Chapter 12 exam 3

Question 1

Which side to move toward in chair to plinth transfers

Answer 1

toward stronger side.

Question 2

Sequence for moving from chair to plinth

Answer 2

1. stands from locked wheelchair - clinician guarding at hip and shoulder.
2. pt steps with stronger leg , onto step stool, holding onto plinth for stability
3. pt brings the weaker leg up to stool and piviots to sit on plinth, while clinician continues to guard
4. pt scoots back into secure postion on plinth.

Question 3

Transferring from plinth to chair with assistance

Answer 3

1. position chair as if stand pivot transfer. pt sits on edge of plinth, guarded, and step stool beneath the pt’s feet.
2. pt places both feet down onto the stool and then steps to the floor, leading with the weaker foot.
3. pt pivots until backs of thighs contact the front edge of the chair. clinican may need to carefully nudge step stool out of way with one foot, if it is in the way.
4. pt sits down in the chair, with repositioning as needed.
5. The legrests are replaced and footplates lowered to ensure safe transportation.

Question 4

Preparing pt

Answer 4

eplain procedure, answer questions, and provide reassurance as needed. AMAP.ANAP

Question 5

Preparing the environment

Answer 5

• position wheelchair with casters forward
• apply wheelocks
• remove legrests and the armrest on the side the patient will be moving toward.

Question 6

Preforming the task

Answer 6

clinician in front of patient who can see the pt’s face calls the transfer as they can more readily see the pt’s face. clinician supporting legs.

Question 7

Dependent Transfer from chair to floor - two persion pt lift.

Answer 7

1. Clinicion in ready position - armrest and legs removed. - clinician in front supporting pt’s legs and facing direction of transfer. Clinician behind pt is straddling the drive wheel, arms reaching around the pt’s upper body.
2. clinician “locks” the pt’s forearms by crossing his hands over the pt’s crossed arms.
3. on 3 count - both clinicians lift the pt up and move toward the mat.
4. maintaining good body mechanics, the clinicians lower the pt to the mat.

Question 8

Dependent floor to chair transfer with two clinicians

Answer 8

1. Clinicians in ready position. chair locked with armrest up foot plates off. Both clinicians are in deep squat. front clinician faces direction of travel, supporting legs. clinician behind reaches around pt’s upper body with forearms crossed.
2. on count of 3 both clinicians rise lifting the pt in unison.
3. The clinicians carry the pt toward the chair, clearing the drive wheel.
4. above wheelchair seat, the clinicians lower the pt to the wheelchair before replacing the armrest and legrests.

Question 9

Independent transfer from Chair to floor with UE and LE mobility

Answer 9

1. pt scoots to the front of the seat, turning slightly, and moves one foot forward.
2. pt reaches toward the floorwith one hand while bringing the contralateral knee to the ground.
3. the pt lowers hips to side sitting

Question 10

Indepedent transfer from floor to chair with UE and LE mobility

Answer 10

1. pt begins in side sitting and comes to a quadruped position facing the chair
2. pt brings one knee forward into half kneeling while reaching to the arm of the chair with the ipsilateral arm.
3. Rising (coming to full standing) and turning her back to the char the pt reaches back with the other arm
4. pt sits with hips fully back in chair.

Question 11

independent chair to floor

Does the pt have limited LE ROM - yes

Answer 11

Consider long sitting or turnaround into quadruped

Question 12

independent chair to floor

Does the pt have limited LE ROM - no
Does the pt have limited UE ROM - Yes

Answer 12

Consider quadruped facing the chair

Question 13

independent chair to floor

Does the pt have limited LE ROM - no
Does the pt have limited UE ROM - no
Does the pt have limited UE strength - yes

Answer 13

Consider long sitting with a step stool

Question 14

Independent transfer from Wheelchair to Floor with limited LE use, Lateral Pivot into side sitting

Answer 14

1. Grasp the wheelchair frame with the trailing hand and position the feet to the trailing side. Slide the leading hand down the leg and place the hand on the floor.
2. Maintaining a forward trunk lean and using both UEs for support, pivot the hips off the seat
3. Lower the hips to the floor and adjust the sitting position as needed.

