Related knowledge about wheelchairs
Wheelchairs are one of the important auxiliary tools for the disabled, which can facilitate the travel of the disabled and promote the employment of the disabled. Development, the Federation of Disabled Persons distributes wheelchairs for some disabled people, and understands that wheelchairs are an important guarantee for helping disabled people in their employment, travel and life:
(1) Structure and function of wheelchairs
The structure of the wheelchair
The ordinary wheelchair is generally composed of four parts: the wheelchair frame, the wheel, the braking device and the seat.
1. Large wheels carry the major weight. The diameter of the wheel is 51, 56, 61, 66cm. Pneumatic tires are often used, except for a few solid tires that are required by the use environment.
2. There are 12, 15, 18, 20cm diameters for small wheels, and the small wheels with large diameter are easy to cross small obstacles and special carpets. However, if the diameter is too large, the space occupied by the entire wheelchair becomes larger, making it inconvenient to move. The normal small wheel is before the big wheel, but in the wheelchair for paraplegics, the small wheel is often placed after the big wheel. It should be noted that the direction of the small wheel should be perpendicular to the big wheel, otherwise it is easy to fall.
3. The hand wheel rim is unique to the wheelchair, and the diameter is generally 5cm smaller than the large rim. When the hemiplegia is driven with one hand, an additional one with a smaller diameter is available for selection. The hand wheel rim is generally pushed directly by the patient. If the function is not good, in order to facilitate the drive, the following changes can be made: (1) Add rubber on the surface of the hand wheel rim to increase the grinding force. (2) Add knobs around the rim of the handwheel. There are the following types of push handles: ① Horizontal push handle. For C5 spinal injuries. Therefore, when the biceps are healthy, the hand is placed on the push handle, and the cart can be pushed forward by flexing the elbow. If there is no horizontal push handle, it cannot be pushed. ② Push the handle vertically. For rheumatoid arthritis when shoulder and hand joint movement is limited. Therefore, the horizontal push handle cannot be used. ③ Bold the push handle. It is used for patients with severely limited finger movement and it is difficult to make a fist. It is also suitable for patients with osteoarthritis, heart disease or the elderly.
4. There are three types of tires: solid, inflatable and tubeless. The solid type travels faster on flat ground, is not easy to burst, and is easy to push, but it vibrates greatly on uneven roads, and it is not easy to pull out when stuck in the groove of the same width as the tire; The vibration is smaller than the solid one; the tubeless inflatable type will not puncture because the tubeless, and the inside is also inflated, it is comfortable to sit up, but it is more difficult to push than the solid one.
5. The brake wheels should have brakes on each wheel. Of course, if the disabled person with hemiplegia can only use one hand, he can only use one hand brake, but an extension rod can also be installed to operate the brakes on both sides. There are two types of brakes: (1) Notch brakes. This brake is safe and reliable, but more laborious. After adjustment, it can also be braked on slopes. If it is adjusted to level 1 and cannot be braked on flat ground, it is invalid. (2) Toggle brake. Using the principle of leverage to brake after passing through several joints, its mechanical advantage is stronger than that of the notch brake, but the failure is faster. In order to increase the braking force of the patient, an extension rod is often added to the brake, but this rod is easily damaged, and should be checked frequently considering the particularity of the disabled.
6. The height, depth and width of the seat depend on the patient’s body type, and the material texture also depends on the disease. Generally, the depth is 41, 43cm, the width is 40, 46cm, and the height is 45, 50cm.
7. Seat cushions In order to avoid pressure ulcers, high attention should be paid to cushions used by the disabled. It is possible to use eggcrate or Roto cushions as much as possible. This cushion is made of a large piece of plastic with a It is composed of a large number of papillary plastic hollow columns with a diameter of about 5cm. Each column is soft and easy to move. After the patient sits, the pressure surface becomes a large number of pressure points, and the patient moves a little, so that the pressure points can be changed continuously. , to avoid frequent pressure on the same area to cause pressure ulcers. If there is no such cushion, layered foam should be used, its thickness should be 10cm, the upper layer should be 0.5cm thick high-density polyarethane foam, and the lower layer should be medium-density plastic of the same nature. The density ones are supportive, and the medium density ones are soft and comfortable. In the sitting position, the ischial tubercle bears a lot of pressure, often exceeding 1 to 16 times the pressure at the normal capillary end, and is prone to ischemia to form pressure ulcers. In order to avoid excessive pressure here, a piece is often dug on the corresponding pad to make the ischial tuberosity overhead. When digging, the front should be 2.5cm in front of the ischial tubercle, and the side should be 2.5cm outside the tubercle. The depth is about 7.5cm. After digging, the cushion is in a concave shape and the gap is behind. If the above cushion is used with an incision, it can effectively prevent the occurrence of pressure ulcers.
8. The leg rest and the leg rest can be straddled on both sides or split on both sides, both of which are ideal for swinging to one side and detachable. Attention must be paid to the height of the footrest. If the foot support is too high, the hip flexion angle is too large, and more weight is added to the ischial tuberosity, which is easy to cause pressure ulcers there.
9. The backrest has height and can be tilted or not. If the patient has good balance and control of the trunk, a wheelchair with a low backrest can be used to enable the patient to have a greater range of motion. Instead, use a high-back wheelchair.
10. The armrest or arm rest is generally 22.5~25cm higher than the seat surface of the chair, and some arm rests can be adjusted in height. You can also put a lap board on the arm rest for disabled people to read and eat.
Power Wheelchairs
After the Second World War, the number of disabled people increased, and the demand for wheelchairs in society soared. Due to the disabled people’s desire to return to society and live independently, the performance and quality of wheelchairs are constantly improved and improved. Electric wheelchairs are a typical example. Some advanced electric wheelchairs have applied a lot of high-tech. The electric wheelchair is used when the patient’s hand function is very weak and cannot drive the ordinary wheelchair, or although it can be driven, but the walking distance is long, the physical strength cannot bear it, or when the body is weak and cannot be driven at all.
(3) Selection of a wheelchair
The most important consideration when choosing a wheelchair is the size of the wheelchair. The main body parts of a disabled person in a wheelchair are around the ischial tuberosity of the hip, around the femur, around the fossa and around the scapula. The size of the wheelchair, especially the width of the seat, the depth of the seat and the height of the backrest, and whether the distance between the footrest and the seat cushion is appropriate, will affect the blood circulation of the disabled person’s focus area, and cause skin abrasion and even pressure sores. In addition, the safety of the patient, the ability to operate, the weight of the wheelchair, the location of use, and the appearance should also be considered.
