三院會議部分final draftpt studnets

1、Erin Curtis, SPTTravis Sparks, SPTCreighton University School of Pharmacy and Health ProfessionsDepartment of Physical TherapyPosture for Wheelchair Users Understand the needs and benefits of good posture in standing and sitting.Recognize and replicate the ideal posture for sitting.Identify the need

2、 for wheelchair modations for patients with spinal cord injuries.Be able to make changes to fit, cushioning, and otion to promote independence. ObjectivesStrong spinal columnMaintenance of spinal curvesCervical, Thoracic, and LumbarJoint healthGood force distribution to muscles and ligamentsAdaptive

3、 shorteningOptimal organ functionBenefits of Good PostureWhat Do We Mean by “Good Posture”?SkullCervical SpineShoulderTrunk and Lumbar SpineHipKneeAnkleSitting Posture90 degrees90 degrees90 degreesWheelchair PrescriptionFit of the wheelchairStability to maintain good seated posturePositioning Suppor

4、tAllow for mobility to promote independencePreventionFacilitate respiration to reduce risk for pulmonary complicationsCushioning to reduce risk for ulcersKey Concepts for Wheelchair PrescriptionStandard Wheelchair PostureBackArmThighFoot90/90/90Seat Width1-2inches from both trochantersAllows for:Bul

5、ky clothingOrthosesPrevents integumentary break down over trochanters Fitting Fitting Seat DepthBack of knee should be 2 inches past from of seatPopliteal fossa circulation maintenanceFitting Seat BackReaches back just below inferior angle of the scapulaAllows for upper extremity movement and indepe

6、ndenceFitting Leg RestsLength is appropriate for tibia lengthAttempt 90 degree angle at kneeNot always possible Fitting Arm Rests1 inch higher than elbows when arms at sidePrevents glenohumeral joint subluxationShould be low enough to sit at tableDamage to the spinal cordComplete or pleteDifferent p

7、osture seen with different injury levelsSpinal Cord InjuriesIdeal posture may not be possible due to:Decreased trunk strengthDecreased neck strengthDecreased UE and LE strengthSpinal Cord InjuriesLap BandMolded back or seatCushioningDifferent sized wheelsTilt-in-spaceSport Specific Changes in Wheelc

8、hairs for SCIVariations of WheelchairsSports WheelchairsRecumbent WheelchairsPowered WheelchairsCushioning Very important for patients with SCIHelp to prevent pressure soresTypes Air, foam, liquid (gel) cushionsTilt-in-spaceStability Due to weakness secondary from SCIPrevention of subluxation and jo

9、int laxity issuesShoulderAllow balance between stability and movementHigher backsHigher armrestsLab bandsPowered Wheelchairs Indicated when:UE strength is not sufficient for wheelchair propulsionSignificant coordination or strength deficits, or paralysis presentCognitive awareness intactUsed for:Spo

10、rt and recreationIncreased freedom of movementConsider:Type of sportTerrainPt. strength (trunk, UE, hand)Sports WheelchairsIndependence = always the goal! wheelchair+accessories.jpg 298Search by imageExploring Your Options in Wheelchair AccessoriesSummaryMajor anatomical landmarks are used to screen

11、 a patients postureGood posture in both standing and sitting provide many benefitsSoft tissue and joint healthWheelchair fitting includes seat height, seat depth, back rest height, arm rest height, and leg rest position90/90/90 positionVarious methods exist for wheelchair modificationPatients with s

12、pinal cord injuries require more stability and cushionSafety and soft tissue healthLevel of injuryDifferent types of wheelchairs for patient needsPromote patient safety and independenceSummary ContinuedTHANK YOU! Picture - Magee DJ. Orthopedic physical assessment. Philadelphia, Pa: Elsevier Saunders; 2006.Oatis CA. Kinesiology: The mechanics and pathomechanics of human movement. Baltim