Services: Evaluation Details
Each client is evaluated by either a physical therapist or an occupational therapist in conjunction with a RTS. As required or requested, an evaluation may be completed by the above mentioned team in conjunction with a Physical Medicine and Rehabilitation physician. All evaluations are initiated by a referral from a physician at which point the evaluation can be scheduled. On average, an evaluation lasts one and a half hours. Evaluations generally include, but are not limited to, a full seating evaluation in the client’s current wheelchair and seating system, a full mat evaluation in both supine and sitting, assessment of strength, range of motion, sensation, tone, and a skin inspection. Assessment of functional skills is completed in wheelchair and sitting on the mat, as needed. Further assessment may include pressure mapping, trial of various equipment, molded seating assessment, gait analysis, balance assessment and home assessment.
- A full mat evaluation is often completed by both the therapist and RTS to assess the following:
- sitting evaluation outside of client’s current seating system while still engaging gravity
- supine evaluation to fully assess general postures, range of motion, spasticity, etc in a gravity-eliminated position
- active/passive range of motion
- skin integrity (complete visual inspection)
- general physical measurements
- skeletal/orthopedic assessment
- Demo Equipment: High-end rehabilitation equipment often requires trials of various pieces of equipment to ensure the successful achievement of the desired therapeutic and functional goals of the client. Wheelchair Seating Service has a large inventory of equipment, including power wheelchairs, manual wheelchairs, a multitude of seating and positioning products, alternative drive systems, etc., that can be utilized to determine whether a recommended solution does indeed meet the client’s needs.
Wheelchair Seating Service has also established very strong relationships with manufacturers which allows the rehabilitation technology supplier (RTS) to often obtain equipment, which we may not already have, for further evaluation. This may require subsequent visits as we wait to obtain the equipment from the manufacturer.
As NRRTS members, we make every effort to abide by the NRRTS ethics to “do everything necessary to provide high-quality equipment, ongoing support and long-term service.” We feel that a full evaluation, including equipment trials, as necessary, is an integral component of the success of our clients in achieving full functional and clinical goals.
- Pressure Mapping: Evaluations of clients who have current skin breakdown or who are at risk for skin breakdown often require a more intensive evaluation of their seating system relative to their anatomy. This may require pressure mapping, to identify higher areas of pressure on the seating surface which may be cause for concern for potential skin breakdown. This tool is used to identify potential modifications to a current seating system or whether other seating solutions are more beneficial to the client. The pressure mapping consists of a map that is placed in between the client and the client’s seating system. The client simply sits on the system while it is connected to the computer. Areas of high pressure are located.
Wheelchair Seating Service is able to provide our client’s with state of the art pressure mapping through the use of the Roho Xsensor X3 Display.
- Molded Seating: It is occasionally recommended that a client obtain custom molded seating. If the therapist, physician, and rehabilitation technology supplier (RTS) determine that off the shelf seating will not achieve the desired goals for a seating solution, then a custom molded seating system is recommended. These are often used to accommodate postural asymmetries, orthopedic deformities, maximum support which cannot be achieved with linear supports, and/or skin protection.
Each RTS at Wheelchair Seating Service has several molded seating systems at their disposal including:
- In-Home Assessment: Certain equipment requires an in-home assessment by the rehabilitation technology supplier (RTS). An RTS will need to assess door widths, general access into the home, surfaces/flooring that client may be rolling over (inside/outside), access into bathrooms and bedrooms, general safety concerns in the home, and any other obstacle that may prevent the client from being able to fully utilize the recommended equipment in the home.
An in-home assessment is required for all clients who have Medicare and for whom a power wheelchair is being recommended.