One of the first steps in the prescription of a wheelchair for a client, after the interview and information gathering, is the hands on assessment. The hands on assessment is crucial as it provides key information necessary for matching client needs with product parameters.
What should the hands on assessment include?
- Observation of the client in his/her existing equipment, if applicable
- A full mat evaluation in both supine and sitting, completed on a firm surface.
The hands on assessment allows the therapist to determine a multitude of information about the client, including: sitting posture; range of motion; muscle strength; tone; skin integrity; balance; and endurance. This assessment provides information regarding the presence or absence of pelvic obliquity, pelvic rotation, anterior pelvic tilt, and posterior pelvic tilt, and whether these postures are fixed or flexible. In addition, the hands on assessment provides information as to how much trunk support is required by your client and whether or not lateral support is needed.
Click on the following links for a videos that I found on You Tube that provide the “how to” for a mat evaluation completed in supine: http://www.youtube.com/watch?v=Is8WAT4i9ZU and in sitting: http://www.youtube.com/watch?v=Phy9p9J3SsY&feature=related. The lengths of the videos are 6 minutes and 5 minutes, respectively.
Sheilagh Sherman, OT Reg. (Ont.)
Clinical Rehab Product Consultant
Sunrise Medical Canada
Note: The content of this blog is not meant to be prescriptive; rather it is meant as a general resource for clinicians to then use clinical reasoning skills to determine optimal seating solutions for individual clients.