Wheelchair Prescription Assignment by Steph Rothe

Case Study

stephrothe123 — 2024-01-31 20:19:35 UTC

Neurological Level of Injury: S4-5 ASIA D

Emliano Esteban

Age: 35

Gender: Male

Occupation: Middle school teacher

Emiliano had experienced a spinal cord injury five months ago due to a fall on the step into his house. He has experienced incomplete paralysis in the lower extremities with sensory preservation up to S4-S5 level.

PLOF: Emiliano enjoyed participating in marathons and pickleball matches within his community.

CLOF: Emiliano is currently using a SBQC for mobility and has some difficulties with defecation. Also, when ambulating in the community he uses a wheelchair. He is on medical leave but is motivated to return to work. He has stated he has difficulty enjoying walks in his neighborhood and shopping due to uneven terrain and difficulty going up his house stairs. Patient stated having a hard time getting out of his sofa by favoring his left side for getting up.

Environmental Factors: He lives in a two-story house and requires modifications such as a ramp to get in and out of the entrance.

Personal Factors: He has stated that he has a supportive wife and extended family to aid him. He is on medical leave but is motivated to return to work.

Recommendations: For Emiliano the ideal wheelchair model is an ultra-lightweight wheelchair because he is fully independent. This ultra-lightweight model is the lightest model available and will allow Emiliano to easily carry / transfer his wheelchair into and out of his car. The ultra-lightweight wheelchair also allows for easier mobility when navigating his home as well as more efficient propulsion in the community.

Frame

stephrothe123 — 2024-01-31 20:27:09 UTC

We would prescribe a rigid frame, since Emiliano’s NLI is L3 he is independent with transfers and bed mobility. It offers a decrease of weight for Emiliano when maneuvering at his house or school and less weight when placing it in the car.

Backrest

stephrothe123 — 2024-01-31 20:27:25 UTC

We would prescribe a backrest with a height of 16 inches to allow for Emiliano to have enough support just below the inferior angle of the scapula. This would allow Emiliano to be able to propel the wheelchair with his arms in a comfortable manner. This height will also help to eliminate postural deviations while sitting in the wheelchair and help Emiliano to maintain trunk stability.

Wheel/Tire Selection

stephrothe123 — 2024-01-31 20:27:43 UTC

When selecting wheels/tires for Emiliano’s wheelchair, we want to consider his current limitations which are enjoying walks in the neighborhood and going shopping due to uneven terrains. He also has participation restrictions of being unable to participate in marathons or play pickleball. The Cambered wheels will be fitting for Emiliano to maneuver through various environments and put less strain on his shoulders when propelling due to the angle of the wheels. We would need his wheels to have an anterior axle, which will allow him to assume wheelies when necessary. This will allow him to ascend and descend curbs as well as propel over uneven terrain. This will also give him the opportunity to return to his hobbies, by providing stability and agility during recreational activities.

Wheelchair Cushion

stephrothe123 — 2024-01-31 20:28:00 UTC

Since Emiliano has 5/5 in all UE key muscle groups it would be best suited to use a foam cushion. It is the lightest and offers stable posture and transfers which would be most beneficial for him when returning to work as a school teacher. It does have poor pressure relief but since he has 5/5 in all UE key muscles, he has the strength to perform many pressure relief techniques.

lblanco70_1 — 2024-06-06 20:33:47 UTC