State Spinal Cord Injury Service
Spinal Seating Modules
Case study: Paolo
Case study questions
Paolo did not regain any lower limb activity for functional transfer by the end of his inpatient rehabilitation.
- List the functional tasks that Paolo performs in his wheelchair. How would these tasks influence the selection of the wheelchair frame style and seat frame configuration?
- What are the social and environmental factors that will influence the accessory options for his wheelchair?
- What can Paolo do about his pain?
Case study answers
- List the functional tasks that Paolo performs in his wheelchair. How would these tasks influence the selection of the wheelchair frame style and seat frame configuration?
- Transfers from wheelchair to bed, commode and car
- Seat to floor height
- Ability to more forward for transfer with seat rake
- Independent in his personal ADL
- Sufficient wheelchair stability to perform ADL tasks
- Prepare a basic meal
- Front frame angle and seat to floor height to access kitchen
- Intermittent catheterisations
- Able to move pelvis forward and open hip angle with seat rake and seat depth
- Wheelchair skill for active wheelchair mobility
- Rigid frame tends to have a higher performance for active user
- What are the social and environmental factors that will influence the accessory options for his wheelchair?
- Large block with a long, moderately sloped, concrete driveway
- Maximise propulsion efficiency through the provision of light weight wheelchair, axle position adjustment and seating components that enhance postural stability
- Use a taxi and wheelchair accessible bus
- Assess for headrest and tie down points
- Go to the pub with his mates
- Consider wheelchair manoeuvrability in tight environment – taper front frame and front frame angle
- ‘Tinkering’ with motorbikes
- Consider puncture-proof tyres as active garages/workshops often contain sharps
- Large block with a long, moderately sloped, concrete driveway
- Review by seating or spinal clinicians for wheelchair setup and wheelchair propulsion pattern
- Reduce the wheelchair overall weight e.g. minimise the weight of the under chair bag, use high pressure pneumatic tyres instead of solid
- Reduce roll resistance by using medium size castor
- Ensure the rear wheels and castors are in good alignment
- Consider ergonomic push rims to reduce forearm and wrist pain, e.g. natural fit hand rims