Watch the video version of this episode on YouTube – https://youtu.be/_d_BMGgEWkU 

A physical therapist works with a patient with hemiparesis who uses a hemiplegic chair for mobility. Which activity would become more challenging for the patient based on this specific type of wheelchair?

1. Reaching for objects outside the base of support
2. Standing up from the seat of the chair
3. Performing independent pressure relief
4. Elevating the legs for edema management

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A physical therapist works with a patient with hemiparesis who uses a hemiplegic chair for mobility. Which activity would become more challenging for the patient based on this specific type of wheelchair?

1. Reaching for objects outside the base of support
2. Standing up from the seat of the chair
3. Performing independent pressure relief
4. Elevating the legs for edema management

Wheelchair Prescription
Proper wheelchair prescription is crucial because it ensures individuals with mobility impairments receive the ideal type of chair to meet their specific needs, enhancing both their comfort and independence. Each patient’s physical condition, posture, mobility level, and daily activities vary significantly and therefore a one-size-fits-all approach is not effective.

There are an extremely large number of wheelchair types and categories. Here are just a few of the many terms a physical therapist may encounter.

Single-arm drive chair, Bariatric chair, Amputee chair, Foot drive chair, Pediatric chair, Reclining chair, Manual chair, Electric chair, All terrain chair, Tilt chair, Rigid ultra-light chair, Sport chair, Travel chair, Lions, Tigers, and Bear Chair. 

The question is specifically asking which activity would become more challenging with the use of a hemiplegic chair.

Hemiplegic Chair
A hemiplegic chair (i.e., foot drive chair) incorporates a seat that is approximately two inches lower than a standard chair to enable the user to use the lower extremities to propel the chair. The patient typically uses one handrim and one or both feet to help propel and steer the wheelchair. One or both front riggings on the wheelchair are removed to provide the feet with the necessary space for propulsion.

If you were able to generate an image similar to what you see here, you are likely in great shape to answer the question correctly. 

Conversely if you generated an image like this, you may be scrambling. 

When examining this question, it is critical that the focus is exclusively on the type of wheelchair (i.e., hemiplegic chair) as opposed to the patient’s pathology and associated impairments.

Let’s explore each of the options:

Option 1 - Reaching for objects outside the base of support 
Reaching for objects outside the base of support may be challenging for the patient depending on the extent of weakness or paralysis following a stroke. However, a hemiplegic chair would not increase the complexity of this task.

Option 2 - Standing up from the seat of the chair 
Standing up from the seat of the chair would be more challenging with a hemiplegic chair since the lower seat would require significantly more upper and lower extremity strength to attain a standing position.

Option 3 - Performing independent pressure relief 
Performing independent pressure relief may be challenging for the patient depending on the extent of weakness or paralysis following a stroke. However, a hemiplegic chair would not increase the complexity of this task.

Option 4 - Elevating the legs for edema management 
Elevating legrests are not a feature that is specific to a hemiplegic chair. If elevating legrests were required for this patient, a hemiplegic chair would not increase the complexity of this task. The legrests, if present, would need to be removable since the lower extremities are used to propel the chair.

The correct answer is Option 2

Let’s explore the all student data:
32% of students selected Option 1, Reaching for objects outside the base of support
40% of students selected Option 2, Standing up from the seat of the chair, the correct response
14% of students selected Option 3, Performing independent pressure relief
14% of students selected Option 4, Elevating the legs for edema management

System Classification
This question is a Non-Systems question which represents approximately 14% of all exam items.

Content Outline Classification
This question is an Equipment, Devices, and Technologies; Therapeutic Modalities question which represents approximately 6% of all exam items.

Level Classification
This question is a Level 2 question since the question requires students to integrate numerous pieces of information or to apply knowledge in a given clinical scenario. Remediation of Level 2 questions occurs by increasing flexibility with academic content and by carefully analyzing decision making processes when answering applied examination questions.

Academic Focus Area
Looking to review related academic content? Check out pages 696-699 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!