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Wheelchair Assessment

Michelle Lange, OTR, ABDA, ATP/SMS

November 22, 2021

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Question

What is typically included in a wheelchair assessment?  

Answer

Assessment is typically done with a wheelchair supplier and a clinician. The clinician looks at the clinical and functional aspects of the wheelchair, but the wheelchair supplier knows the equipment well and can match specific client parameters to product features.

Lightweight, ultra-lightweight, pediatric, and bariatric manual chairs are considered complex rehab equipment. Complex rehab equipment is typically recommended by someone with a specific credential, ATP, or Assistive Technology Professional. This is a certification from RESNA, the Rehabilitation Engineering and Assistive Technology Society of North America. Depending on the funding source, a person must have an ATP certification to recommend complex rehab-level chairs.

Some suppliers and clinicians may also have an additional certification called the SMS, Seating, and Mobility Specialist. The ATP is a more general assistive technology examination, whereas the Seating and Mobility Specialist certification is an extra layer of expertise in this area. When we are assessing, the supplier must have adequate experience, including an ATP certification.

Considerations include:

  • Strength, range of motion, muscle tone, and orthopedic status
  • Cardiopulmonary status and fatigue
  • Potential for change in function or size
  • Positioning needs
  • Environmental needs


We need to look at the client's strength, range of motion, muscle tone, and the orthopedic status during the assessment. These areas are going to dictate their seating system needs and their ability to self-propel. This does not mean that you need to spend hours on standardized testing. You need to look at the client's strength and range of motion that are required to self-propel a manual wheelchair. The client's muscle tone and orthopedic status are also going to impact seating. 

Cardiopulmonary status is another area to assess as this person might experience difficulty during self-propulsion if their heart rate goes up or their fatigue is excessive. There are some clients out there who absolutely could self-propel a manual chair. However, due to the cardiopulmonary cost, they need power mobility.

We also need to keep in mind the potential for change in functional abilities or size. If the client has a progressive condition, we need to decide if a self-propelling manual chair is appropriate. It might suit their needs now, but it may not after some years. Size changes are certainly expected in the pediatric population, but adults change in size as well.

Positioning in the manual wheelchair is incredibly important. If someone is not positioned well, they will not be able to propel the manual wheelchair very well.

Finally, we need to look at the environment. What type of environment is this person in most of the day? Do they live on smooth linoleum or shag carpets? What are their community needs?


michelle lange

Michelle Lange, OTR, ABDA, ATP/SMS

Michelle is an occupational therapist with over 30 years of experience and has been in private practice, Access to Independence, for over 15 years. She is a well-respected lecturer, both nationally and internationally and has authored numerous texts, chapters, and articles. She is the co-editor of Seating and Wheeled Mobility: a clinical resource guide, editor of Fundamentals in Assistive Technology, 4th ed., NRRTS Continuing Education Curriculum Coordinator and Clinical Editor of NRRTS Directions magazine. Michelle is a RESNA Fellow and member of the Clinician Task Force. Michelle is a certified ATP, certified SMS, and is a Senior Disability Analyst of the ABDA.

 


Related Courses

Matching Products to Seating Needs
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #4099Level: Introductory1 Hour
  'Clear presentation and examples of differing seating systems for positioning needs'   Read Reviews
Once the wheelchair seating assessment has been completed and seating interventions considered, it is time to match specific client needs to product interventions. This course presents various categories of seating systems. Seating systems, whether linear, contoured, or molded, are comprised of primary support surfaces, secondary support components, and materials. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Dependent Mobility Intervention
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #4102Level: Introductory1 Hour
  'Good information about dependent mobility interventions'   Read Reviews
Dependent mobility devices are not designed for self-propulsion. These include adaptive strollers, transport chairs, tilt-in space manual wheelchairs, reclining manual wheelchairs, and standard manual wheelchairs. For very small children, adaptive strollers are often required to meet positional and dependent mobility needs. Other dependent mobility bases, such as transport chairs and standard wheelchairs, are used for quick trips or for temporary use. Clients may also use a dependent mobility base as a backup to a power wheelchair. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Augmented Mobility Intervention
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #4107Level: Introductory1 Hour
  'Introduced kinds and uses of devices but would like assessment tools for choosing proper ones for specific pt needs'   Read Reviews
Augmented mobility is used with clients who require assistance in ambulation. This category of equipment includes walking canes, crutches, walkers, and gait trainers. Augmented mobility is used to prevent falls, increase mobility, and provide strengthening and dynamic weight-bearing. This course will systematically present each of these options with clinical indicators. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Manual Wheelchair Mobility: Self-Propulsion
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #4176Level: Introductory1 Hour
  'great presentation'   Read Reviews
Most manual wheelchairs are designed for self-propulsion and fall into categories. This course systematically explores each category with clinical indicators, as well as optimal frame configuration to increase propulsion efficiency and reduce the risk of repetitive stress injury.

Power Wheelchair Advanced Features
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3990Level: Advanced2 Hours
  'I have very little experience in this area and I learned a lot! Fascinating stuff!'   Read Reviews
Power wheelchairs do far more than drive – the driving method can be used to navigate and control other features including Reverse, Speeds, Power Seating, or an Interfaced Assistive Technology device (i.e. a communication device). Power Wheelchairs can send Bluetooth signals to control devices such as tablets and smartphones. Finally, new SMART technologies are making power wheelchairs safer and more efficient for everyone. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.