RoughRiderTM Service Quickstart: Assessment and Order Form
Contents
1. This Quickstart accompanies the Whirlwind Basic Guide to Wheelchair Service and Distribution which can be found at www whirlwindwheelchair org service RoughRider user group The RoughkRider RR is most appropriate for riders for whom all of the following statements are true The rider has The ability to maintain a sitting position in the RoughkRider wheelchair Good head control No significant contractures The following body measurements Body Measurement Range Wheelchair sizes Hip Width between 10 and 19 12 14 19 70 7 17S Io Upper Leg Length 17 5 or greater 17 seat depth on 15 75 seat Lower Leg Length 12 to 17 up to 18 with extra cushion 10 to 15 adjustable footrest height plus 2 3 cushioning Backrest Height support at 12 5 to 16 5 from seat 14 16 18 A RR has a 12 degree seat angle 90 degree seat to back angle with sling seat and sling backrest Extra cushion foam can be used to accommodate longer lower legs and to decrease backrest height Refer to Whirlwind s Guide to Wheelchair Distribution for assess I7 actual seat depth ment ordering and fitting instructions mlS optional seat depth _ At time of wheelchair fitting record final measurements of wheel chair setup in User Manual 4 P Acknowledgement of Assessment A Date st Rider s name lt 1 Rider s Signature d Evaluator s name 4 Evaluator s Signature th Ackn2. active sliding low muscle mass older age are present make a change to the cushion to reduce the pressure at that location Grade Three It is hard to remove your hand and Grade Three pressure at one of the locations at risk will you can feel restricted blood flow require that the cushion be adapted to reduce the to the tips of your fingers after 10 20 pressure at that location seconds g Incorrect and W correct fabric buckle lacing Check pressure grade sitting i in the wheelchair with an appropriate cushion win elchair l Updated 17 May 10 San Francisco State University 1600 Holloway Ave SCI 251 San Francisco CA 94132 USA http wh hirlwindwheelchair org 1 415 338 6277 Modifying cushion Whirlwind pressure relief cushions will come with extra base layers which can be positioned underneath the base foam to provide additional cutout for the Iscial Tuberosities ITs by lifting the rider up to create more depth for the rider s tissue to be supported Add layers and check for pressure again If there is still grade two or three pressure present modify the cutout shape in the base foam by removing carving with a knife a little material at a time around the area of high pressure If pressure cannot be resolved with these simple solutions refer to a practitioner with further training and instruct the rider to do longer pressure reliefs more often as well as frequent skin checks If there are any active or rec
3. elevation No Cushion sitting on sling seat 3 4 below flat seat 3 4 below flat seat Whirlwind Wheelchair Updated 17 May 10 San Francisco State University 1600 Holloway Ave SCI 251 San Francisco CA 94132 USA http whirlwindwheelchair org 1 415 338 6277 An experienced wheelcair rider should orient new riders to their wheelchair once they have been properly fit Play a game of follow the leader to practice riding skills and include attendants in the training See the Whirlwind Basic Guide to Wheelchair Service and Distribution at www whirlwindwheelchatr org service Rider orientation Topics Wheel locks Brakes Transfers in and out of chair e independent and assisted e To from chairs e To from the floor e Leaning Moving the Wheelchair e Forward Backward Turning e Uphill downhill e Wheelies curbs e Pressure Management e Axle Position e Transporting Wheelchair e Attendant Training e Transfers e Up Down Curbs e Up Down stairs Maintenance e Cushion Care e Cleaning e Tires e Parking Brakes e Repair ae ee a Were d Henne eal Whirlwind Wheelchair Updated 17 May 10 San Francisco State University 1600 Holloway Ave SCI 251 San Francisco CA 94132 USA Attp whirlwindwheelchair org 1 415 338 6277 Hips sliding forward Put a cushion between the rider s back and the backrest if the seat is too long Tie or velcro the cushion to the seat if the cushion is sliding Trunk falls
4. forward Use up to 1 2 cushioning behind the rilower back and under to help rider s torso to recline farther into the sling backrest Use a more supportive seating system Trunk falls to side Is wheelchair too wide A narrower wheelchair will help Use up to 1 2 cushioning behind the rilower back and under to help rider s torso to recline farther into the sling backrest Use a more supportive seating system Difficult to self propel Is a narrower wheelchair possible Is rider sitting On enough cushioning Could the rider propel with one leg Can an assistant help rider practice riding skills Move the wheel axles forward Improper leg position Adjust footrests and calf strap for better leg and foot support Build or cut contour abductor foam between knees or Adductor foam outside of knees into cushion with foam to position knees Gap between foot and footrest A Raise footrest height to lightly support foot Add blocks raises to footrest if the footrest cannot be raised enough Front of thigh is not Lower footrest supported by cushion If needed insert extra foam underneath cushion Seat fabric presses back of knee Tighten back fabric Put a cushion between the backrest and rider s back to move the rider forward and adjust the axle position forward Wheelchair is tiopy backwards Move the wheels backward one axle position Beginner riders balance point of a wheelie holds caster wheels 7 9 high Experienced
