NBCOT - Wheelchair Seating and Mobility Exam Questions with Correct Answers Graded A+

NBCOT - Wheelchair Seating and Mobility Exam Questions with Correct Answers Graded A+ Goals for Bodily Structures - Answers -Improve skeletal allignment -prevent, reduce, accommodate deformity -preserve skin integrity -maintain fxn of organs (resp, circ) Goals for Function - Answers -enable sitting (postural control and stability) -wheeled mobility -increase comfort -normalize muscle tone -position head for visual input -decrease fatigue Goals for activity participation - Answers -enhance mvmt to enable participation in self-care, education, work, play, leisure -promote social acceptance and self-esteem Evaluation - Answers -occ profile -history taking interview -observation -physical examination OT Process - Answers -referral -evaluation of need -recommendations for system (include client's compliance) -documentation of need -ordering system -fitting system to client -in-clinic training (client, caregivers, attendants) Determining Musculoskeletal Capacities - Answers -observe client's posture/stabilty in current system (check for alignment and deformity) -Transfer client on a mat table -observe control of UE, head, neck -observe client's seated position when unsupported -observe position of pelvis and trunk -observe/asses UE and LE (ROM, strength, quality, tone, spasticity, tremor, reflex) -reposition in supine -reassess pelvic/spinal alignment d/t change in influence of gravity -signs of pressure or shear pressure ulcers Hands-free sitter - Answers -maintain seated position without use of hands -system emphasizes mobility, stability (BOS), and comfort Hands-dependent sitter - Answers -uses one or both hands to maintain seated position -pelvic and trunk support required in system Propped sitter - Answers -lacks ability to sit without support -total body support required of system for posture and repositioning Deformities - Answers -apply pressure to deformity to determine whether they are flexible or inflexible -flexible may be corrected by wheelchair support -inflexible/fixed deformity needs to be accommodated with a system Pelvic Obliquity - Answers -one side of pelvis is lower than the other side -can result in scoliotic posture and pressure ulcers on ischial tuberosity Kyphosis - Answers -pelvis rotates posteriorly (sacral sitting) -flexion of the lumbar spine -tends to slide forward on seat Scoliosis - Answers -the pelvis rotates to one side -spine and trunks moving to opposite side Lordosis - Answers -pelvis rotates anteriorly -increased curvature of lumbar spine -tends to use UE for support Windswept deformity - Answers -pelvis rotates laterally -with thighs moving to one side Seating Principles - Answers - Seating/wheeled mobility: seating forms the interface between the vlient and mobility device -Seated Position: -Sitting as Dynamic Posture: frequent motion during sitting -Seating Biomechanics: pelvis and thighs serve as BOS, pelvic positioning is key to stability Seated Position - Answers -hips, knees, ankles at 90 deg -pelvis neutral -head in midline -arms at side of trunk -elbows flexed 90 deg Pressure Measurment - Answers client sits on pressure sensitive mat Flat (planar) Cushion - Answers -do not accomodate body shape -for clients who need no or minimal postural support -client able to reposition self independently Standard Contour Cushion - Answers -based on typical body size -distribute less pressure acreoss their surface -less expensive than custom-made surfaces Custom-contour Cushion - Answers -shaped to client's body -provide most support -distribute pressure across surface