Rehabilitation Technology

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Objectives:

1. Gain some historical perspective on the development of "seating and mobility" as an art and a science.
2. Be able to troubleshoot a problematic seating and mobility system and recommend appropriate corrections.
3. Be able to prescribe and justify an appropriate seating and mobility system for a variety of adult and pediatric rehabilitation patients.
4. Be aware of the existence of various seating components, ADL and comunications devices, gadgets, and techniques and their appropriate uses.

Lesson Plan:

• 3/21/06 - Wheelchair and seating information session - use the Quia quiz for your IRAT this week and look up additional information, study these web site materials if you need to
• 3/28/06 - Questions and feedback on the quiz, intro to ADL and communication
• 4/4/06 - GRAT, cases - several of mine and feel free to bring your own to do as time allows, or even post-course on-line

Materials:

From Pam's original lecture:

Study this chart!

1. Postural control
2. Deformity - asymetrical vs symmetrical, correctable vs fixed
3. Sensation

TROUBLESHOOTING GUIDE

• Size
• Tippability, center of gravity, center of rotation
• Start at the pelvis and work your way up
• Seat and back angle options
• Extra supports
• Proper use of hip guides, abductor, tray, trunk support, headrest

Some items not covered you should look up if you have not heard of:

• One-arm drive kits
• Power or power assist add-ons
• Offset hinges
• Crutch holders
• Drink holders
• Skirt guards
• Gloves


• Bariatric Equipment

Transportation Safety -

MEDICAL JUSTIFICATION -

• not able to walk or extremely limited walking
• has pressure sore or need for pressure relief
• independence and hand/arm function
• prevent or slow progression of deformity, provide orthopedic support or comfort

ADLs - useful gadgets vs human assistance

• basic: eating, grooming, bathing, dressing, toileting, transfers
• instrumental: cooking, cleaning, laundry


• fine motor deficit
• weakness
• ataxia
• one-handedness- easier than commonly thought

UE vs LE prosthetics-

DEVELOPMENTAL EQUIPMENT-

ADULT NEEDS-

Adaptive Driving basics-

1. get permit first
2. specialized eval unless cerebral function and upper extremities intact
3. medical safety issues - seziure control for 6-12 months depending on state, VOLUNTARY reporting preferred, diabetes and heart disease can pose greater risks
4. hand controls - sufficient gross leg movements, fast enough and without looking at feet (check proprioception)
5. advanced controls
6. add-ons - switch a function from one side to the other

ADA issues and accessibility -

Relationships -

Communications-

• Who needs a device, and for what?
• academics - IDEA, section 504 - handwriting replacers
• what is Section 508?

Sensory disability

• hard-of-hearing
• deaf vs Deaf
• low vision, blind
• deaf-blind, blind and decreased tactile sensation - greater challenges

Disability Etiquette and language

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Since my M.D. also stands for Messy Desk, please use my e-mail!
Write me anytime at:vstefans@george.ach.uams.edu