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Spectrum of Disabilities

We at Reach Out and Care (ROC) Wheels strive to accommodate the seating and
positioning needs of a wide range of impairments and disorders affecting children today. Some
of them are easily recognizable and some are very rare. This makes having a proper
diagnosis considerably difficult at times.

Listed below are some of the impairments and disorders that are seen more frequently. By no
means is this list all inclusive, so use resources available to you to help you in those cases
where you just don't know.

Cerebral Palsy
Children suffering traumas from harsh environment
Genetic and dysmorphic disorders
Neurologic disorders
Immunologic and metabolic disorders
Spinal cord injury
Traumatic brain injury
Shaken Child Syndrome
Fetal Alcohol Syndrome and "crack" babies

The most common disability served is Cerebral Palsy. Below is detailed information on cerebral
palsy.

CEREBRAL PALSY (Mild to severe)

CEREBRAL PALSY is a collection of motor disorders resulting from damage to the brain that
occurs before, during, or after birth. The damage to the child's brain affects the motor system,
and as a result the child has poor coordination, poor balance, abnormal movement patterns, or
a combination of these characteristics.

Cerebral palsy is a static disorder of the brain, not a progressive disorder. The neuromotor
disorders associated with cerebral palsy are not temporary. Therefore, a child who has
temporary motor problems, or who has motor problems that get worse over time, does not
have Cerebral Palsy. Children with Cerebral Palsy have many other kinds of medical problems.
Not all of these problems are related to brain injury, but most of them are neurological in
nature, including epilepsy, mental retardation, learning disabilities and attention
deficit-hyperactivity disorders.

Congenital Cerebral Palsy (cerebral palsy that exists from birth) is responsible for the largest
proportion of cases of cerebral palsy. Injuries sustained during the birthing process (i.e. anoxia)
or in early childhood may be considered the cause of cerebral palsy.

Children with Cerebral Palsy

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Содержание Rockit

Страница 1: ...USER GUIDE ...

Страница 2: ...w rocwheels org V1 February 2015 Mission Statement To provide mobility for people with disabilities in developing countries and to partner together for ministry youth empowerment wheelchair distribution manufacturing and educational development ROC Wheels is a faith based 501 C 3 non profit organiza tion Providing wheelchairs and other mobility products for people in developing countries without r...

Страница 3: ...Functional Positioning Essential Wheelchair Features Wheelchair Safety Basic Measuring Guide ROC Chair Fitting Guide Measuring Worksheet Seat Cushion Seat Belt Back Cushion Tilt in Space Hip Hip Guides Abductor Arm Rest Foot Ankle Support Trunk Supports Independent Mobility Chest Harness Therapeutic Tray Head Support Hip Angle Adjustment Custom Applications Wheelchair Distribution Procedures Wheel...

Страница 4: ...elf care skills including feeding dressing bath ing and homemaking The physical therapist helps gain independence in mobility skills including getting in and out of a bed and chair walking or using a wheelchair and going up and down stairs The speech language pathologist assists with listening reading speaking writing and thinking skills and also provides therapy for swallowing disorders The socia...

Страница 5: ...wheelchairs come with a full spectrum of positioning components a therapeutic tray and an adjustable wheel base for the more active self propelling child Over the years it has become more evident that aggressive early intervention for a child from infancy to age 4 is a critical element in the proper development of the child with a disability The main reasons for aggressive early intervention are P...

Страница 6: ...e Lever Quick Release Rear Wheels An gle Height Width AdjustableTrunk Supports Adjustable Height Seat Back Contoured Adjustable Head Rest Wheel Lock Height Angle Adjustable Foot bed Swiveling Front Wheels Tilt Lever Ar m Hand Knee Angle Adjust Ratchet Chest Harness Seat Belt Anti Tippers ...