Question 15

Independent transfer from floor to wheelchair using a lateral sitting pivot, and limited LE use.

Answer 15

1. Bring the front of the chair beside the body with thte hips next to the footplate and lock the chair. Grasp the wheelchair frame with the leading hand.
2. breing the feet close to the buttocks and pin the knees with the chin
3. place the trailing hand, in a fist, beside the hips. While maintaining a forward trunk lean, push down with both arms and swing the hips up onto the seat of the char
4. Adjust upright sitting position and reposition the feet on the footplate.

Question 16

Independent Transfer from wheelchair to floor with limited LE use, Forward into Long-sitting

Answer 16

1. secure locks, swing legrests out of way and scoot forward in chair with knees extended.
2. maintaining one hand on the armrest, the otpt reaches down with the other hand for the caster
3. pt lifts trunk , slides forward and begins the descent
4. pt is seated on the floor in long-sitting.

Question 17

floor-to-wheelchair backward lift transfer. Limited LE

Answer 17

1. pt positions chair with the casters forward, applies the locks, raises the flootplates, moves footrests out of way. Pt has back to chair in longsitting.
2. pt places one hand on chair arm and one on floor.
3. depressing the shoulder girldle and extending the elbows, the pt pushes the body weight up and places the buttocks onto the wheelchair seat.
4. pt completes the movement to the seat of the chair by bringing the other hand to its armrest and lifting the body up and back. The transfer is complete with the pt in a good sitting position and feet supported.

Question 18

Independent Transfer from Wheelchair to Floor with Limited LE Use, Forward Into Side-sitting.

Answer 18

1. Lock chair, move footplates out of way, scoot forward in chair with balls of feet incontact with the floor. Grasp both sides of the wheelchair seat at the front or at the lower levels of desk arms.
2. pt lowers body into the kneeling position
3. pt then either moves into an intermediate quadruped position, or…
4. moves directly into a side-sitting position on the mat.

Question 19

Independent Transfer from wheelchair to Floor with LImited LE Use, Turnaround into Quadruped

Answer 19

1. Pt moves the hips to one side into a partial side sitting postion as the knees naturally lean toward the opposite side.
2. pt shifts right hand to the left armrest and begins to shift the location of the left hand
3. pt now has both hands in position (right hand on left arm, left hand on right arm.)
4. pt pushes down through both forearms raising hips off the seat and turning to face the back of the wheelchair.
5. pt lowers himself onto knees
6. pt uses one hand to unlock the wheelchair and push it slightly away to assume a quadruped position.

Question 20

Limited LE floor to Wheelchair turnaround technique

Answer 20

1. In quadruped position, facing the wheelchair, pt places his hands on the wheelchair seat and assumes tall kneeling. One arm is internally rotated, placed on same side arm rest.
2. Pusing down with both arms, the pt lifts the body and turns the trunk away from the internally rotated arm until at least one hip is securly resting on the seat
3. The patient shifts his hand position so the right right hand is on the right armrest, left hand on the left armrest and the trunk is facing forward
4. The pt adjusts his seating position and the wheelchair.

I can’t picture this. and the pictures don’t help. I’m going to have to

Question 21

Use of step stool

Answer 21

• decreases necessary shoulder strength and ROM
• In side sit transfer to floor from wheelchair, use of stool for hand placement.
• In forward and back transfer, use of stool directly in front of wheelchair as an intermittent seating surface and a place hor hand placement.

Question 22

Pt’s individualized chair to floor method

Answer 22

1. pt leans forward, keeping trunk over BoS, with feet in full contact with floor
2. Reaches for the mat with one hand, rising up on balls of feet
3. Reaching for the mat with the other hand as well, he is now in a good position to
4. lower the hips into side sitting

Wearing bilateral AFOs

Question 22

Individualized Floor to chair transfer - modification of turnaround floor to chair technique

Answer 22

1. pt moves through side sitting toward kneeling while maintaining ankles in a neutral position.
2. In kneeling, pt places hands on the wheelchair seat to balance
3. Pusing down through the arms, the pt lifts body up and turns.
4. pt places buttocks on the seat
5. pt readjusts to a more upright position
6. process ends with pt in good sitting position.