5. ause of pressure sores Coccyx Comfort cushion Cushion cover not pictured Ischial tuberositi s Top Layer Base Layer Greater trochantets Sub Layer 1 Sub Layer 2 Layers of a Whirlwind Pressure Relief Cushion Pressure Sore Risk Areas Check Pressure Grades e Adjust footrests see Fitting Guide e Detatch the bottom strap of the backrest fabric on the wheelchair and adjust the footrests to fit the rider while sitting on a pressure relief cushion e Ask the rider to sit back on your hand s in the wheelchair e Find each of the risk area locations Ischial tuberosity greater trochanter Coccyx with your fingers e The rider should then place his or her hands on their legs face forward and relax into a natural and comfortable sitting posture e Evaluate the pressure grade using the chart below and modify the cushion if needed see Fitting Guide e Replace the backrest fabric as it was The fabric should be tight when the chair is open but not so tight as to pull the sidesframes of the chair together or to prevent the seat fabric from being opened fully The strap webbing should pass through the buckle three times see photo below You can wriggle your fingers easily Grade One is safe for most people Grade Two You can t wriggle your fingers but If there is Grade Two pressure at one of the risk locations you can remove them easily and several risk conditions history of pressure sores moisture heat shearing or
6. d just below the bottom of the shoulder blade For less active riders needing more trunk support the back support can be close to the level of the armpit Find this height by using your hands held flat to measure the lowest place on the riders back where he or she is comfortably supported Measure from the seat surface to the point on the back that is most appropriate for this D Backrest Height rider To determine the wheelchair backrest height add 1 for the compressed cushion that the rider will be using Whirlwind Wheelchair Updated 17 May 10 San Francisco State University 1600 Holloway Ave SCI 251 San Francisco CA 94132 USA http whirlwindwheelchair org 1 415 338 6277 boe ooo SSS Raen SSS Rider AGE ooo Raersensr oo RiderReference OOS Rider contactintormaron Distibuting Organization SSS Assessment performed by Yes No 1 Rider has head control 2 Rider can maintain upright sitting position 3 Rider does not have significant contractures C 4 Rider needs pressure relief cushion C C Notes on Pressure management If any of the answers for questions 1 3 are No in the grey boxes the RoughRider may not be appropriate for this rider A Hip Width Rider Hip Width oOo Wheelchair Width 12 C 14 laz 17 4 17 l l Hip Width B Seat Depth Upper Leg Length l Rider Upper Leg Length O Seat Depth on Wheelchair leg th C Lower Leg Lengt
7. ently healed pressure sores remove some material approximately 0 5 below that area After selecting the number of foam layers to use and further carving the foam if necessary place a plastic cover between the top layer and base layer if needed and enclose the cushion in its cover The pleats in the cover the closure system and the cutout should be at the back of the cushion ok wr Vite Carve areas of high Use additional layers under Replace base foam in plastic pressure if needed base foam if needed if needed in cushion cover Using extra cushions to accommodate longer lower leg length If the rider has a long lower leg length that cannot be accomodated by the RoughkRider wheelchair without additional cushioning add additional foam underneath the cushion fo lift the rider higher off the seat fab ric This foam can be placed inside the cushion cover and underneath the base foam as long as it does not stretch the top fabric of the cushion cover Raising a rider with extra foam will increase the tippiness of the chair and make it more difficult to fit knees under tables Approximate elevation gains of compressed cushions at back of cushion Cushion Type Back Elevation from seat Front Elevation from seat Comfort Cushion Foam pressure relief cushion without sub layers 11 2 Foam pressure relief cushion with 2 sub layers 1 1 2 2 1 4 Additional 2 of foam lift under cushion adds 1 1 2 elevation adds 1 1 2
8. h Rider lower leg length 10 to 15 height range from footrest to seat fabric plus 2 additional height from the cushion 12 to 17 Optional Add up to 2 of extra foam Backrest Height D Add 1 for cushioning to find backrest height Wheelchair Backrest Heights 14 E 16 Upper Leg Length 18 m Lower Leg Length c Whirlwind Wheelchair Updated 17 May 10 San Francisco State University 1600 Holloway Ave SCI 251 San Francisco CA 94132 USA Attp whirlwindwheelchair org 1 415 338 6277 Cushion Check Sensation Level See Whirlwind Service Guide Riders without full sensation at seat surface should use a pressure relief cushion The Cushion should be about 1 2 wider than the seat width to hold the cushion in place in the chair The rider should sit on their cushion for the next fitting steps Seat Width Check that the seat width is appropriate for the rider no more than Grade 1 pressure on the hips see Whirlwind s Cushion Fitting Guide Seat Depth Check that the front of the seat fabric is not pressing on the back of the rider s legs when the legs are tucked back as far as they will be allowed check the calf strap Look for a minimum of 1 2 gap 1 1 4 is preferable Footrest Height With the rider sitting in the chair wearing the footwear they will be using in the char place one hand under the lower thigh closer to the knee on the cushion and one hand