Страница 7: ...escription Size 1 Size 2 13 Inch Max Hip Width 15 Inch Max Hip Width Hip Angle Positions 90 81 73 25 degrees 90 81 73 25 degrees Tilt in Space Positions 5 40 degrees 5 40 degrees Seat Back Height Range 11 1 2 18 13 21 Seat Depth Range 8 13 10 15 Hip Width Range 7 13 9 15 Lower Leg Length 5 13 1 2 5 14 1 2 Push Handle Adjustability multi adjustable multi adjustable Overall Width with rear wheels 23...

Страница 8: ...lncer grasp of Says mama Shy but plays raisin dada 2 games gives other words affection 18 months Walks up steps Stacks 3 blocks Points to Helps with simple manages spoon named body tasks imitates parts follows simple command 24 months Alternates feet Stacks 6 cubes 50 word Washes dries helps get dressed on stairs kicks turns book pages larger vocabulary ball follows 2 steps commands 30 months Jump...

Страница 9: ...f sensory feedback received by the child Most of the child s body is held in a relatively static position with little joint mobility with roost of the tactile and kinesthetic activity limited to the face and arms For example even though a child is on a mobile scooter board he cannot roll or wiggle in and out of various places and the de creased perceptual experi ences should not be disregarded Ass...

Страница 10: ...Axis of the Human Body Plane Axis Joint Motion Sagital Plane frontal Flexion extension Frontal Sagital Abduction lateral rotation radial ulnar rotation Transverse Vertical Medial lateral rotation supination pronation Right left rotation horizontal ab adduction FRONTAL AXIS SAGITAL AXIS VERTICAL AXIS Descriptive Terminology ...

Страница 11: ...nt When the hip angle is adjusted to a more open or closed position The anatomic pivots pictured represent the major pivot points of the human body The center of gravity is the center of mass is There is an equal weight distribution on both sides of the center of gravity Passive Body Alignment Active Sitting Position Non functional Sitting Position ...

Страница 12: ...quity The Pelvis The pelvis influences total body alignment and without a good pelvic foundation positioning of the legs trunk or arms becomes undermined Ischial Ledge A ledge created in a seat cushion to block the ischial tuberosity which can help keep the pelvis back in the neurtal position in the seat Ischial Tuberosity The pointed bony protrusion on the bottom portion of the pelvis When th pel...

Страница 13: ...onists muscles primarily responsible for an action due to their contraction Antagonists muscles that relax to smooth the action of the agonists Directions of move ment Flexion brings a body part forward Extension moves a body part to the rear Abduction moves an appendage laterally from the midline Adduction moves an appendage toward the midline Circumduction movement of an appendage in a circle ar...

Страница 14: ...process until an accurate diagnosis is ascertained Funding In many cases due to the difficulty of a proper diagnosis many funding agencies won t provide for proper special equipment until the time the child is properly diagnosed Agencies focus is on the bottom line and not the child s medical needs at the early stages Also the level of education at the funding agencies for the people approving fun...

Страница 15: ...a collection of motor disorders resulting from damage to the brain that occurs before during or after birth The damage to the child s brain affects the motor system and as a result the child has poor coordination poor balance abnormal movement patterns or a combination of these characteristics Cerebral palsy is a static disorder of the brain not a progressive disorder The neuromotor disorders asso...

Страница 16: ...tly from one child to the other not all statements hold true for all children with cerebral palsy Spasticity refers to the inability of a muscle to relax increased muscle tone You will find that the child also has restricted range of motion due to the constant muscle rigidity When the arm or leg is moved the initial resistance is strong Sometimes the spasticity will relax and other times it will n...

Страница 17: ...ldren Some of these children will present with seizure activity A large number will have strong ex tension thrusting behaviors How do we manage them You will also need to look at what type of mobility these children will need Do they have the ability to self propel independent or will they need someone to push them dependent Will they need special life support equipment If so how do we accommodate...

