Wheelchair Skills: Difference between revisions
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== Introduction == | == Introduction == | ||
Many wheelchair users live and work in places where it is difficult for them to get around, for example areas where the ground is rough, sandy or muddy, or where there are steps, kerbs or small cramped spaces. Training in wheelchair skills can help wheelchair users to tackle some of these obstacles, either independently or with assistance. | Many wheelchair users live and work in places where it is difficult for them to get around, for example areas where the ground is rough, sandy or muddy, or where there are steps, kerbs or small cramped spaces. Training in wheelchair skills can help wheelchair users to tackle some of these obstacles, either independently or with assistance. <ref name=":0">World Health Organization. Wheelchair Service Training Package - Reference Manual for Participants - Basic Level. World Health Organization, Geneva. 2012</ref> | ||
According to the Wheelchair Skills Programme "skill in wheelchair use is not an end in itself, it is a means to an end. In terms of the WHO’s International Classification of Function (2001), wheelchair skills are Activities. The ability to perform them represents “capacity” and their use in everyday life represents Performance. The purpose of these activities is to overcome barriers in the environment and to thereby permit the wheelchair user to fulfill their desired role in society (Participation). Other potential benefits of wheelchair-skills training for wheelchair users and caregivers include fewer acute and overuse injuries, an improved sense of wellbeing (through self-esteem, self-efficacy, confidence and personal control, the sense of becoming newly enabled, empowered and having accomplished something of worth), improved development (of children) and having fun. <ref name=":1">Kirby RL, Smith C, Parker K, McAllister M, Boyce J, Rushton PW, Routhier F, Best KL, Mortenson B, Brandt A. The Wheelchair Skills Program Manual. Published electronically at Dalhousie University, Halifax, Nova Scotia, Canada. www.wheelchairskillsprogram.ca.</ref> | |||
As we highlighted during assessment, the characteristics of the wheelchair - including its features, fit and setup - can have major impact on skill performance. In helping improve the safety, effectiveness and efficiency of wheelchair use, service-delivery providers should try to optimize both the the wheelchair (e.g. by moving the axles of a manual wheelchair forwards), wheelchair user (e.g. by improving strength or range of motion), and ensure optimal training. <ref name=":0" /><ref name=":1" /> | |||
== Wheelchair Handling == | == Wheelchair Handling == | ||
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=== Pushing === | === Pushing === | ||
Pushing correctly requires less effort. Push from 10 o’clock to 2 o’clock position. Use long smooth action to push. | Pushing correctly requires less effort. Push from 10 o’clock to 2 o’clock position. Use long smooth action to push.<ref name=":0" /> | ||
==== Smooth Ground ==== | ==== Smooth Ground ==== | ||
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==== Turn In Place ==== | ==== Turn In Place ==== | ||
Hold one push rim towards the front and the other towards the back. | Hold one push rim towards the front and the other towards the back. | ||
Pull the forwards hand backwards and push the backward hand forwards at the same time. | Pull the forwards hand backwards and push the backward hand forwards at the same time. <ref name=":0" /> | ||
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|- | |- | ||
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==== Incline ==== | ==== Incline ==== | ||
Lean Forward - this helps to stop the wheelchair tipping. When practising, have an assistant stand behind for safety. To Stop or Rest - Turn the wheelchair sideways on. | Lean Forward - this helps to stop the wheelchair tipping. When practising, have an assistant stand behind for safety. To Stop or Rest - Turn the wheelchair sideways on. <ref name=":0" /> | ||
https://youtu.be/353XfUoTn7c | https://youtu.be/353XfUoTn7c | ||
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==== Decline ==== | ==== Decline ==== | ||
Lean backwards. Let the push rim slide slowly through the hands. Experienced wheelchair users who are able to do a “wheelie” (i.e. balance the wheelchair on the rear wheels only) may roll down a slope on their back wheels. This is very efficient. | Lean backwards. Let the push rim slide slowly through the hands. Experienced wheelchair users who are able to do a “wheelie” (i.e. balance the wheelchair on the rear wheels only) may roll down a slope on their back wheels. This is very efficient. <ref name=":0" /> | ||
