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Patient is a 38 year old year old male who fell putting up Christmas decorations. He is 6' 1" and weighs around 200 pounds.

PLOF: Fully independent with all ADLs. Worked as the owner of a t-shirt printing shop. He has three kids who love to be outside. He is also an active participator in CrossFit workouts, coaches kids sports, and loves to hike and fish.

PMH: No other known comorbidities

CLOF: Patient is independent with mobility and is able to ambulate using forearm crutches and/or AFO’s for 850ft before becoming fatigued. At that point, he must take a seat and rest. Patient is independent with all ADL’s that require only UE. A wheelchair is needed for longer duration activities and at work.

Environmental factors: Lives in a one story ranch home on 10 acres. In his home, there is one step leading to the front door, one step leading to the garage, and a basement. He does have goats and pigs which require feeding daily.

Personal Factors: Patient has low levels of depression (score of 5 on PHQ-9), as well as some anxiety around how he is perceived needing a wheelchair for sports coaching and exercising. He also worries how he will be able to traverse his property with his CLOF.

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To support the patient's height and size, we recommend a lightweight model. This model provides a balance between durability, which allows for mobility over rough terrain, and portability. This model would also allow for ease and independence when transporting in/out of cars as needed.

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A folding frame would be more appropriate for this patient since his ASIA impairment scale grade can be classified as ASIA D. With an ASIA D SCI, our patient has some innervation present in the lower extremities. This would allow him the ability to utilize his lower limbs for movement as the chair allows for foot propulsion, better positioning with the fold away leg supports, pressure relief, and potentially strengthening of the leg muscles. Additionally, the patient may be able to maintain more independence with a fold frame since it is easier to transport.

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Patient has good trunk control, the backrest should be low (around lumbar height). So it supports the pelvis/lower trunk but does not restrict upperbody movement.

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Pneumatic tires are recommend since this patient has a low-level NLI. This selection may be better for shock absorption, further allowing our patient to easily traverse his property and sports field when coaching. In addition, pneumatic tires have less resistance when rolling so it would ease the strain on the UE.

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A foam cushion is recommended due to its light weight and support for active users. A foam cushion also provides pressure relief, prevents shearing forces, and allows for better positioning.