Страница 18: ...pper extremities to move and be prepared for functional activity Active Body Position Tilting forward into a ready posi tion for activity Note how the pelvis is aligned with the spine and the child is tilted slightly forward poised to reach out or engage in a number of activi ties Sacral Sitting Position Posterior Pelvic Tilt This sitting position puts pressure on the sacrum and ischial tuberositi...

Страница 19: ...nt With proper seat depth this same will lean back to reach the support surface This client can sit with a neutrally tilted pelvis will create posterior pelvic tilt and an erect spine The client sitting in A firm foot bed and a seat belt can provide posterior pelvic tilt despite the 90 degree a platform to establish postural alignment seat back angle due to lack of lower extremity neutral pelvic s...

Страница 20: ...these parameters would be adjustable Seat Inclination Helps prevent the user s buttocks from sliding forward which can occur secondary to de creased friction from seating surfaces designed to decrease surface pressure and enhance transfers Forces which occur with sudden acceleration or deceleration Sliding due to road shock and vibration Helps keep the user s back against the backrest and aids in ...

Страница 21: ...ill improve diaphragmatic breathing Will assist with forward weight shifts Lower thoracic support Should be firm just below the inferior angle of the scapula Will promote spinal extension Will provide stabilization of the thorax Leg footrest position Creates stability for the seating system Decreases fatigue Helps maintain pelvis back in chair Helps keep user in contact with the back support Helps...

Страница 22: ...22 Wheelchair Safety ...

Страница 23: ...23 ...

Страница 24: ...24 ...

Страница 25: ... Belt should be firmly tight ened to help position the pelvis back in the seat in a neutral position The feet should rest firmly on the footbed to provide support for lower extremities Head Rest should provide enough support to enable the child to bal ance laterally as well as fore and aft without preventing the child s ability to shift position to engage in functional activities The seat back cus...

Страница 26: ... and the function for the various ROCKIT Wheelchair features When complet ing the Measurement Worksheet please be as thorough and as accurate as possible If possible please include additional pictures if this will help to further illustrate the nature of the child s disability Tool Kit The basic adjustment tools for the ROC Wheelchair are 7 1 16 nut driver 5 32 allen wrench 3 4 wrench for front wh...

Страница 27: ...__ right___ 4 Top of Shoulders to Seat _______ 1 3 left 2 4 right 3 Office Info Only What type of wheelchair would you suggest ____________________ Person filling out form ____________________ Before picture After picture 4135 Valley Commons Dr Suite D Bozeman Montana USA 59718 Info ROCWheels org www rocwheels org 29 ...

Страница 28: ...th efforts made to obtain a neutral position The pelvis influences total body alignment and without a good pelvic foundation positioning of the legs trunk or arms becomes undermined A firm Seat with the legs fully supported in a neutral position is very important The seat depth is the most important measurement If it is to long the pelvis tilts back if it is to short the thighs are not supported a...

Страница 29: ...he may slump If too far back he may pull forward to become more erect It is important to position the child as erect as possible to encourage the child to develop the strength and balance necessary to improve When necessary tilt the child back for support but always be ready to enable the child to challenge gravity 90 degrees 7 14 21 28 35 42 Seat back is ad justed with 7 16 nut driver Seat back h...

Страница 30: ...Abductor Adduction Adduction Front Caster Arm Rest The arm rests provide upper extrem ity support which can enable the individual to maintain alignment ena bling improved function The arm rests also serve as the support for the therapeutic tray To install the abductor block position child cor rectly Then poke a hole through the upholster and through the seat base Abduction Insert information about...

Страница 31: ...ied through the heel This may require blocks or straps to achieve Foot Ankle Support After achieving a proper base of support in the pelvis and legs attention must be turned to obtain neutral trunk alignment Proper relationships between normal spinal curves and the position of the ribs is desired This also helps decrease changes of developing spinal deformities Most distortion of spinal curves com...

