Seated Evaluation

1
Seated Evaluation
2
Goals of Sitting Evaluation

• Fitting patients to wheelchair
• Preventing physical problems
• Postural
• Skin
• Function
• Allowing patient to be more independent/active in
  every day activities
• Patient Goals

3
Skin Evaluation

• Determine history of skin problems
• Note any current problems
• Sores or Ulcers
• Important causal factors include pressure, shear,
  temperature, and moisture
• Redness or any Discoloration
• Scarring or Calluses

4
Seating and Mobility Assessment

• Mat Evaluation Determine needed corrections
• Unsupported Sitting
• Laying Supine (face up)
• Simulation Techniques Determine how best to make
  corrections
• Hand Simulation
• Seated Simulation
• Actual Assessment

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Mat Evaluation (Supine)

• Requires multiple people
• Goal is optimal trunk alignment

6
Mat Evaluation (Supine)

• Full ROM tests of lower extremities
• Include flexion, abduction/adduction,
• and rotation
• Pelvic alignment is key!!

• Note limb measurements and optimal joint angles

7
Mat Evaluation (Seated)

• Use thin surface to allow for full knee flexion
• Repeat motions and measurements from supine
  assessment
• Note fixed and flexible deformities
• Assess Balance
• Independent
• Dependent on hands
• Fully Dependent

8
Supports/Cushioning

• Used for postural correction, improving
  stability, counteracting muscle
  weakness/spasticity, positioning in chair

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Simulation Techniques

• Hand Simulation
• Hands simulate forces applied by supports
• Determine necessity, required force, desired
  location

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Simulation Techniques

• Seating Simulation
• Adjustable chair frame with interchangeable
  components
• Verifies findings from hand simulation desired
  outcomes reached?

11
Simulation Techniques

• Actual Assessment
• Assess actual commercial products for desired
  outcomes, make a decision

12
References

• Carison MJ, Payette MJ, Vervena LP. Preventing
  Ulcers From Seating. Journal of Prosthetics and
  Orthotics 1995 Vol 7, Num 2, p 51
• Schmeler, M. Performance validation of a pow-ered
  wheelchair mobility simulator. Proceedings of
  the Eleventh Annual International Seating
  Symposium, Pittsburgh, University of Pittsburgh
  Press, 1995 146-149.
• Bergen, AF. Assessment for Seating and Wheeled
  Mobility Systems. Team Rehab Report Articles,
  April 1998 p.16-18,20,22. Available online
  http//www.wheelchairnet.org/WCN_ProdServ/Docs/Tea
  mRehab/RR_98/9804art1.PDF
• Bergen AF, Presperin J, Tallman T. Stepping
  Into The Sitting Assessment. Team Rehab Report
  Articles, Jan/Feb 1992 p.39-42. Available
  online http//www.wheelchairnet.org/WCN_ProdServ/
  Docs/TeamRehab/RR_92/9201art4.PDF
• www.invacare.com provided seating simulator
  images