Cane to Wheeled Mobility – What are the Options?...4-wheeled rollator: • Provides support when...
Transcript of Cane to Wheeled Mobility – What are the Options?...4-wheeled rollator: • Provides support when...
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Cane to Wheeled Mobility – What are the Options?
Jean L. Minkel, PT, ATP
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Speaker
∗ Jean Minkel, PT, ATPSenior Vice President, Rehab ServicesIndependence Care System – ICSNew York, New York
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Ambulation Aides
∗ Cane∗ Provide a minimal
amount of additional stability for persons with decreased standing balance
∗ Useful when one lower extremity has limited weight-bearing, secondary to pain or weakness
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Canes – Base of Support
Straight Care Hurry Cane Quad Care
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On the Go – Safely!!
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Walkers
Pick-Up Walker:• 4 point stability• Good stability – sit to stand• Needs to be picked-up
when walking
Walker with Wheels:• Glides without
Picking up• No Brakes
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Rollator Walker
4-wheeled rollator:• Provides support when walking• Brakes improve stability going from
sit-to-stand• Seat and Basket popular features• Wide base of support
3- wheeled rollator• Smaller profile, tighter turning
radius• Bit less stability• Available with basket – not seat
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On a Roll !
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Manual Wheelchairs
Transport Chair
∗ Smallest Profile – Rear Wheels fit under seat.
∗ Overall width about the same as the width of the chair
∗ Lightweight and easily transportable
∗ Best for short distances, short time periods
∗ Not highly adjustable∗ Can be challenging to push
over uneven surfaces, due to small wheels
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Manual Wheelchairs
Hybrid – Transport Chair
∗ Receiver accepts a Large wheel in the rear – increases ease of pushing outdoors
∗ Quick release wheels, decreases overall width in tighter environments.
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Manual WheelchairsStandard Manual Wheelchair:• Highly Durable• Fixed Axle Position – Highly
Stable• Often used in Long-term care
facilities and in Rental Fleets
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Manual Wheelchairs
Lightweight Manual chair∗ Lighter weight frame
than standard chair – BUT not any easier to push
∗ Axle adjustment is just-UP – Standard HEIGHT DOWN – Hemi HEIGHT for foot propulsion
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Manual WheelchairsUltra-light Wheelchairs• Easier to push• Less to do with
weight and more to do with Axle adjustment
• Further the axle is forward, the easier the chair is to push – and TO TIP OVER!
Folding Frame Note the Cross Frame under the seat
Adjustable Axle
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Manual Wheelchairs
Ultralight – Rigid Chair
∗ Axle bar under the seat slides along the seat rail.∗ Moved forward, easy to “pop
into wheelie”
∗ Rigid frame – no cross frame∗ To transport – Rear Wheels are
quick release, backrest folds down
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Manual Wheelchairs
Tilt Chair:• Postural support chair –
Dependent Mobility• Change position relative to gravity• Seat to back and Seat to foot rest
angles stay the same
Recliner Chair:• Changes body positioning by opening
the Seat to Back angle and the seat to leg rest angle
• Able to achieve a lying-down position
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Power-AssistBridge Products between
Manual and Power Mobility
∗ Replacement Push Wheel∗ Rims mounted into an in-
hub motor∗ One push has an
extended range – longer distance for each push
∗ Reduced number of push strokes with less force
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Power-Assist
Rear Mounted 5th Wheel – Omni -track Wheel allows veering
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ScootersPOV – Power-Operated Vehicle
∗ Does not look like a wheelchair!
∗ Great way to “augment mobility” – when longer distances are harder to manage
∗ Requires good sitting balance and
∗ The ability to keep arms on the tiller, controlling speed with hand and fingers
3-wheeled scooter
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Scooters
4 – wheeled Scooter∗ Increased turning
stability∗ Increased
wheelbase – greater turning radius
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Power Mobility
∗ Joystick operation∗ Power chair using a
traditional wheelchair frame
∗ Standard wheelchair seating
∗ Small foot print
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Indoor Power Mobility
∗ Separate Power Base from the Seat
∗ Joystick Operation∗ Small drive wheels and
motors∗ 6 wheels total for stability
and tight turning radius
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Indoor / Outdoor Power Mobility
Rear Wheel Drive Mid-Wheel Drive Front Wheel Drive
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Indoor / Outdoor Power Mobility
Rear Wheel Drive Chairs∗ Most stable ride when
traveling at high speed outdoors
∗ Need to have rear anti-tippers, as most of the weight is on the rear of the chair
∗ Approach a hallway turn from the wall on the far side of the hallway
Rear Wheel Drive
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Indoor / Outdoor Power Mobility
Mid Wheel Drive Chairs∗ Tightest 360 degree
turning radius – great for indoor maneuverability.
∗ 6 wheeled power base ∗ Approach hallway turns
by coming down the middle of the hallway into the middle of the door, then turnMid-Wheel Drive
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Indoor / Outdoor Power Mobility
Front Wheel Drive Chairs∗ Drive wheels in the front
provide increased obstacle climbing performance
∗ No rotating casters in front allow for the users feet to be close to the front edge of the chair
∗ Approach a hallway turn from the wall closest to the door – turning needs clearance behind the chair
Front Wheel Drive
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Power Seating
Power Tilt Power Recline and Elevating Legrests
Tilt, Recline and Elevating Legrests
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Power Seating
Seat Elevator
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Standing Options
Manual Stander –Manual Wheelchair
Power Stander on Power Chair
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Questions ?
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∗ Mobility Alternatives – From Canes to WheelchairsAvailable at:http://www.unitedspinal.org/pdf/canes_to_wheelchairs.pdf∗ USAtechguide – Web guide to mobility devices http://www.usatechguide.org/∗ Contact Information for speaker∗ Jean Minkel, PT, ATP – email – [email protected]
Additional Information