https://youtu.be/7DzjDFZ4Cfs | https://youtu.be/7DzjDFZ4Cfs | ||
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==== Partial ==== | ==== Partial ==== | ||
Being able to do a partial wheelie is very useful for a wheelchair user. The wheelchair user can lift the front wheels to clear small kerbs, stones and bumps. Roll the wheelchair backwards until hands are in the 10 o’clock position. Then push forwards quickly. The castor wheels should come up. With practice, it is possible to lift the castor wheels at the right time to clear small obstacles. Always make sure that there is an assistant standing behind the wheelchair user when they begin to practise this skill. | Being able to do a partial wheelie is very useful for a wheelchair user. The wheelchair user can lift the front wheels to clear small kerbs, stones and bumps. Roll the wheelchair backwards until hands are in the 10 o’clock position. Then push forwards quickly. The castor wheels should come up. With practice, it is possible to lift the castor wheels at the right time to clear small obstacles. Always make sure that there is an assistant standing behind the wheelchair user when they begin to practise this skill. <ref name=":0" /> | ||
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===== With Assistance ===== | ===== With Assistance ===== | ||
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Go up backwards. Tilt wheelchair on to back wheels, positioned against the first step. Assistant pulls backwards and upwards - rolling the wheelchair up. Wheelchair user can assist by pushing the push rim backwards. A second assistant can assist by holding on to the wheelchair frame from the front (not footrests). | Go up backwards. Tilt wheelchair on to back wheels, positioned against the first step. Assistant pulls backwards and upwards - rolling the wheelchair up. Wheelchair user can assist by pushing the push rim backwards. A second assistant can assist by holding on to the wheelchair frame from the front (not footrests).<ref name=":0" /> | ||
==== Descending ==== | ==== Descending ==== | ||
===== With Assistance ===== | ===== With Assistance ===== | ||
Go down forwards. Tilt the wheelchair on to back wheels. Assistant lets the back wheels roll down slowly, one step at a time. Wheelchair user can assist by controlling the wheelchair with the push rims. A second assistant can help by steadying the wheelchair from the front, holding on to the wheelchair frame (not footrests). | Go down forwards. Tilt the wheelchair on to back wheels. Assistant lets the back wheels roll down slowly, one step at a time. Wheelchair user can assist by controlling the wheelchair with the push rims. A second assistant can help by steadying the wheelchair from the front, holding on to the wheelchair frame (not footrests).<ref name=":0" /> | ||
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== Wheelchair Transfers == | == Wheelchair Transfers == | ||
The ability to get in and out of the wheelchair easily and safely, with or without assistance, will help a wheelchair user in daily life. Getting in and out of the wheelchair | The ability to get in and out of the wheelchair easily and safely, with or without assistance, will help a wheelchair user in daily life. Getting in and out of the wheelchair is called “transferring”. | ||
=== Sitting Transfers === | === Sitting Transfers === | ||
Revision as of 21:59, 30 June 2018
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Introduction[edit | edit source]
Many wheelchair users live and work in places where it is difficult for them to get around, for example areas where the ground is rough, sandy or muddy, or where there are steps, kerbs or small cramped spaces. Training in wheelchair skills can help wheelchair users to tackle some of these obstacles, either independently or with assistance. [1]
According to the Wheelchair Skills Programme "skill in wheelchair use is not an end in itself, it is a means to an end. In terms of the WHO’s International Classification of Function (2001), wheelchair skills are Activities. The ability to perform them represents “capacity” and their use in everyday life represents Performance. The purpose of these activities is to overcome barriers in the environment and to thereby permit the wheelchair user to fulfill their desired role in society (Participation). Other potential benefits of wheelchair-skills training for wheelchair users and caregivers include fewer acute and overuse injuries, an improved sense of wellbeing (through self-esteem, self-efficacy, confidence and personal control, the sense of becoming newly enabled, empowered and having accomplished something of worth), improved development (of children) and having fun. [2]
