anti-slip devices, arm rests installed on handrails, wheelchair tables to facilitate patients to eat and write, etc.
Things to note when using a wheelchair
When pushing a wheelchair on a flat surface: the elderly person should sit firmly and hold the wheelchair firmly, and step on the pedals firmly. The caregiver stands behind the wheelchair and pushes the wheelchair slowly and steadily.
Pushing a wheelchair uphill: When going uphill, you must lean forward to prevent backward rollover.
Reversing the wheelchair downhill: Reversing the wheelchair downhill, taking one step back and moving the wheelchair down a little. Stretch your head and shoulders and lean back, asking the elderly person to hold on to the handrails.
Going up the steps: Ask the elderly to lean against the back of the chair and grasp the handrails with both hands. Don’t worry.
Press your feet and step on the booster frame to raise the front wheel (use the two rear wheels as the fulcrum to move the front wheel smoothly up the step) and place it gently on the step. After the rear wheel is close to the step, lift the rear wheel. When lifting the rear wheel, move closer to the wheelchair to lower the center of gravity.
Rear foot-assisted rack
Push the wheelchair backwards when going down the steps: Turn the wheelchair upside down when going down the steps. The wheelchair goes down slowly, stretch your head and shoulders and lean back, and ask the elderly to hold on to the handrails. The body is close to the wheelchair. Lower your center of gravity.
Pushing a wheelchair up and down the elevator: Both the elderly person and the caregiver should face the forward direction – the caregiver in front and the wheelchair in the back – tighten the brakes in time after entering the elevator – inform the elderly person in advance when entering and exiting the elevator and passing through uneven places – enter and exit slowly.
Post time: Jan-29-2024