Страница 32: ...forward flexion may be used If the child hangs on them backward tilting is nec essary Harnesses will not control side bending and should not be allowed to inter fere with arm functions A chest Harnesses can be very instrumental in keeping the shoulders aligned uprightly ...

Страница 33: ...ship between the head neck and shoulder girdle produces pathology in the other Ideally the head should be righted with the eyes horizontal and neutrally aligned on the neck Mobility of the head on the neck should be allowed within the range that the child can control Some frequently encountered head problems are from 1 floppy necks 2 enlarged occiputs 3 extensor hypertonus in the neck 4 sidebend i...

Страница 34: ... able the ROCKIT wheelchair to provide the maximum therapeutic and functional benefit The foam inside the head rest seat back and seat bottom covers can be accessed to add foam as necessary to ensure the correct amount of support and contouring 1 2 3 How many beneficial things can we accomplish with a simple strapping system and the addition of a therapeutic tray 3 strategically placed straps Wide...

Страница 35: ...table footrest can be raised to the seat base to extend the seating platform an additional 9 inches The ROCKIT Wheelchair is specially configured to provide the growth therapeu tic support and anthropometric positioning to accommodate a large segment of the pediatric population with mid through profound deformities It is also well suited to custom configuring to fit a child using the child s perso...

Страница 36: ...fy the consignee and contact person that will receive the shipment Coordinate with partners and consignee to determine a location for storage of the mobility prod ucts until the distribution team arrives Coordinate with partners and consignee the distribution sites and necessary logistical support for transporting the mobility products and distribution team if multiple sites Coordinate with part n...

Страница 37: ...ter and become worse Visit the distribution site and layout the flow for the distribution Identify the entry custom fitting stations and exit point Work with the team on a simulated fitting including translators and physical therapists Begin with the waiting area proceeding to the entry point finding their measuring work sheet Direct the recipient and caregiver to a custom fitting station and intr...

Страница 38: ...a cious as they wait for their wheelchair Explain the distribution to everyone and what they should expect during the distribution Flow throughout the process Time involved with custom fittings and how this may effect their wait time To be attentive and learn as much as they can during the fitting ask questions Hand out the measuring worksheets to the care giver or recipient Begin the distribution...

Страница 39: ...this information The following guide helps you understand the type of mobility devices that can be prescribed based on the individual needs of the wheelchair recipient Pediatric Strollers and Wheelchairs Who is it for Pediatric wheelchairs must allow for growth as well as numerous levels of disability The adaptive wheelchair is for children with moderate to severe disabilities provides support for...

Страница 40: ... more expensive lightweight wheelchair Pa tients normally need little adaptive support and chair angle adjustability Lightweight wheel chairs are more sophis ticated and more expen sive due to the special types of wheels and op tional components avail able such as an adjust able wheelbase for high performance mobility They often come in many colors These chairs are often more efficient to self pro...

Страница 41: ...th fixed or other non correctible deformities that prevent them from sitting in a more upright position Often people are too weak to sit upright An elevating leg rest is often needed as is additional specialized seat ing support to provide proper positioning support and pressure relief Who is it for Tilt in space assists the child s muscular trunk control against gravity If it is too erect he may ...

Страница 42: ...ong up per body capacity They often enable mobility on roads and byways and can provide a vehicle for helping sus tain a roadside business since many bike have a large storage area for car rying goods Power Wheelchair Who is it for The power wheelchair provides the gift of inde pendent mobility for people who cannot self propel and are cognitively able to navigate with the chair Power chairs can b...

Страница 43: ...zed adapta tions to the appropriate wheelchair Some chil dren need special life support equipment includ ing suction machines ventilators IV poles and other critical care items Some children have developed fixed deformities which creates the necessity of configuring the chair to accommo date the abnormal body position Who is it for There are a wide variety of seating sur faces including foam air c...

Страница 44: ...44 P O Box 11765 Bozeman Montana USA 59719 Info ROCWheels org www rocwheels org ...

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