Deck 13: Seated Mobility: Sitting but Not Sitting Still--Fitting and Propelling a Wheelchair

Question 1

You are working in a rehabilitation hospital and are responsible for helping patients obtain appropriate durable medical equipment. In considering wheelchair casters, which of the following choices would be most appropriate if you were concerned primarily about chair stability?

A) 2-in. casters
B) 5-in. casters
C) 6-in. casters
D) 8-in. casters

Answer 1

D

Question 2

Why is a wheelchair considered a mobility orthosis?

Answer 2

The external support provided by the wheelchair makes it an orthosis. However, in addition to providing support, the wheelchair is designed to facilitate mobility.

Question 3

Your patient is a 43-year-old woman with multiple sclerosis who needs a wheelchair for occasional use, especially for locomotion over long distances. Her husband will push her during such trips. He will also put the chair in the car trunk for transportation. Which of the following is likely to be the most appropriate type of legrest for this patient?

A) Elevating legrests
B) Fixed legrests
C) Removable swing-away legrests
D) Rigid footplate only

Answer 3

C

Question 4

Which of the following measures for wheelchair fitting is best taken with the patient in supine?

A) Back height
B) Seat height
C) Seat depth
D) Seat width

Question 5

When assisting a patient with wheelchair fitting, which of the following is the first goal in achieving postural stability?

A) Positioning the feet correctly
B) Positioning the head correctly
C) Positioning the pelvis correctly
D) Positioning the trunk correctly

Question 6

Use of a sling seat in a wheelchair tends to result in all of the following except

A) a forward head posture.
B) decreased thoracic kyphosis.
C) bilateral hip adduction and internal rotation.
D) increased stress on the structure of the trunk.

Question 7

What is meant by "90-90-90"? ____________________.

Question 8

Which of the following is true regarding properly positioned wheelchair armrests?

A) They add no additional weight to the chair.
B) They position the shoulder in 0° abduction.
C) They are not designed to be load-bearing.
D) They can decrease the weight on the buttocks.

Question 9

Your patient is getting ready to leave rehabilitation and needs a wheelchair for use at his office. He plans to spend several hours in the chair each day, although by the end of the day his upper extremities are fatigued from wheelchair propulsion. He weighs 220 lb. and is 6 ft, 2 in. tall. Which of the following armrest options would be best for this patient?

A) Removable desk armrests
B) Fixed full-length armrests
C) Removable full-length armrests
D) Tubular armrests

Question 10

Your patient is a 63-year-old man who is undergoing chemotherapy and radiotherapy for treatment of colon cancer and is very weak as a result. His mobility level has been decreasing over the past few years, and he has very tight hamstring and hip flexor muscles. You are helping him select a wheelchair that he can use at home, where he lives alone. Which of the following legrests would be most appropriate for this patient?

A) Removable articulating legrests
B) Removable elevating legrests
C) Nonremovable, fixed footrests
D) Removable swing-away legrests

Question 11

Which of the following wheelchair frames is most appropriate when the primary concern is shock absorption when traveling over rough or uneven surfaces?

A) Folding-frame wheelchair
B) Heavy-duty wheelchair frame
C) One-arm-drive wheelchair
D) Standard wheelchair box frame

Question 12

List at least four factors that must be considered in wheelchair selection.

Question 13

You are instructing a patient about wheelchair propulsion in a nursing home setting. Assuming that the patient has adequate strength and range of motion, what instructions should you give the patient for the most efficient forward propulsion using both hands?

A) Place one arm behind you and one slightly in front of you (at the 10 o'clock and 12 o'clock positions on the pushrims).
B) Place both arms behind you (at approximately the 10 o'clock position on the pushrims).
C) Push the pushrims forward with long strokes, releasing them at about the 4 o'clock position on the pushrims.
D) Push the pushrims forward with short, quick strokes.

Question 14

List three potential physical and physiological risks associated with independent wheelchair propulsion. ____________________

Question 15

Which of the following is the best way for a wheelchair user to negotiate very steep slopes?

A) Go up the slope using a zigzagging path.
B) Have someone pull the chair up the slope backward.
C) Tip the chair into a wheelie position and go up the slope backward.
D) Tip the chair into a wheelie position and go up the slope forward.

Question 16

Wheelchair selection is the domain of the durable medical equipment vendors and as such does not fall within the scope of skilled patient care.

Question 17

Which of the following represents the best safety instruction for a patient who is learning to manage a sideways fall in a wheelchair?

A) Extend the arm toward the floor in the direction of the fall.
B) Flex the elbows to allow the arm muscles to absorb some of the impact.
C) Laterally flex the head away from the ground and tuck the arms close to the chest.
D) Tuck the chin toward the chest to protect the head.

Question 18

For the optimal push angle, wheelchair seat alignment should allow how much elbow flexion when the hand is at the apex of the wheel?

A) 20° to 30°
B) 45° to 60°
C) 80° to 90°
D) 100° to 120°

Question 19

The most common method of transporting a patient in a wheelchair up and down steps is to ascend the steps backward.
Short Answer

Question 20

Which of the following best describes an articulating legrest?

A) It is lighter than a standard elevating legrest.
B) It can be raised to a maximum of 70°.
C) The footplate extends a few inches as the legrest is elevated.
D) It stays the same length as the legrest is elevated.