Course Description

Every manual wheelchair user would like their chair to be a high-performance machine. Performance is impacted by principles involved in translating human movement into movement of a wheelchair and factors that contribute to energy loss. In order to help end users achieve maximum performance, persons involved in the wheelchair selection process need to have a fundamental understanding of how people use their wheelchairs, and how those wheelchairs function.

This presentation will examine the real-world behaviors of manual wheelchair users and discuss the mechanical principles and factors that affect propulsion efficiency. In addition to explaining some details of the science involved, we hope to inspire participants to think critically about their current understandings and beliefs on this topic.

Course Objectives

Upon completion of this course participants will be able to:

• Cite 2 examples of how end users move about in wheelchairs during everyday life.
• Describe 3 physical principles that impact propulsion efficiency of a manual wheelchair. List 3 locations or components on a manual wheelchair where manufacturers have attempted to reduce the transmission of WBV to the user.
• Describe 3 component selections that impact propulsion efficiency of a manual wheelchair.

Course Instruction Details

• Course Audience: Suppliers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Course Description

Professionals involved in manual wheelchair prescription must work with end-users to create a configuration that achieves optimum results for comfort, postural stability, function, and propulsion efficiency. As professionals involved in manual wheelchair prescription and fitting, the value we bring to the process is directly related to our knowledge.

This knowledge should always be evolving with integration of new research evidence. Without this requisite knowledge, we are ill-equipped to contribute to the quality of life of manual wheelchair users. This presentation will dive into the details of wheelchair set-up factors that must be considered to optimize postural stability and propulsion efficiency for end users. Factors include horizontal axle position, vertical axle position, seat height, seat angle, back height, back angle, and front frame angle.

Consideration will be given to the relationship between these factors and the current research supporting optimization of each factor. We will address how to make prescriptive decisions while providing for potential changes in clinical need and the value of implementing follow-up to reoptimize the wheelchair over time.

Course Objectives

Upon completion of this course participants will be able to:

• Describe the influence of weight distribution on manual wheelchair rolling efficiency.
• Describe the relationship of upper extremity position to force application during manual wheelchair propulsion.
• List 3 aspects of manual wheelchair set up to assess during follow-up visits.

Course Instruction Details

• Course Audience: Suppliers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate to Advanced
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Course Description

There are many firmly held opinions about what factors most dramatically affect manual wheelchair propulsion efficiency. Which factors have the greatest impact and are most important to consider? Is it the weight of the chair? Is it the component selection? Like an automobile, is it the way it is tuned or set up that optimizes efficiency?

Prescribing professionals must understand how people use their manual wheelchairs. They must also understand how wheelchairs actually work as a machine. Armed with this knowledge, the professional can make appropriate decisions to optimize efficiency while meeting the user's needs for support, stability, and function.

This presentation will discuss factors commonly considered to be predictors of manual wheelchair propulsion efficiency. We will compare these factors in light of what current research suggests as being predictive and then provide some applicable conclusions to inform clinical practice.

Course Objectives

Upon completion of this course participants will be able to:

• Cite 2 examples of how end users move about in wheelchairs during everyday life.
• List and explain 2 principles of physics that impact propulsion efficiency of a manual wheelchair.
• 3 characteristics of component selections that influence propulsion efficiency of a manual wheelchair.
• List 2 examples of propulsion maneuvers influenced by rotational inertia, and describe a strategy for each to lessen that influence.

Course Instruction Details

• Course Audience: Dealers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Individuals who are exposed to whole body vibration may have health problems associated with that exposure, both acutely, and over time. Many people may not be aware of these detrimental effects, and the problems they may create. This vibration exposure may be encountered through occupation, recreation or through the use of a manual wheelchair, for example. The challenge for the manual wheelchair user, however, is that it may not be feasible for them to avoid the circumstances that expose them to this whole body vibration.

Course Description

Significant exposure to vibration (whole body vibration - WBV) has been linked to a variety of adverse health conditions in able bodied workers exposed to WBV during occupation. For individuals in wheelchairs, WBV can not only have an adverse effect on comfort, ride quality and energy expenditure, but the WBV these individuals experience in their chairs can contribute to pain, degenerative conditions, interference with ADLs, increased spasticity and other negative health consequences.

Wheelchair manufacturers have attempted to mitigate the detrimental effects of WBV through a variety of approaches in the past. However, much of the technology has been insufficient to meaningfully dampen the WBV a person in a manual wheelchair sustains. This presentation will discuss the issues associated with WBV for the manual wheelchair user, the pros and cons of some of the remedies that have previously been used, and the unique application of design principles and materials that allow for dampening WBV.

Course Objectives

Upon completion of this course participants will be able to:

• List two characteristics each of drive wheels and of caster wheels and explain how they influence manual wheelchair propulsion efficiency.
• Explain the importance of drive wheel diameter as it relates to rolling resistance.
• List two examples of manual wheelchair propulsion maneuvers where rotational inertia has a significant influence, and describe a strategy for each to lessen that influence.

Course Instruction Details

• Course Audience: Dealers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Individuals with neurologic disabilities deal with a number of challenges in completing activities of daily living. One of the most significant of those challenges is acquiring a mobility device that allows them to maximize their independence with both mobility and performance of their activities of daily living. For certain of these individuals the adaptive equipment that is often provided may be inadequate to achieve the potential for that participation and independence.

Course Description

Neurologic disabilities such as CP, ALS, MS, and SCI figure more prominently in discussions about the impact and importance of complex rehabilitation technology than CVA, yet more than 795,000 people in the United States suffer a CVA annually. Moreover, stroke reduces mobility in more than half of those over age 65. Medicare qualification requirements and reimbursement cuts have negatively influenced the caliber of wheeled mobility devices CVA survivors receive. Many obtain an upright, manual wheelchair that qualifies for Medicare rental reimbursement.

It is well documented that manual tilt-in-space wheelchairs provide seat angle adjustments that can facilitate pressure relief, postural control, and activity specific positioning, but these chairs are often not prescribed due to limitations related to independent propulsion, weight, and transport.

This presentation will explore the research supporting the use of tilt. Topics will include: how changes in seat angle affect posture and pressure distribution, seat height and angle characteristics that impact self-propulsion, the relationship between independent mobility and incidence of pressure ulcers, and how changes in seat angle can influence activities of daily living. The clinical justification and documentation requirements for Medicare reimbursement of the E1161 code will be outlined, and participants will be educated on options to achieve the clinical benefits of manual tilt while enabling self-propulsion and transport.

Course Objectives

Upon completion of this course participants will be able to:

• Cite 3 aspects of propulsion affected by seat height and changes in seat angle
• Cite 2 elements of the relationship between independent mobility and incidence of pressure ulcers
• Provide 2 examples of how changes in seat angle can impact pressure and affect posture
• Provide 2 examples of how changes in seat angle can affect participation in activity specific ADLs
• Produce documentation that clinically supports Medicare reimbursement of E1161 code

Course Instruction Details

• Course Audience: Dealers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU