Seating and Wheeled Mobility: A Clinical Resource Guide

Seating and Wheeled Mobility: A Clinical Resource Guide presents clinical assessment considerations when working with a person with a disability who may need wheelchair seating for postural support, skin integrity, or a wheelchair base to best meet dependent or independent mobility needs.

Michelle L. Lange and Jean Minkel have designed this text to support occupational and physical therapists, complex rehabilitation technology suppliers, and even third-party payers who are interested in wheelchair seating and mobility assessment and applications. Seating and Wheeled Mobility provides a wide spectrum of information from foundational information for those practitioners who are new to the field to in-depth, population-specific information for practitioners who perhaps have not worked with a particular population in the past.

Information sharing, opportunities for demonstration and trial, and patience on the part of the clinician working with the person with a disability are all critical precursors to the actual process of making equipment recommendations.

Seating and Wheeled Mobility is divided into sections, each addressing a different area of clinical practice.

• The first section is an in-depth presentation of the assessment process and the critical understanding of pressure management needed by the clinical team when working with a client population who rely on wheeled mobility.
• The second section focuses on postural support. Also included is a completely updated method to measure and describe the seated person and related support surfaces needed when recommending a device.
• The third section lays the foundation for clinical decision making around the assessment for and application of the most appropriate wheeled mobility device.
• The fourth section provides in-depth clinical applications for each category of mobility devices. Also addressed is proper documentation to assist in the funding of these devices.
• The fifth section provides population-specific information regarding the clinical application of position, pressure management, and functional mobility as it applies to the pediatric, geriatric, and bariatric populations, as well as persons with both degenerative and complex neuromuscular impairments.
• The last section presents additional considerations when working with persons who are aging with a disability, environmental assessments, transportation, and the application of standards.

Seating and Wheeled Mobility: A Clinical Resource Guide provides the depth and breadth of the clinical practice of wheelchair seating and mobility to both those who are new to the field, as well as seasoned professionals.

Dedication

Acknowledgments

About the Editors

Contributing Authors

Foreword by David Cooper, MSc Kines, Rehab Tech and Maureen Story, BSR(PT/OT)

Foreword by Mark R. Schmeler, PhD, OTR/L, ATP, RESNA Fellow

Introduction

Section I              Postural Support and Pressure Management: Foundational Information

Chapter 1             Seating and Mobility Evaluations for Persons With Long-Term Disabilities: Focusing on the
                                Client Assessment

                                Jean L. Minkel, PT, ATP

Chapter 2             Pressure Management for the Seated Client

                                Jo-Anne Chisholm, MSc, OT and Joanne Yip, BSR, OT

Section II            Postural Support and Pressure Management: Clinical Applications

Chapter 3             Postural Support and Pressure Management Considerations for Hands-Free Sitters

                                David Kreutz, PT, ATP

Chapter 4             Postural Support and Pressure Management Considerations for Hands-Dependent Sitters

                                Sharon Sutherland, PT

Chapter 5             Postural Support and Pressure Management Considerations for Prop Sitters

                                Jill Sparacio, OTR/L, ATP/SMS, ABDA

Chapter 6             Standardized Measures of the Person, Seating System, and Wheelchair

                                Kelly Waugh, PT, MAPT, ATP and Barbara A. Crane, PT, PhD, ATP/SMS

Chapter 7             Posture Management 24/7

                                Atli Ágústsson, PT, MSc Bioeng and Guðný Jónsdóttir, PT, MSc

Section III          Wheeled Mobility: Foundational Information

Chapter 8             Mobility Assessment: The Mobility Algorithm

                                Elizabeth Cole, MSPT, ATP

Section IV          Wheeled Mobility: Clinical Applications

Chapter 9             Manual Mobility Applications for the Person Able to Self-Prope

                                Lauren E. Rosen, PT, MPT, MSMS, ATP/SMS

Chapter 10           Power Mobility Applications: Mobility Categories and Clinical Indicators