As we highlighted during assessment, the characteristics of the wheelchair - including its features, fit and setup - can have major impact on skill performance. In helping improve the safety, effectiveness and efficiency of wheelchair use, service-delivery providers should try to optimize both the the wheelchair (e.g. by moving the axles of a manual wheelchair forwards), wheelchair user (e.g. by improving strength or range of motion), and ensure optimal training. [1][2]
Wheelchair Handling[edit | edit source]
Folding[edit | edit source]
Lifting[edit | edit source]
Wheelchair Mobility[edit | edit source]
Pushing[edit | edit source]
Pushing correctly requires less effort. Push from 10 o’clock to 2 o’clock position. Use long smooth action to push.[1]
Smooth Ground[edit | edit source]
Rough Ground[edit | edit source]
Soft Ground[edit | edit source]
Turning[edit | edit source]
Turn In Place[edit | edit source]
Hold one push rim towards the front and the other towards the back. Pull the forwards hand backwards and push the backward hand forwards at the same time. [1]
Moving Turns[edit | edit source]
Moving Sideways[edit | edit source]
Negotiating Slopes[edit | edit source]
Incline[edit | edit source]
Lean Forward - this helps to stop the wheelchair tipping. When practising, have an assistant stand behind for safety. To Stop or Rest - Turn the wheelchair sideways on. [1]
https://youtu.be/353XfUoTn7c https://youtu.be/tDkcc96OO3Y
Decline[edit | edit source]
Lean backwards. Let the push rim slide slowly through the hands. Experienced wheelchair users who are able to do a “wheelie” (i.e. balance the wheelchair on the rear wheels only) may roll down a slope on their back wheels. This is very efficient. [1]
https://youtu.be/7DzjDFZ4Cfs https://youtu.be/BOAOQj86wI4 https://youtu.be/Sqkof8ry7GQ https://youtu.be/hNUdoX3drAw https://youtu.be/e8EbuilTGJ0
Wheelies[edit | edit source]
Partial[edit | edit source]
Being able to do a partial wheelie is very useful for a wheelchair user. The wheelchair user can lift the front wheels to clear small kerbs, stones and bumps. Roll the wheelchair backwards until hands are in the 10 o’clock position. Then push forwards quickly. The castor wheels should come up. With practice, it is possible to lift the castor wheels at the right time to clear small obstacles. Always make sure that there is an assistant standing behind the wheelchair user when they begin to practise this skill. [1]
Negotiating Curbs[edit | edit source]
Ascending[edit | edit source]
Descending[edit | edit source]
Negotiating Steps[edit | edit source]
Ascending[edit | edit source]
With Assistance[edit | edit source]
Go up backwards. Tilt wheelchair on to back wheels, positioned against the first step. Assistant pulls backwards and upwards - rolling the wheelchair up. Wheelchair user can assist by pushing the push rim backwards. A second assistant can assist by holding on to the wheelchair frame from the front (not footrests).[1]
Descending[edit | edit source]
With Assistance[edit | edit source]
Go down forwards. Tilt the wheelchair on to back wheels. Assistant lets the back wheels roll down slowly, one step at a time. Wheelchair user can assist by controlling the wheelchair with the push rims. A second assistant can help by steadying the wheelchair from the front, holding on to the wheelchair frame (not footrests).[1]
Independently[edit | edit source]
Wheelchair Transfers[edit | edit source]
The ability to get in and out of the wheelchair easily and safely, with or without assistance, will help a wheelchair user in daily life. Getting in and out of the wheelchair is called “transferring”.
Sitting Transfers[edit | edit source]
Independent[edit | edit source]
Assisted with Transfer Board[edit | edit source]
Standing Transfers[edit | edit source]
Independent[edit | edit source]
Assisted with Transfer Board[edit | edit source]
Floor Transfers[edit | edit source]
Pressure Relief Techniques[edit | edit source]
Leaning Forward[edit | edit source]
Side to Side Lean[edit | edit source]
Pressure Lift[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 World Health Organization. Wheelchair Service Training Package - Reference Manual for Participants - Basic Level. World Health Organization, Geneva. 2012
- ↑ 2.0 2.1 Kirby RL, Smith C, Parker K, McAllister M, Boyce J, Rushton PW, Routhier F, Best KL, Mortenson B, Brandt A. The Wheelchair Skills Program Manual. Published electronically at Dalhousie University, Halifax, Nova Scotia, Canada. www.wheelchairskillsprogram.ca.
