Braces and wheelchairs

Many physically handicapped children who partici­pate in physical education programs use a wheelchair for locomotion or wear braces, and some children require both devices. The physical educator should have a working knowledge of the care and maintenence of lower extremity braces and wheelchairs. One of the teacher's responsibilities is daily observation of the student's use and care of ambulation equipment. In conjunction with related services, the child's class­room teacher, family, and physical educator should develop a program to maximize the use of ambula­tion devices in the physical education setting and be­yond the school boundaries. In addition, any prob­lems that arise with the ambulation devices should be communicated to the special or regular class teacher or the parents.

Leg Braces

Leg braces are metal or plastic support frames that are strapped to the body above and below specific joints to assist with ambulation. The main purposes of lower extremity braces are to support the weight for ambulation, to control involuntary movements, and to prevent or correct deformities.

In general, there are three classifications of lower leg braces – short leg braces, long leg braces, and hip braces.

Short Leg Brace

A short leg brace is appropriate when the dis­abling condition occurs at the ankle joint. Although there are several different types of short leg braces, the simplest form consists of a single metal upright bar attached to the shoe with a cuff around the calf of the leg. When more stability is needed, double upright bars are used. The design of this type of brace should facilitate the control of four movements of the ankle joint. Leather straps attached to the metal uprights and strapped around the ankle assist with control of the ankle joint.

Long Leg Brace

The long leg (knee-ankle-foot) brace assists with control of the ankle and knee joint. The fundamental purpose of the long leg brace is to prevent hyperextension of the knee caused by weak extensor muscles. The brace must be in different po­sitions when the student is sitting as compared to standing. To accommodate the different positions of the knee, various types of locks are placed at the knee joints, the most common of which is a sliding metal lock that is easily locked and unlocked by hand. The knee joint of the long leg brace is locked when the individual is sitting in a chair. Locking de­vices may also be used to control the ankle when this type of brace is used.

Long Leg Brace with Pelvic Band

The long leg brace may extend from below the ankle to above the hip. Such a brace is called a hip-knee-ankle-foot long leg brace. The purpose of such a brace is to control movements of the hip joint as well as the knee and the ankle. To assist with the control of the hip joint, a pelvic band is attached to the top of the upright bar.

The physical education teacher should have a working knowledge of the functions of leg braces.

Some of the characteristics that can be observed are as follows: (1) brace joints work easily, (2) brace and anatomical joints coincide, (3) upright conforms to the leg, (4) brace is of correct length, and (5) upright coincides with the midline of the leg.

Wheelchairs

The purpose of wheelchairs is to provide a means of locomotion for persons who lack strength, endur­ance, or flexibility of muscles prerequisite for ambu­lation. Persons who can walk but cannot rise from a seated position to a standing position or those who need to transport objects but cannot do so may also need a wheelchair.

There are several types of wheelchairs. However, the most common are made of metal and have four wheels. The two back wheels are large, and the two front wheels are small and mounted on casters that pivot freely. Two or more separate rims that can be grasped to propel the chair are mounted to the back wheels.

Wheelchair design is a continuous process, the goal of which is to make the wheelchair more func­tional. Many special features can be added to make a wheelchair more functional or comfortable, includ­ing armrests, footrests, legrests, and headrests, all of which can be removed. Leg spreaders have also been incorporated into some wheelchairs to prevent the scissoring of legs. There are motorized wheelchairs to accommodate persons who have severe afflictions of the upper extremities. Some other features of a wheelchair are unique folding mechanisms that allow it to double as a stroller or car seat, adjustable Velcro fasteners, pads, and attachable trays.

Дата добавления: 2015-11-16