Chapter 17: Spinal Cord Injury: Wheelchair Skills

For the Instructor Guide and Worksheet Key please contact user services at userservices@mheducation.com

OUTLINE

Objectives:

The student will:

1. Describe various componentry of manual wheelchairs commonly used after spinal cord injury (SCI).

2. Effectively teach and safely guard a client in sitting push-up and weight shifts for pressure relief.

3. Effectively teach and safely guard a client to negotiate stairs, ramps, curbs, including use of wheelie skills, to maximize mobility.

Activity 1. Wheelchair Skills Background Information

Discuss introductory material and wheelchair componentry with students as a group.

Activity 2. Wheelchair Types and Componentry

Discuss and show different types and componentry of wheelchairs.

Activity 3. Pressure Reduction

Place students in pairs and have them practice the following activities switching so each practices the role of the therapist.

1. Sitting push-up

2. Weight shifts (lean forward and to side)

3. Power wheelchair tilt and recline

Activity 4. Wheelchair Training—Wheelies

Place students in pairs and have them practice the following activities switching, so each practices the role of the therapist.

• Static “wheelie”

• Pop a wheelie while propelling the chair forward

Activity 5. Ascending and Descending Curbs and Ramps

Place students in pairs and have them practice the following activities switching so each practices the role of the therapist.

1. Ascend curb

2. Descend curb

3. Ascend ramp

4. Descend ramp

Activity 6. Stairs for the Client Who Uses a Wheelchair

Place students in pairs and have them practice the following activities switching so each practices the role of the therapist.

1. Ascend stairs on buttocks

2. Descend stairs on buttocks

3. Ascend stairs in wheelchair

4. Descend stairs in wheelchair

5. Go up and down the escalator in a wheelchair

Wrap-Up Discussion

Instructor goes over “take home” demonstration of key lab skills.

WORKSHEET

Activity 1. Wheelchair Skills Background Information

Individuals who use a wheelchair as the primary source of mobility can continue to promote neuroplasticity and better health through weight-bearing activities such as the use of a standing table and the use of body weight-supported treadmill training. Research supports the overall health benefits to continuing with this training to improve trunk control in seated activities and for overall bone and cardiopulmonary health (Dolbow 2015).

When ambulation is not possible or efficient, independent mobility is achieved through the use of either a power or manual wheelchair. For individuals with clinically complete spinal cord injury (SCI), it is typical to see power chairs used by individuals with lesions at C6 and higher and manual chairs used by ...