Wheelchair Evaluation & Management In Occupational Therapy

Many Occupational Therapists who work with children and adults in rehabilitation, will perform wheelchair (w/c) assessments to make sure the client is properly fitted and using the appropriate type of wheelchair. Some may need a custom power w/c and others can manage with a manual w/c. Sometimes a special seat cushion is required in order to prevent the skin from breaking down and for comfort when having to sit for long periods of time. The OT will also help the person learn how to manage the w/c in the environment.

The therapist may need to assess a person's ability to use custom controls on a power w/c, in order for the person to effectively navigate in the environment. This may be needed for a spinal cord patient who is unable to use their hands. For others, the OT evaluation is for posture and positioning for comfort. And the OT can provide education for proper use; especially with transfers in and out of the w/c for safety and accessibility.

For some people, the fact that they need to use a w/c in order to function, can be a difficult experience to cope with. Especially when it is a younger person who was used to being independent. Not being able to walk due to a physical disability can have secondary effects resulting in some kind of mental or emotional problems; such as depression, withdrawal, or difficulty with coping; and it can be viewed by others as a lack of motivation.

The therapist who can recognize the person's difficulty coping, can better help the person deal with this. Occupational Therapy fundamentally believes that people find intrinsic value in performing purposeful activities. And so helping the person find appropriate tasks and hobbies which are meaningful can be a first step with effectively coping with a recent disability. Often an anti-depressant is needed, or even consulting with a psychologist, if the person is willing to acknowledge there might be a problem.

Case Study: An OT is working with a young adult who has had an auto accident and is now paralyzed from the waist down. He will need to learn how to manage a power wheelchair to get around and he will also learn to drive a custom fitted van in order to be independent. This individual is also having a difficult time coping due to a significant change in life, and so the OT will also help him explore alternative skills and activities. This person previously enjoyed playing the piano, and the OT has encouraged him to start playing an electronic keyboard/synthesizer and to record songs onto his computer, and even upload them to the internet. It turns out that music is a good outlet for his anger and difficulty with coping.

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