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“Mobility devices enable persons with disabilities to achieve personal mobility, and access to these devices is a precondition for achieving equal opportunities, enjoying human rights and living in dignity.”1

LEARNING OBJECTIVES

LEARNING OBJECTIVES

  1. Identify when a wheelchair user has basic, intermediate, or complex needs.

  2. List the 8 basic steps of the wheelchair seating and mobility service delivery process.

  3. Explain the difference between a reference neutral sitting posture and a person’s “optimal” sitting posture.

  4. Describe the components of the examination process for determining the most appropriate wheelchair seating and mobility device (WSMD).

  5. Discuss the relationship between elements of the assessment interview and the wheelchair prescription/selection.

  6. Explain the different methods of seating simulation and the expected outcomes.

  7. Describe factors that affect determination of seat and back support features.

  8. Discuss the benefits and contraindications of various seating system features.

  9. Apply the components of a problem-solving model when presented with a clinical case study.

  10. Describe at least 5 basic elements that should be included in the clinician documentation for a WSMD.

INTRODUCTION

According to estimates from the Centers for Disease Control and Prevention, approximately 53 million, or one in five, Americans has a disability of some type and the number is increasing daily.2,3 Roughly 2.2 million people in the United States depend on a wheelchair for day-to-day tasks and mobility.4,5 Wheelchair users are limited in their ability to walk. This may include people who are unable to walk at all and who will need a wheelchair full-time for mobility in all environments; others may need a wheelchair only for longer distances or in certain environments.

In 2001, the International Classification of Functioning, Disability and Health (ICF) introduced language and a framework for disability.6-8 The ICF carefully defines key concepts, including functioning, disability, activity, participation, and personal and environmental factors. Wheelchair seating and mobility (WSM) technologies are, from an ICF perspective, considered an environmental factor that has an impact on a person’s functioning and can facilitate activity and participation.9

A functional mobility limitation such as an inability to walk does not always have to equate to a functional limitation. For example, the function of walking may cease to be disabling if accommodations are made to compensate for the limitation such as with the use of equipment (e.g., wheelchair, walker, cane) and/or accommodations to the environment, such as a ramp or elevator, to enable access to buildings and the community.

The Wheelchair User

People of any age may need a wheelchair—children, adults, and the elderly. The need for a wheelchair can be permanent, or it can be temporary. People with a variety of diagnoses, such as multiple sclerosis (MS), cerebral palsy (CP), or cerebrovascular accident, may need a wheelchair because their walking ability is limited. Other people need wheelchairs who have no ability to walk, including individuals with ...

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