                                Michael Babinec, OTR/L, ABDA, ATP

Chapter 11           Power Mobility: Alternative Access Methods

                                Michelle L. Lange, OTR/L, ABDA, ATP/SMS

Chapter 12           Power Mobility: Optimizing Driving

                                Amy M. Morgan, PT, ATP

Chapter 13           Power Mobility: Advanced Applications

                                Michelle L. Lange, OTR/L, ABDA, ATP/SMS

Chapter 14           Manual Mobility Applications for the Dependent User

                                Sheila N. R. Buck, BSc (OT), OT Reg (Ont), ATP

Chapter 15           Alternate Drive Mechanisms for Manual Wheelchairs: Bridging the Gap Between Manual and
                                Power Mobility

                                Carmen P. DiGiovine, PhD, ATP/SMS, RET and Theresa F. Berner, MOT, OTR/L, ATP

Chapter 16           Documentation of the Seating and Mobility Assessment

                                Julie Piriano, PT, ATP/SMS

Section V            Putting It Together: Specialty Applications

Chapter 17           Considerations When Working With the Pediatric Population

                                Jan Furumasu, PT, ATP

Chapter 18           Considerations When Working With the Geriatric Population

                                Deborah A. Jones, PT, DPT, GSC, CEEAA, ATP and Joanne Rader, RN, MN

Chapter 19           Considerations When Working With the Bariatric Population

                                Stephanie Tanguay, OT/L, ATP

Chapter 20           Considerations When Working With Degenerative Neurological Conditions

                                John “Jay” Doherty, OTR, ATP/SMS

Chapter 21           Considerations When Working With Complex Neurological and
                                Orthopedic Presentations

                                Elizabeth McCarty, OTR/L and Melissa Tally, PT, MPT, ATP

Section VI          Additional Considerations

Chapter 22           Considerations When Working With a Person Who Is Aging With a Disability

                                Susan Johnson Taylor, OTR/L, RESNA Fellow

Chapter 23           Environmental Assessment

                                Cindi Petito, OTR/L, ATP, CAPS

Chapter 24           Wheelchairs and Transportation

                                Mary Ellen Buning, PhD, OTR/L, ATP/SMS, RESNA Fellow

Chapter 25           Application of Wheelchair and Seating Standards: From Inside the Test Lab and Beyond

                Kay Ellen Koch, OTR/L, ATP, RESNA Fellow and Anita Perr, PhD, OT/L, FAOTA, RESNA Fellow

Financial Disclosures

Index

Michelle L. Lange, OTR/L, ABDA, ATP/SMS is an occupational therapist with 30 years of experience and has been in private practice, Access to Independence, for over 10 years. She is a well-respected lecturer, both nationally and internationally, and has authored numerous texts, chapters, and articles. She is the editor of Fundamentals in Assistive Technology, 4th edition, NRRTS Continuing Education Curriculum Coordinator, and Clinical Editor of Directions magazine. Michelle is on the teaching faculty of Rehabilitation Engineering and Assistive Technology Society of North America (RESNA). She is a member of the Clinician Task Force. Michelle is a certified ATP, certified SMS, and a Senior Disability Analyst of the American Board of Disability Analysts.

Jean L. Minkel, PT, ATP is a physical therapist and master clinician well recognized for her work in assistive technology. She is currently the Senior Vice President of Care Coordination and Rehabilitation Services for Independence Care System, a nonprofit, Medicaid long-term care program in New York City. Jean is also an independent consultant who provides educational and consulting service to all members of the assistive technology team—consumers, therapists, suppliers, manufacturers, and payers. Before entering the private sector, Jean was the Director of the Seating and Mobility Program at the Center for Rehabilitation Technology at Helen Hayes Hospital in West Haverstraw, NY. She produced the video series Spending or Investing—Funding Assistive Technology. She is coauthor of the Wheelchair Selection Guide: How to Use the ANSI–RESNA Standards, the Manual Mobility Training Guide, and the Power Mobility Training Guide. The assistive technology community has recognized Jean for her contributions with the RESNA Fellow award in 1995 and the Sam McFarland Mentor Award in 2012.