Selection and use of wheelchairs for hemiplegic patients

  I. How to choose the right wheelchair?  It is best for hemiplegic patients to choose a special hemiplegic wheelchair, but an ordinary standard wheelchair is also available for use when they cannot walk. When selecting a wheelchair, the following aspects should be noted: (a) Sitting width: The patient should have a gap of 2.5cm between the two sides of the hip and the two inner sides of the wheelchair when sitting in the wheelchair.  (ii) Sitting length: the patient sits on the wheelchair, the gap between the N fossa and the front edge of the sitting position should be 6.5cm. (iii) The height of the backrest The height of the backrest should be determined according to the patient’s sitting height and the function of the upper body. The higher the backrest, the more stable the patient sits, and the lower the backrest, the more convenient the upper body and arm activities. If the hemiplegic patient has good trunk stability and control, the distance between the upper edge of the backrest and the patient’s armpit is about 10cm.  What kind of sitting position is better for the patient in the wheelchair?  The patient’s hips are as close as possible to the back of the wheelchair seat cushion, the trunk is straight, the head is upright, the eyes are looking straight ahead, an adjustable table plate is placed in front of the wheelchair, the shoulder of the affected limb is forward, the elbow joint has some extension, the forearm is rotated forward, and the wrist joint is mildly dorsiflexed. A non-slip pad can be placed under the forearm. Note that when sitting in the wheelchair, it should prevent others from slipping, semi-reclining, shoulder retraction and wrist palmar flexion and other poor posture.  Third, the patient should be instructed to drive the wheelchair in this way: while maintaining a good sitting posture, drive the hand circle forward with the healthy hand, land on the ground with the healthy foot, and use the power of the healthy foot to move the wheelchair forward with the backward stirrup, with the direction relying on the healthy foot to grasp.