Wheelchair selection and common sense

Wheelchairs are very widely used tools, such as those with reduced mobility, lower extremity disabilities, hemiplegia, and paraplegia below the chest. As a caregiver, it is particularly important to understand the characteristics of wheelchairs, choose the right wheelchair and be familiar with how to use them.
1. The hazards of improper selection of wheelchairs
Unsuitable wheelchair: too shallow seat, not high enough; too wide seat… can cause the following injuries to the user:
Too much local pressure
bad posture
induced scoliosis
contracture of the joint
The main parts of the wheelchair under pressure are the ischial tuberosity, the thigh and the popliteal area, and the scapular region. Therefore, when choosing a wheelchair, pay attention to the appropriate size of these parts to avoid skin abrasions, abrasions and pressure sores.
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2, the choice of ordinary wheelchair
1. Seat width
Measure the distance between the two buttocks or between the two stocks when sitting down, and add 5cm, that is, there is a 2.5cm gap on each side of the buttocks after sitting down. The seat is too narrow, it is difficult to get on and off the wheelchair, and the hip and thigh tissues are compressed; the seat is too wide, it is difficult to sit firmly, it is inconvenient to operate the wheelchair, the upper limbs are easily fatigued, and it is difficult to enter and exit the gate.
2. Seat length
Measure the horizontal distance from the rear buttocks to the gastrocnemius muscle of the calf when sitting, and subtract 6.5cm from the measurement. The seat is too short, and the weight mainly falls on the ischium, which is prone to excessive local compression; the seat is too long, which will compress the popliteal fossa, affect local blood circulation, and easily stimulate the skin of the popliteal fossa. For patients, it is better to use a short seat.
3. Seat Height
Measure the distance from the heel (or heel) to the crotch when sitting down, add 4cm, and place the pedal at least 5cm off the ground. The seat is too high for a wheelchair to fit at the table; the seat is too low and the seat bones bear too much weight.
4. Seat cushion
For comfort and to prevent pressure ulcers, a seat cushion should be placed on the seat, and foam rubber (5-10cm thick) or gel cushions can be used. In order to prevent the seat from sinking, a 0.6cm thick plywood can be placed under the seat cushion.
5. Backrest height
The higher the backrest, the more stable it is, and the lower the backrest, the greater the range of motion of the upper body and upper limbs. The so-called low backrest is to measure the distance from the seat surface to the armpit (one or both arms stretched forward), and subtract 10cm from this result. High Back: Measure the actual height from the seat surface to the shoulder or backrest.
6. Armrest Height
When sitting down, the upper arm is vertical and the forearm is placed on the armrest. Measure the height from the chair surface to the lower edge of the forearm, and add 2.5cm. Proper armrest height helps maintain proper body posture and balance, and allows upper extremities to be placed in a comfortable position. The armrest is too high, the upper arm is forced to rise, and it is easy to get tired. If the armrest is too low, you need to lean forward to maintain balance, which is not only easy to fatigue, but also may affect breathing.
7. Other aids for wheelchairs
It is designed to meet the needs of special patients, such as increasing the friction surface of the handle, the extension of the brake, the anti-vibration device, the anti-skid device, the armrest installed on the armrest, and the wheelchair table for patients to eat and write.
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3. Precautions for using a wheelchair
1. Push the wheelchair on level ground
The old man sat firmly and supported him, stepping on the pedals. The caregiver stands behind the wheelchair and pushes the wheelchair slowly and steadily.
2. Push the wheelchair uphill
The body must lean forward when going uphill to prevent backwards.
3. Downhill backward wheelchair
Invert the wheelchair downhill, take a step back, and move the wheelchair down a little. Extend the head and shoulders and lean back, asking the elderly to grasp the handrail.
4. Go up the steps
Please lean on the back of the chair and hold the armrest with both hands, don’t worry.
Step on the presser foot and step on the booster frame to raise the front wheel (use the two rear wheels as the fulcrum to make the front wheel move up the step smoothly) and gently place it on the step. Raise the rear wheel after the rear wheel is close to the step. Move closer to the wheelchair when lifting the rear wheel to lower the center of gravity.
5. Push the wheelchair backwards down the steps
Go down the steps and turn the wheelchair upside down, slowly descend the wheelchair, stretch your head and shoulders and lean back, telling the elderly to hold on to the handrails. Body close to the wheelchair. Lower the center of gravity.
6. Push the wheelchair up and down the elevator
Both the elderly and the caregiver turn their backs to the direction of travel—the caregiver is in front, the wheelchair is behind—the brakes should be tightened in time after entering the elevator—the elderly should be informed in advance when entering and exiting the elevator and passing through uneven places—slowly enter and exit.
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Post time: Aug-16-2022