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N - Wheeled Mobility

Figure 2.0 Essential service provision components. based on the WHO Whelchair Service Training Package : Basic Module.2 The wheelchair is the most commonly chosen mobility device and, arguably, the most important assistive device for individuals with SCI and lower limb paralysis. For functional mobility, an individualized approach to the wheelchair provision process is essential. Appropriate seating and mobility systems vary significantly, ranging from an ultra light-weight, rigid-framed wheelchair, mobilized by manually rolling the wheels, to a fully powered wheelchair, driven by breathing into a straw connected to a controller. It is essential that the wheelchair provided is customized for the individual’s physical and functional needs. According to World Health Organization (WHO) guidelines,1 a wheelchair is deemed appropriate when it: • Meets the user’s needs and environmental conditions • Provides proper fit and postural support • Is safe and durable • Is available in the country, and • Can be obtained, maintained and serviced, at an affordable cost. Although other types of mobility devices such as Segways, scooters or standing wheelchairs have been investigated, manual or power wheelchairs are the most common wheeled mobility devices, in Canada. These consist of a mobility base (providing the means of movement) and seating components (the support for function, comfort and health maintenance). To determine appropriate seating and mobility characteristics, several practice components require assessment and prescription by the rehabilitation provider (which would benefit from further study), and by researchers (Figure 2.0). Practice Components Service provision components are: 1. Referral - Required for access to appropriate service providers, which includes an interdisciplinary team, when necessary. 2. Comprehensive Assessment - This cornerstone of mobility device provision includes the following physical and communication components: • Identification of the wheelchair user’s goals, needs and priorities, as well as those of caregivers or family. • Determination of the influence of health status, function within the user’s environment(s), and physical needs such as comfort, skin integrity and posture. • Determination of the level of wheelchair skills (current abilities and needs) to inform seating and mobility component requirements, and skills training to optimize functional mobility. • Analysis of findings to identify the parameters and characteristics of the seating components and mobility base, to best meet the user’s functional mobility needs. Referral Assessment Trial Prescription Funding and Ordering Wheelchair Preparation Fitting User Training Follow-up, Repair and Maintenance 140 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION 2.0


N - Wheeled Mobility
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