WHEELCHAIR

MANAGEMENT

Muhimbili University of Health

and Allied Sciences (MUHAS).
 Physiology Department
 Biomedical Engineering Unit

Prepared By:
CPO Tumaini M. Matandala
What are the benefits of a wheelchair?

1. Mobility
2. Health
3. Independence
4. Self-esteem and confidence
5. Access to community life
 What is an “appropriate wheelchair”?
An “appropriate Wheelchair” is a wheelchair that:

 Meets the user’s needs.

 Meets the user’s environment.
 Is the right match for the user.
 Ensures postural support (helps the user to sit
upright).
 Can be maintained and repaired locally.
 The United nations convention on the rights of
PWDs
“states Parties shall take effective measures to ensure personal
mobility with the greatest possible independence for persons
with disabilities”

Wheelchairs and wheelchair services are very important for

assisting most people with mobility impairments to gain personal
mobility.
 living independently and being included in the community
(article 19)
 Right to education (article 24)
 Right to the enjoyment of the highest attainable standard of
health (article 25)
 Right to work and employment (article 27)
 Right to participate in political and public life (article 29)
 Right to participate in cultural life, recreation, leisure and
sport (article 30).
 Wheelchair Services
 The WHO Wheelchair guidelines outline eight steps
that wheelchair service personnel need to carry out
to provide a wheelchair:

 Referral and appointment.

 Assessment
 Prescription (selection).
 Funding and ordering.
 Product (wheelchair) preparation.
 Fitting
 User training.
 Maintenance, repairs and follow up.
Wheelchair mobility

 Wheelchair Mobility Skills

Pushing
Turning
 Up slopes
Down slopes
 Up steps with assistance.
Down steps with assistance
Partial wheelie.
Sitting upright
 Why is it important to sit upright?

 Health
 Stability
 weight distribution
 Comfort
 preventing problems with posture
 Self-esteem and confidence
How the pelvis affects the way we sit

 When the wheelchair user is sitting

upright, the pelvis is:

1. level (viewed from the front)

2. Upright or slightly tilted forward

(viewed from the side).
How the pelvis affects the way we sit
Pressure sores
 A pressure sore is an area of damaged skin and
flesh.
 A pressure sore can develop in a few hours, but
the results can last for many months and even
cause death.

What causes pressure sores?

1. Pressure
2. Friction
3. Shear
 Pressure sore risk factors
 There are a number of things that make it more
likely that someone will get a pressure sore.

1. Person cannot feel (decreased sensation)

2. Person cannot move
3. Moisture from sweat, water or incontinence
4. Poor posture.
5. Previous or current pressure sore.
6. Poor diet and not drinking enough water.
7. Ageing
8. Weight (underweight or overweight).
Common pressure sensitive areas:
The four stages of a pressure sore What to do
1. A red or dark mark on the person’s skin. The • Remove pressure from that
redness or change in colour does not fade within 30 area immediately.
minutes after pressure is removed. • Keep pressure off until the
skin has fully healed.This may
mean bed-rest.
• Identify the cause and
address this.
• Teach the wheelchair user
how pressure sores are
formed and how to prevent
them in future.

2. A shallow wound. The top layer of skin
may start to peel away or blister.
3. A deep wound; the whole layer of skin
is lost
4. A very deep wound, extending through
the muscle and possibly right down to
the bone.
• Follow the actions for stage 1.
• Refer for treatment of the
pressure sore to an
experienced health care
worker.
• Open pressure sores will need
cleaning, dressing and close
monitoring to ensure they are
healing and do not become
infected.
• Stage 4 wounds may require
surgery
How can pressure sores be prevented

1. Use a pressure relief cushion.

2. Sit upright.
3. Use pressure relief techniques.
4. Eat well and drink lots of water.
5. Avoid friction.
6. Avoid moisture.
7. check skin every day.
8. While lying or sitting, change positions
regularly.
 Pressure relief techniques

Bending forward Side to side leaning

cushions
 What are cushions for?
• A cushion is a very important part of every
wheelchair. cushions provide:
1. Comfort.
2. Posture support (help people to sit more
upright).
3. Pressure relief.
Who needs a cushion?

• Every wheelchair user

should have a cushion.

• Wheelchair users at risk of

developing a pressure sore
should use a pressure relief
cushion.

CBR-Mtendeli Refugee Camp

Kigoma-Tanzania
 Pressure relief cushions
There are different types of pressure relief
cushions including:

 Foam contoured pressure relief

cushions.

 Air/fluid/gel filled cushions.

Types of pressure relief cushions
Transfers
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 can be

called “transferring”.
Three ways to get in and out of the
wheelchair.
• Before recommending or practicing a
transfer with a wheelchair user you need to
know whether he/she can transfer
independently or needs help.

 For transferring independently through sitting

User can lift his/her weight upwards by
pushing with the arms.
 For transferring independently through
standing
User can stand up and take his/her own weight
through the legs
 Independent transfer through sitting
(wheelchair to bed)
Assisted transfer through sitting with a
transfer board (wheelchair to bed)
Assisted standing transfer (bed to
wheelchair)
Independent transfer from wheelchair to
floor