2nd Edition
Seating and Wheeled Mobility A Clinical Resource Guide
Fully revised and updated in its second edition, 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 and to protect skin integrity, or a wheelchair base to best meet dependent or independent mobility needs.
The book 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.
The book is divided into sections, each section addressing a different area of clinical practice in Wheelchair Seating and Mobility.
• The first section is an in-depth presentation of the assessment process and the critical understanding of pressure management. The range of available seating supports is presented as part of the process of selecting product involves understanding the match between the person’s need and the available technology.
• The second section focuses on postural support during a 24-hour period of time, including sitting. Three types of sitters are presented: Hands-Free, Hands-Dependent, and Prop Sitters. Night time positioning needs, in the context of a 24-hour positioning program, are also addressed. This section includes 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 Selection and Fit of the most appropriate wheeled mobility device – manual wheelchair, power wheelchair, or scooter.
• The fourth section provides in-depth clinical applications for each category of mobility devices from manual chairs, power assist to power chairs. The importance of On Time mobility for the very young is presented; along with a chapter focusing on power seating. The final chapter in this section offers guidance in mobility skills training for both manual and power wheelchair users.
• 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 sixth section presents additional considerations when working with persons who are aging with a disability. Other considerations include the importance of both the environment of use and the safe transport of a wheelchair in a vehicle as well as the application of the wheelchair standards test methods in the clinic.
• This second edition adds a chapter on measuring outcomes, through-out the service provision process. A new addition to this edition is a look at the Past, Present and Future of Complex Rehab Technology.
Richly illustrated throughout, this book has been carefully designed to support occupational and physical therapists, complex rehabilitation technology suppliers, and third-party payers who are interested in wheelchair seating and mobility assessment and applications.
Introduction
Michelle L. Lange & Jean L. Minkel
Section I. Postural Support and Pressure Management: Foundational Information
1. Seating and Mobility Evaluations for Persons with Long-Term Disabilities: Focusing on the Client Assessment
Jean L. Minkel
2. Pressure Management for the Seated Client
Jo-Anne Chisholm and Joanne Yip
3. Seating System Categories and Clinical Indicators
Barbara Crume and Jessica Presperin Pedersen
Section II. Postural Support and Pressure Management Clinical Applications
4. 24/7 Postural Care Management
Guðný Jónsdóttir and Patricia Toole
5. Postural Support and Pressure Management Considerations for Hands-Free Sitters
Kendra Betz
6. Postural Support and Pressure Management Considerations for Hands-Dependent Sitters
Deborah L. Pucci
7. Postural Support and Pressure Management Considerations for Prop Sitters
Jill Sparacio
8. General Positioning Strategies and Seating Interventions by Body Location
Lindsay Alford and Cheryl Hon
9. Standardized Measures of the Person, Seating System, and Wheelchair
Kelly Waugh and Barbara A. Crane
Section III. Wheeled Mobility: Foundational Information
10. The Mobility Algorithm – Clinical Decision-Making for a Mobility Device
Cathy H. Carver
11. Manual (self-initiated) Mobility Categories and Clinical Indicators
Mary Shea-Stifel
12. Power Mobility Categories and Clinical Indicators
Michael Babinec and Becky Breaux, MS, OTR/L, ATP
13. Dependent Mobility Categories and Clinical Indicators
Sheila N. R. Buck and Stefanie Sukstorf Laurence
Section IV. Wheeled Mobility: Clinical Applications
14. Optimally Configuring Manual Wheelchairs for Self-Propulsion
Lauren E. Rosen
15. Power Assist and alternative drive mechanisms for Manual Wheelchairs
Carla Nooijen, Theresa Berner and Carmen DiGiovine
16. Power Mobility Assessment: Determining Readiness and Providing On Time Mobility
Heather A. Feldner, Samuel W. Logan and Andrina Sabet
17. Power Seat Functions: Putting Evidence into Practice
Ginger Walls
18. Power Mobility: Optimizing Driving
Amy Morgan and Faith Saftler Savage
19. Power Mobility: Driving Methods
Michelle L. Lange
20. Power Mobility: Advanced Features and Applications
Jill Baldessari, Leah Barid and Michelle L. Lange
21. Training Manual and Power Wheelchair Mobility and Maintenance Skills
Ronald Lee Kirby and Lynn Worobey
Section V. Putting it Together – Specialty Applications
22. Considerations When Working with the Pediatric Population
Lisa K. Kenyon
23. Considerations When Working with the Geriatric Population
Christie Hamstra and Deborah A. Jones
24. Considerations When Working with the Bariatric Population
Stephanie Tanguay
25. Considerations When Working with Degenerative Neurological Conditions
John “Jay” Doherty
26. Considerations When Working with Complex Neurological and Orthopedic Presentations
Elizabeth McCarty and Melissa Tally
Section VI. Related Content
27. Considerations When Working with a Person Who is Aging with a Disability
Susan Johnson Taylo, Bonita Sawatzky and Linda Bennet
28. Environmental Assessment
Cindi Petito
29. Wheelchairs and Transportation
Miriam A. Manary
30. What are Standards for Wheelchairs and Wheelchair Seating?
Kay Ellen Koch, Kara Kopplin and Anita Perr
31. Documentation of the Seating and Mobility Assessment
Julie Piriano
32. Measuring Seating and Wheeled Mobility Outcomes
Emma M. Smith and Paula W. Rushton
33. Complex Rehab Technology in North America – Past, Present, and Future Perspectives
Tom Borcherding
Biography
Michelle L. Lange, OTR/L, ATP/SMS is an occupational therapist with over 38 years of experience in the area of assistive technology. Michelle’s work in assistive technology covers a broad range of roles and services. She evaluates and treats children and adults with a variety of diagnoses as well as provides consultation and education in the areas of wheelchair seating and mobility, accessibility, assistive technology access, and mounting. Michelle is a well-respected lecturer, both nationally and internationally, and has presented over 750 courses, webinars, and recorded content. She is on the OccupationalTherapy.com advisory board. Michelle has authored over 250 publications, including texts, text chapters, and articles. She is a member of the RESNA Assistive Technology Journal Editorial Board. She is a current member of the Clinician Task Force and the Wheelchair Skills Program Advisory Board. Michelle is a RESNA Fellow, as well as a certified Assistive Technology Professional (ATP) and Seating and Mobility Specialist (SMS).
Jean L. Minkel is a physical therapist and compassionate clinician well recognized for her work in Assistive Technology. Jean has a passion for insuring that people with a mobility disability have access to the products and services needed to support full participation in life. Jean works directly with the disability community to identify unmet needs in product development, ableist practices in the therapy community and restrictive coverage policies which prevent access to the devices that meet the needs of the wheelchair user. Jean is the Senior Vice President of Rehab and Mobility Services for Independence Care System, a not for profit program, supporting people living with a physical disability in New York City. She leads On A Roll, an OT/PT private practice specializing in Seating and Wheeled Mobility services. Jean is also an independent consultant who provides educational and consulting service to all members of the A.T. team. Jean has been recognized for her expertise by being named a RESNA Fellow and awarded the Sam McFarland Mentor Award.
