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Name: Date: MR #: Wheelchair Seating and Positioning Evaluation Account #: Birth Date: Sex: Physician: PATIENT INFORMATION: Name: Physician: Date seen: Address: Physician Fax #: This evaluation/justification
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How to fill out wheelchair seating and positioning

How to Fill Out Wheelchair Seating and Positioning:
01
Start by ensuring that the individual's wheelchair is properly adjusted to their specific needs. This includes adjusting the seat height, backrest angle, and footrest position to provide optimal support and comfort.
02
Assess the individual's posture and alignment in the wheelchair. Check for any asymmetry or deviations in the spine, pelvis, or extremities. Make necessary adjustments to promote proper alignment and prevent pressure sores or discomfort.
03
Evaluate the individual's lower extremity positioning. Ensure that the feet are resting comfortably on the footrests, with proper foot placement and support. Adjust the footrest angle if needed for a more ergonomic position.
04
Check the individual's upper extremity positioning. Make sure their arms are well-supported and positioned comfortably on the wheelchair armrests. Adjust the armrest height and width to ensure proper alignment and minimize strain on the shoulders and arms.
05
Assess the individual's trunk support. Ensure that the backrest provides adequate support and stability for their posture. Make any necessary adjustments to the backrest angle, lumbar support, or lateral support to maintain proper alignment and prevent slumping or leaning.
06
Consider the individual's head and neck support. If needed, provide additional support through the use of headrests or cushions. Adjust the headrest height and angle for optimal comfort and alignment.
07
Periodically reassess the individual's seating and positioning to account for any changes in their condition or needs. Regularly check for any signs of discomfort, pressure sores, or improper alignment and make adjustments accordingly.
Who Needs Wheelchair Seating and Positioning:
01
Individuals with mobility impairments who rely on wheelchairs for mobility may require proper seating and positioning. This includes those with spinal cord injuries, neurological conditions, muscular dystrophy, or other conditions that limit their ability to walk or stand.
02
People with disabilities that affect their posture, such as scoliosis or kyphosis, may benefit from specialized wheelchair seating and positioning. Proper support and alignment can help prevent further progression of spinal deformities and improve comfort.
03
Individuals with pressure sores or skin integrity issues may require specific wheelchair seating and positioning to distribute pressure evenly and reduce the risk of pressure ulcers.
04
People undergoing rehabilitation after surgery or injury may need proper wheelchair seating and positioning to support healing and prevent complications.
05
Those with conditions that cause muscle weakness or paralysis, such as multiple sclerosis or cerebral palsy, may rely on wheelchair seating and positioning to maintain stability and functional mobility.
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What is wheelchair seating and positioning?
Wheelchair seating and positioning refers to the arrangement and adjustments made to a wheelchair to ensure the user's comfort and safety.
Who is required to file wheelchair seating and positioning?
Healthcare professionals and caregivers responsible for the wheelchair user are required to file wheelchair seating and positioning.
How to fill out wheelchair seating and positioning?
To fill out wheelchair seating and positioning, one must assess the user's needs, make necessary adjustments to the wheelchair, and document the details of the seating and positioning.
What is the purpose of wheelchair seating and positioning?
The purpose of wheelchair seating and positioning is to provide the user with proper support, comfort, and safety while using the wheelchair.
What information must be reported on wheelchair seating and positioning?
Information such as the user's measurements, current seating arrangement, any specific needs or adjustments, and the date of assessment must be reported on wheelchair seating and positioning.
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