7-10. Wheelchair Assessment, Design, Justification, and Managment

Vocabulary flashcards covering key terms, components, measurements, wheelchair types, power bases, controls, cushions, and documentation concepts from the lecture.

Wheelchair (WC) Assessment

Systematic evaluation of a patient’s physical, functional and future needs to select an appropriate wheelchair.

Seat Depth

Horizontal distance from the back of the buttocks to the popliteal fold minus 2-3 inches to avoid calf pressure.

Seat Width

Distance across the widest part of the hips plus just enough clearance (≈2 in) for comfort or orthotics.

Seat Height

Vertical distance from the floor to the seat; may be standard, hemi (≈17.5 in), higher or lower for function.

Back Height

Distance from seat surface (including cushion) to inferior angle of scapula; adjusted for postural control.

Seat-to-Footplate Height

Measurement from bottom of heel to underside of thigh minus cushion height to set footrest length.

Armrest Height

Distance from elbow flexed at 90° to seat surface; add cushion height and ~1 in for support and comfort.

Hemi-Height Wheelchair

Chair with lowered seat (17–19 in) allowing propulsion with one or both feet; not limited to stroke patients.

Bariatric Wheelchair

Heavy-duty frame and wider seat to accommodate higher weight; more durable but heavier.

Amputee Wheelchair

Rear axle moved posteriorly to balance weight loss of missing limbs; often fitted with anti-tippers.

Reclining Wheelchair

Backrest reclines via hydraulic release for patients unable to sit upright; risk of shear if positioned poorly.

Tilt-in-Space Wheelchair

Seat and back tilt together to redistribute pressure and reduce shear; useful for pressure relief.

Folding Frame Wheelchair

Cross-brace design; easier to transport and store but heavier with more moving parts that can break.

Fixed Frame Wheelchair

Rigid frame; lighter, more stable seating and fewer breakable parts, but harder to transport.

Companion (Travel) Chair

Small-wheeled, minimal upholstery chair pushed by caregiver; lightweight and economical.

Standard Weight Chair

Institutional chair with fixed arms/leg rests; 35–50 lb; basic features—common ‘loaner’ model.

Lightweight Chair

Manual chair under 35 lb; adjustable axle, multiple foot/leg rests and more custom options.

Ultra-Lightweight Chair

High-performance manual chair as light as 13 lb; many custom features; requires detailed justification.

Specialty Wheelchair

Includes hemi-height, amputee, reclining, tilt-in-space and bariatric designs for specific needs.

Adjustable Axle

Modifiable wheel position affecting stability and propulsion efficiency; essential for customized fit.

Spoke Wheels

Lightweight standard rear wheels requiring more maintenance than mag wheels.

Mag Wheels

Composite, low-maintenance wheels; heavier than spoke designs.

Pneumatic Tires

Air-filled tires offering smoother ride but requiring upkeep; may include solid inserts.

Solid Tires

Maintenance-free tires with firmer ride; suit indoor or even surfaces.

Push Rims

Hand rims attached to rear wheels; may have coatings or projections (quad knobs) for grip.

Wheel Locks (Brakes)

Devices that immobilize wheels; types include anterior, posterior and scissor mounts.

Brake Extensions

Lengthened levers enabling users with limited reach or opposite hand to lock wheels.

Full-Length Armrests

Longer arms providing more support and tray attachment; harder to approach tables.

Desk Arms

Shortened front section allowing closer approach to desks; often reversible with removable feature.

Swing-Away Footrests

Foot supports that pivot aside for easier transfers; may be removable.

Elevating Leg Rests

Calf-supporting rests that raise for edema or LE injuries; bulkier to manage.

Front-Wheel Drive Power Base

Power WC with drive wheels front; open front but larger rear swing; moderate turning radius.

Mid-Wheel Drive Power Base

Power WC with central drive wheels; smallest turning radius; less effective on uneven ground.

Rear-Wheel Drive Power Base

Power WC with rear drive wheels; good outdoor traction but widest turning radius and front obstruction.

Joystick Control

Most common power WC interface; many grip shapes and sensitivities.

Sip-and-Puff Control

Pneumatic switch system operated by inhaling/exhaling into a straw; for high-level quadriplegia.

Head Array

Proximity sensors in headrest detecting head pressure/position to drive power chair.

Chin Control

Small joystick or toggle positioned at chin for users with limited UE function.

Foot Control

Drive interface manipulated with feet; useful when upper-extremity control is limited.

Standing Wheelchair

Power or manual system that lifts user to standing, aiding pressure relief and physiologic benefits.

iBOT

Gyroscopic power wheelchair capable of climbing curbs, stairs and balancing on two wheels.

Foam Cushion

Basic or multi-layered foam providing low cost, mild pressure redistribution; not for open wounds.

Gel Cushion

Heavier cushion whose gel moves with user for pressure relief; good if adjusted properly (e.g., Jay).

Air Cushion (Roho)

Adjustable air-cell cushion offering excellent pressure redistribution but high maintenance.

Honeycomb Cushion (Supracor)

Breathable, washable cushion with mild pressure relief; comfortable for users with intact sensation.

Hybrid Cushion

Combines foam, gel or air layers (e.g., Roho Hybrid Elite) for tailored pressure management.

Anti-Tippers

Rear or front extensions preventing wheelchair from tipping during inclines or transfers.

Letter of Medical Necessity (LMN)

Detailed justification explaining why each wheelchair component is required for patient function.

CSHCN Measurement Form

Children with Special Health Care Needs form listing 12 body measurements for precise WC fitting.

Pressure Relief

Routine off-loading technique preventing skin breakdown; may be aided by cushions or tilt-in-space.

Wheelies

Skill of balancing on rear wheels to navigate curbs or uneven surfaces; requires training.