9. holding the sole of the foot with the footrest flipped out of the way Find the optimal height of the foot where there is moderate pressure under the thigh where the foot is not hanging and both foot and thigh bear approximately equal amounts of weight Adjust the footrest height by loosening the footrest clamp bolt and raise or lower the footrest until the weight of the foot and lower thigh on your hands are equal If the footrests can t be adjusted low enough add extra foam under the cushion after considering the drawbacks see Service Guide Backrest Height Check that the backrest supports the rider s back first supporting the rider s trunk and secondly allowing pushing on the handrims Check the backrest height again later if cushion height is changed in the fitting process Pressure Relief Cushion Adjustment if needed Evaluate pressure on seat surface and add additional cutout layers under the cushion or carve away foam where needed See cushion fitting guide on the following pages Rear Axle Adjustment Adjust the position of the rear wheels to meet the rider s needs a forward position increases the rearward tippiness of the chair but makes the chair easier to push and use In rough terrain Rider Orientation to Wheelchair A wheelchair rider should train new riders and attendants in independent and as sisted skills including moving in the chair the use of parking brakes transfers pressure management wheelies and leani
10. ng for rough terrain and managing curbs and steps Additional topics are maintenance cleaning repairs and wheelchair adjustments including footrest and rear axle position A game of follow the leader over mixed terrain helps riders learn and teach each other riding skills Check Comfort Ask about comfort and feel for high pressure grades after a half hour of use and make adjustments if needed This is a critical fitting step Whirlwind Wheelchair Updated 17 May 10 San Francisco State University 1600 Holloway Ave SCI 251 San Francisco CA 94132 USA http whirlwindwheelchair org 1 415 338 6277 For riders with full sensation at seat surface a comfort cushion may be adequate The cushion should fit the chair width and seat depth The Whirlwind comfort cushion is 2 of foam covered in a water resistant fabric cover The comfort cush ion lifts the rider approximately 1 off the seat surface in the rear and 2 off the seat surface in the front of the chair Riders without full sensation at seat surface should use a pressure relief cushion The following information can be used to customize the fit of a Whirlwind pressure relief cushion The Whirlwind pressure relief cushion has optional sub layers and an optional plastic layer between the top foam and the base foam Include the plastic if the cushion is likely to frequently come in contact with urine but be sure to soend extra time educating about moisture as a c
11. owledgement of Fitting Date Rider grant permission to Whirlwind Wheelchair to use and publish my photograph for optional Client file cr Closed door conference Public images E Rider s name Rider s Signature Evaluator grant permission to Whirlwind Wheelchair to use and publish my photograph optional C Evaluator s name Signature Whirlwind Wheelchair Updated 17 May 10 San Francisco State University 1600 Holloway Ave SCI 251 San Francisco CA 94132 USA http whirlwindwheelchair org 1 415 338 6277 1 Head Control When sitting in a chair with a backrest can the rider independently hold up and move his her head If no the RoughRider is not likely an appropriate chair for this rider 2 Maintain Sitting Can the rider independently maintain upright sitting in a standard chair with a backrest If no the RoughkRider is not likely an appropriate chair for this rider 3 Contractures Are there contractures in hips or knees that would prevent the rider from sitting comfort ably in the Roughkider wheelchair Contractures Tight muscles that have become shortened and make it difficult to move the joint If yes the RoughRider is not likely an appropriate chair for this rider 4 Sensation Does rider have full sensation at seat surface Incomplete sensation increases the likeli hood of pressure sores Yes the rider will receive a comfort cushion No the rider will receive a pressure relief cu
12. riders balance point of a wheelie holds caster wheels 5 7 high Whirlwind Wheelchair Updated 17 May 10 San Francisco State University 1600 Holloway Ave SCI 251 San Francisco CA 94132 USA http whirlwindwheelchair org 1 415 338 6277
13. shion A Hip Width A Hip Width e Position the rider sitting with the pelvis upright on a firm surface e Measure the distance between the widest points of the hips or thighs without compressing any tissue e Record this measurement e Select seat width using the following chart The Whirlwind RoughkRider Distribution Guide explains pressure sore risk Risk of Pressure Sores Chair Width Prescription High Risk and or bony hips At least Hip Thigh Width 1 2 refer to Service Guide B Seat Depth At least Hip Thigh Width For riders with extra hip width As narrow as comfortable without causing high pressure B Seat Depth Upper Leg Length With the client sitting upright on a firm surface measure the distance from the back of the pelvis to the back side of the lower leg the back of the knee Record this measure ment Subtract 1 2 to find the maximum seat depth to allow for soace between the knee and seat fabric Record seat depth C Lower Leg Length With the rider sitting on a firm surface wearing the footwear they will be using measure the distance from the bottom of the foot to the underside of the front of the thigh Re C Lower Leg Lengih cord this measurement Subtract 2 for the cushion to find the desired length between the seat upholstery and the footrest The footrest height can be adjusted when the wheelchair is fit for a rider D Backrest Height Generally the top of the back support should be locate
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