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Dependent Mobility

Dependent Mobility
Michelle Lange, OTR/L, ATP/SMS
July 10, 2015
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Learning Objectives

  • The participant will be able to describe clinical indicators for adaptive strollers.
  • The participant will be able to describe clinical indicators for transport or standard manual wheelchairs.
  • The participant will be able to describe clinical indicators for a manual tilt in space wheelchair.

Introduction

Why would someone need these particular devices?  In the case of strollers, these are available in very small sizes to accommodate our very smallest clients.  Some of our clients only need a mobility base for transport use only, such as getting from the car into the doctor’s office.  Once in the doctor's office, the client may transfer to a waiting room chair and truly uses this device only for transportation.  It might be the client only requires a manual wheelchair temporarily, such as when visiting Disneyland, and they are going to rent a dependent mobility base while there.  It also might be that the client has an inability to self-propel a manual wheelchair and the dependent mobility base is a backup to a power chair. In this case, the power wheelchair is providing independent mobility while the dependent mobility base backs that up.  The client’s power wheelchair may not be operational, the accessible vehicle used to transport that power wheelchair may not be working, or the destination that this client and caregiver are going to is not accessible.  In these cases, the power chair may be left at home and the dependent mobility base is used.  Some clients cannot use a power wheelchair and are unable to self-propel a manual chair, so they use simply a dependent mobility base. 

One of our main goals in using some form of dependent mobility base includes dependent transport.  It is important that we can get a client from one area to another, whether it is an area within the home, an area in the community, getting between appointments, etc.  

A mobility base also always supports some type of seating system.  It is important to choose a mobility base that can support the seating system that best meets the client’s needs.  Part of the job of the seating system is to prevent any sort of pressure ulcer development and to provide adequate postural support for the client.  This is part of the job of the seating system and as a result, the mobility base as well. 

Finally, dependent mobility also can provide fatigue management for client.  This is particularly pertinent to tilt in space chairs by providing that tilt and change in position, and this can be accomplished sometimes with recline as well.  We can help to compensate for someone's fatigue by providing more reclined or tilted position.  That tilt or recline position also can help with postural management and pressure ulcer prevention, in addition to working with the wheelchair seating system. 


michelle lange

Michelle Lange, OTR/L, ATP/SMS

Michelle Lange is an occupational therapist with over 35 years of experience and has been in private practice, Access to Independence, for over 15 years. She is a well-respected lecturer, both nationally and internationally, and has authored numerous texts, chapters, and articles. She is the co-editor of Seating and Wheeled Mobility: a clinical resource guide. She is the former NRRTS Continuing Education Curriculum Coordinator and Clinical Editor of NRRTS Directions magazine. Michelle is a RESNA Fellow and member of the Clinician Task Force. Michelle is a RESNA certified ATP and SMS.

 



Related Courses

Continued Conversations, The CE Podcast: The Top Ten Mistakes Clinicians Make During Seating and Mobility Evaluations
Presented by Michelle Lange, OTR/L, ATP/SMS
Audio
Course: #4610Level: Introductory1 Hour
This podcast will be a conversation about common mistakes made during wheelchair seating and mobility evaluations. The discussion will give you new ideas to improve the evaluation process!

Wheelchair Mobility: Power Wheelchair Alternative Driving Methods
Presented by Michelle Lange, OTR/L, ATP/SMS
Video
Course: #4363Level: Advanced2 Hours
While some clients require a power wheelchair to achieve independent mobility, not all will be able to use a standard joystick. Clients with paralysis, muscle weakness, increased muscle tone, and uncontrolled movements can often drive a power wheelchair successfully when matched to the most appropriate alternative driving method. This course will systematically explore various alternative driving methods, including specific features, to match these complex client needs. Case studies will be used throughout.

The Seating and Mobility Specialist (SMS) Certification: An Overview
Presented by Michelle Lange, OTR/L, ATP/SMS
Video
Course: #4201Level: Advanced1 Hour
The Seating and Mobility Specialist (SMS) certification recognizes competence in assessment and intervention. This course will cover what this certification is, who the SMS is designed for, why it was developed, why the SMS may be beneficial to a clinician and how to acquire this certification.

Wheelchair Seating: Considerations for the Hands-Free Sitter
Presented by Michelle Lange, OTR/L, ATP/SMS
Video
Course: #4202Level: Advanced1 Hour
Wheelchair seating is designed to provide postural support and alignment, stability for function and mitigate pressure issues. This course will address assessment and intervention when working with a client who can sit without the support of their hands, referred to as the ‘hands-free’ sitter.

Wheelchair Mobility: Optimizing Driving in Power Wheelchairs
Presented by Michelle Lange, OTR/L, ATP/SMS
Video
Course: #4462Level: Advanced1 Hour
Power wheelchair evaluation determines appropriateness for power wheelchair use and then determines the optimal power wheelchair base, power seating, driving method and other needed components. Optimizing power wheelchair driving is critical to improve outcomes and includes choosing the best drive wheel configuration, utilizing tracking technologies, and programming.

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