Page 274 - Handbook of Electronic Assistive Technology

Chapter 9 • Powered Mobility 263

Table 9-1 Assessment Areas for Powered Mobility and Rationale—cont’d

Assessment Area Rationale
Height Where the person has long legs, consideration must be given to the distance
of the footplates to the floor – a higher seat to ground height may be required.
Equally, someone who is shorter may require shorter footplate drop tubes and a
lower seat to ground height; this, however, may lead to the person being seated
very low to the ground, which can be socially isolating, and so a seat raiser unit
might be indicated.
Weight Every wheelchair has a weight capacity, which is the sum of the user’s weight
and any seating system. Heavier people may require a wider track width (in
respect of stability) or larger capacity batteries (to provide an acceptable driving
distance).
Communication Durability of the footplates, hangers and backrest needs to be considered (e.g.,
people with quadriplegic cerebral palsy tend to extend at the hip and knee when
they talk).
Where a communication aid is used, line of vision should not be obscured.
Space behind the backrest may be required when communication aid mounting
systems allow the device to be swung back.
Vision Understanding a person’s visual impairment and how they compensate for it is
very important. It is possible for someone to drive with very restricted vision. In
some cases it will be appropriate to construct a variety of plans to cater for a
range of scenarios – for example, the person might be fully independent indoors
at home and in their daily settings but be fully dependent on a carer using an
attendant control in unfamiliar or very busy surroundings.
Hearing The importance of hearing will be dependent on the context within which
the wheelchair is to be used. If busy roads are to be crossed, hearing will be
more significant, but again the person may be able to compensate for a lack
of hearing.
Skin condition A point to consider along with posture and seating generally, the ability to
offload fragile tissues using tilt and recline will be an important consideration.
Neurological signs and symptoms A postural assessment will determine the impact of neurological phenomena.
Some users will require a greater degree of tilt/recline to rest/function
comfortably.
Sensation Poor sensation can lead to significant tissue damage, e.g., in powered mobility
if feet are inadequately protected, fall off the plates or get caught in doorways –
the person may continue driving, oblivious to the damage they are doing to
their feet.
Orthopaedic interventions, This is mostly associated with postural assessment, but an important question is
including pharmacological means whether any intervention such as surgery is imminent, because this may change
the advice you give.
Relevant medication Does medication affect the person’s functional ability during the day? Is the
person taking medication for pain, and if so where do they experience pain?
Does this provide an indication for tilt/recline or specialist seating? Some
medication can induce drowsiness, which could be an issue for safe driving. It
may be appropriate to request whether medication can be reviewed.
Continued