Deck 17: Assistive Technology: Positioning and Mobility

Question 1

When providing positioning intervention for Kevin, choose the most appropriate intervention and the correct order in which you would address/provide the supports.

A) Anterior chest panel to keep his trunk back in the chair, followed by a lumbar pad and footrests
B) Firm and slightly contoured seat support, lateral supports, a padded pelvic belt, and footrests
C) Lateral trunk supports to prevent left sided lean, anterior chest panel, and a contoured seat cushion with a 4-in.-high abductor pad
D) Slightly contoured but firm back support, lateral trunk supports, headrest, and footrests
E) Seat to back angle of 110 degrees, pelvic positioning belt, and headrest then footrests

Answer 1

B
Explanation: Start with the sitting support and then provide the other supports.

Question 2

The use of power mobility should be considered

A) as a last resort when other forms of mobility are unsuccessful.
B) for children older than the age of 5.
C) for children who score at an age-appropriate level on a cognitive test.
D) as a means to overcome mobility limitations for any child.

Answer 2

D
Explanation: Children who will never ambulate, whose ambulation is inefficient, or whose abilities have declined as a result of trauma or progressive neuromuscular disorders should be assessed for power mobility.

Question 3

For best results regarding pelvic stability and upper extremity reaching, Kevin's pelvic belt should be placed

A) across his anterior superior iliac spines.
B) 45 degrees to the sitting surface to stop anterior pelvic mobility.
C) close to 90 degrees to the sitting surface to provide stability but allow anterior pelvic mobility.
D) across his chest at the level of the 6th rib to help stop the lateral lean and provide a stable base for shoulder girdle movement.

Answer 3

B
Explanation: A general rule is to position the belt at a 45-degree angle, bisecting the pelvic/femoral angel to maintain a neutral pelvis.

Question 4

Which of the following positioning (seating) changes would be your best recommendation for Kevin using his current mobility base?

A) Keep the sling seat, but provide a planar back with lateral trunk supports.
B) Keep the sling back, but provide a planar seat and swing-away lateral trunk supports.
C) Provide a firm, possibly contoured, seat and back with pelvic positioning belt and footrests.
D) Leave the sling seat and back and provide a pelvic positioning belt and footrests.
E) Provide a recline (open seat-to-back angle) feature to allow for pressure relief throughout the day.

Question 5

Ian uses a Quickie manual wheelchair with a planar seat cushion. He extends very hard out of his seating system, pushing up against the abductor (medial thigh) support. His mom says that even with the seat belt Ian will not stay back in the seat unless this abductor support is secured onto the chair. The most likely cause of Ian's positioning problem is

A) the abductor support/pommel is not working effectively and should be tighter and more secure.
B) a lack of sufficient lateral trunk support.
C) the seat cushion is not providing sufficient contour or firmness to give the best posterior support for his pelvis.
D) a lack of sufficient anterior trunk support.

Question 6

Which of the following mobility options would be most beneficial for Kevin?

A) A manual (dependent-propelled) wheelchair that is designed to allow Kevin to push the chair with his feet
B) A manual wheelchair, but have Kevin increase his walking using his walker throughout the school
C) Power wheelchair at school, and a manual chair and walker for use at home and in his community
D) Power mobility at school and at home, if his family home and transportation can accommodate the chair

Question 7

You are evaluating a child with myelodysplasia (spina bifida) whose lesion is at L1-2. His parents are concerned that he is not able to keep up with his peers, even though he can walk with support of orthoses and forearm crutches. Your recommendation for mobility would include

A) continuing use of orthoses and forearm crutches in all environments so that he does not lose any additional abilities.
B) continued use of orthoses and forearm crutches indoors and a manual wheelchair that he can propel outdoors or over longer distances.
C) discontinuing use of orthoses and forearm crutches and using a manual wheelchair in all environments.
D) discontinuing use of orthoses and forearm crutches, using a manual wheelchair indoors, and using a power wheelchair outdoors.
Kevin is a 17-year-old adolescent with athetoid cerebral palsy. Kevin participates in many aspects of his school day in a typical classroom with his peers, but he goes to a special education resource room for tutoring. For the past 5 years, he has been using a manual wheelchair with a sling back and seat that belonged to his deceased grandmother. The footrests have been removed. He frequently complains of a back pain and has to be repositioned in his wheelchair because he slides out. He is often observed hanging over the left armrest of his wheelchair. He is dependent on others to push his current wheelchair to all activities at school, though he can move backward using his feet and his extensor tone. He has a ring walker that he uses sometimes to move through the halls, but he is often late for class. Kevin is nonverbal, but he uses his eyes and hand to answer "yes" and "no" questions. His scores on IQ tests are in the low 80s. The school team is asking for your input regarding assistive technology that might assist Kevin to achieve his educational goals. His primary goals include (1) easier and faster movement on his own, (2) making money, (3) dating, and (4) going to college to become a history teacher.

Question 8

During a physical examination for a seating system, physical therapists should begin by examining the child's

A) pelvic position.
B) hip range of motion.
C) trunk position.
D) knee range of motion.

Question 9

If you are providing assistive technology as mandated under the Technology Related Assistance Act, the evaluation for this technology

A) is not considered to be a critical part of the acquisition process.
B) is necessary to establish matches between children's abilities and the features of specifically recommended technology.
C) can be conducted by any team member who happens to know the child, regardless of their knowledge and expertise in assistive technology.
D) should only be conducted by professionals in a rehabilitation hospital setting.

Question 10

You are examining a 12-year-old with fixed deformities at the pelvis, trunk, and hips for a seating system. Which of the following supports would be most appropriate?

A) Firm, planar seat and custom contoured back support
B) Custom contoured seat and sling back support with knee blocks
C) Custom contoured seat and detachable lateral trunk supports on a planar back
D) Custom contoured seat and back support
E) Supine wedge for bed positioning, as the child should not be up in a wheelchair

Question 11

Planar seating systems are most appropriate for a child with

A) moderate postural problems or flexible postural asymmetries.
B) mild postural problems, symmetrical posture, and no structural deformities.
C) fixed structural deformities.
D) severe postural problems resulting in asymmetrical posture.

Question 12

Under the Technology Related Assistance Act and the Individuals with Disabilities Education Improvement Act, assistive technology includes any item, piece of equipment, or product system that is used to increase, maintain, or improve the functional capabilities of people with disabilities. These laws do not cover services to train either children or their caregivers and professionals involved in the use of that equipment.

Question 13

Assistive technology involves

A) the assistive technology device only.
B) the services necessary to obtain assistive technology devices only.
C) both the assistive technology device and services.
D) the assistive technology device and the acquisition of the device.