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Wheelchair Skill, Pressure Mapping, and Self Care

- Lock the brakes - Position wheelchair close to transfer surface - Position feet on footrests - Grip armrests and seat - Slide buttocks onto seat - Swing legs onto footrests Self: - Lock brakes - Position wheelchair close to transfer surface - Grip armrests and seat - Slide buttocks onto seat - Swing legs onto footrests Safety: - Ask for assistance if needed - Do not overreach - Maintain balance and center of gravity Tips: - Practice makes perfect - Use transfer board if needed

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Ahmad Fourze
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32 views33 pages

Wheelchair Skill, Pressure Mapping, and Self Care

- Lock the brakes - Position wheelchair close to transfer surface - Position feet on footrests - Grip armrests and seat - Slide buttocks onto seat - Swing legs onto footrests Self: - Lock brakes - Position wheelchair close to transfer surface - Grip armrests and seat - Slide buttocks onto seat - Swing legs onto footrests Safety: - Ask for assistance if needed - Do not overreach - Maintain balance and center of gravity Tips: - Practice makes perfect - Use transfer board if needed

Uploaded by

Ahmad Fourze
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Wheelchair

Skill and
Pressure
Mapping
Ahmad Fauzi Bin Ahmad Termizi
Occupational Therapist
Well Yes, They can

Can a person with


disability can perform his
self task independently?
Well, you can ask the
presenter !

How the person able


perform these task if they
on this wheelchair and
unable to move freely as
before?
Activities of Daily Living?
● Fundamental skills required to independently care for
oneself or skills required to manage one’s basic
physical needs.
● ADL is used as an indicator of a person’s functional
status.
● Measurement of an individual’s ADL is important as
these are predictors of admission to nursing homes,
need for alternative living arrangements,
hospitalization, and use of paid home care
Occupational Therapy Approach for Spinal
Cord Injury

Focus on recovering physical functions affected by spinal cord


Restorative injury. While damage to the spinal cord is permanent, motor and
Strategies sensory functions can be relearned because of the spinal cord’s
neuroplasticity.

New ways to accomplish everyday tasks. This may include


Compensatory
modifying the environment, adapting the activity, or educating
the patient on compensatory techniques and equipment. Strategies
Environmental
Modification
External environmental
modifications can take many
forms. These can include
assistive devices, alterations of
a physical structure, object
modification, and task
modification
Activity Adaptation
Adaptation is a change in the
structure, function, or form of the
activity to promote a better
adjustment and it makes
performing an activity easier.
Adaptation may involve changing
the tool or the technique used to
complete a task.
Wheelchair
Assessment
Factor to Consider :
● Measurement of hip
width or seat width
● Bed mobility status
● Sitting balance and
tolerance
● Transfer method
Type of wheelchair
Type of wheelchair
Pressure
Mapping
Pressure Ulcer Among Wheelchair User
● 60% of persons with SCI develop a pressure
ulcer at some time
● Impaired circulation, sensation, and muscle
contraction puts you at risk for pressure
ulcers.
● Any person with a neurologic injury whose
ability to feel and move is altered is at risk
for trauma to the skin and tissue beneath
the skin.
What skin breakdown means to as a wheelchair
user?
● Dressing changes, close monitoring of
skin, limited sitting time, and restriction of
normal activities-including lost time from
work-disrupt daily life for days, weeks, or
even months.

● Dealing with a pressure ulcer can be


discouraging, even depressing, especially
if you worked very hard to take good care
of your skin

● Complications such as wound infections can occur, which increase healing time and
can lead to other medical issues.
Pressure

Causes of Shear
Pressure Ulcer

Microclimate
Pressure
What is pressure?
● Pressure results when force is applied on or
against an object by making contact.
● In seating, equipment such as the seat and/or
back support surface are in contact with the body,
thus, creating pressure.

What are peak pressures?


● Peak pressures are high pressure directly under
or against the bony prominences.
Shear
● Shear occur between the body and the support
surface. This can be thought of as the sliding/gripping
between the body and support surface.
● Result from external shear forces to pull and stretch
the cells and tissues in multiple directions.
● Between the bony prominence and soft tissues, as
gravity is pressing the skeleton downward and tissues
are resisting
Microclimate
Microclimate refers to the temperature, humidity, and airflow next to the skin surface. The
CPG notes that an increasing body of evidence suggests that the microclimate between
skin and the supporting surface play a role in the development of pressure injuries.

How is microclimate created?


Increased body temperature at the skin surface, increased tissue temperature, and/or
increased moisture at the skin surface due to:

● sweat
● urinary or fecal incontinence
● drainage from wounds
● sitting on a non-breathable seat surface preventing ventilation
● contact with a non-breathable support surface
How to Prevent Pressure
Ulcers
How Can They Be Prevented?
● Pressure sores can be prevented from limiting the time spent in one
position.

● Typically you should move every 15 minutes, even if you need help from
someone else to accomplish the task.

● Wheelchair pushups, if you have the upper body mobility, can be useful to
prevent pressure sores, and, can help you to perform effective transfers.

● Early identification is also important for preventing and skin should be


checked daily with changes noted.

● Using talcum powder to minimize friction and lotion to keep skin healthy
and supple also provide significant prevention.
Wheelchair seat cushions
● Cushions contour to your body and provide you support
which aids in healing.

● Cushions can allow for prolonged sitting, but you need to


ensure you do not exceed the time prescribed by your health
care team.

● One of the primary roles of cushions is to prevent the


development of future sores.

● There are many different types and sizes of cushions so be


sure to work with your health care team to choose the right
cushion for you.
Wheelchair Cushion Form Liquid Gel Interconnected Air Cells Vicair Air Cushion

Ability to Redistribute Pressure Medium High High

Stability Highest Medium High

Adjustability Low High High

Weight Heavy Medium Light

Breathability Low Medium High

Maintainability Does not require much Needs regular inflation Does not require much
maintenance maintenance maintenance

Risk of Deflation Low High Low


Area of Highest Pressure
Pressure Redistribution
How to set up
RoHo Cushion
Wheelchair
Skill
What are importance of Wheelchair Skill?
● Many wheelchair users live and work in
places where it is difficult for them to
get around
● Effective training of wheelchair skills in
rehabilitation and community settings is
key to increasing participation by
individuals with mobility limitations and
may also reduce the incidence of pain
and chronic overuse injuries.
Basic Requirement for Wheelchair Skill Training

Good Upper Body Good Truncal


Strength balance
Suitable wheelchair :
Essential
Wheelchair
Skill
Getting On The
Wheelchair

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