Certificate Program
Seating and Wheeled Mobility
These courses will provide you with the foundational skills to evaluate a range of clients who would benefit from wheeled seating and mobility.
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About this Certificate Program
Many people with disabilities require a wheelchair seating system to provide postural support, pressure distribution, and alignment and to optimize functional abilities. The first half of this series begins with seating assessment and moves through specific seating challenges as well as interventions. Many people using a wheelchair seating system will only achieve independent mobility through a power wheelchair. The second half of this series addresses power mobility, beginning with determining readiness, including research that supports early provision of power mobility with young children. Other courses address power wheelchair configuration considerations, power seating, alternative driving methods, mobility training, and advanced features. This technology is very sophisticated to provide independent mobility to a wide range of clients as well as provide control of external assistive technologies through the power wheelchair.
Target audience
Therapists (OTs, COTAs, PTs, PTAs) working with clients who require wheeled seating and mobility interventions.
Goals & objectives
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The participant will be able to identify when seating intervention is required.
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The participant will be able to list common seating challenges and appropriate interventions.
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The participant will be able to list three developmental benefits of pediatric power mobility.
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The participant will be able to list three proportional and three nonproportional power wheelchair driving methods.
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The participant will be able to identify three power seating options and clinical indicators for each.
What’s included in the Certificate Program
Accredited Online Courses*
17 hours of online video lectures and patient demonstrations.
Interactive Learning Assessments
Case-based quizzes to evaluate and improve clinical reasoning.
Case Study Interviews
Recorded Q&A sessions between instructors and practice managers.
Certificate Program overview
Section 1
Wheelchair Seating 6 ItemsWheelchair Positioning: The Mat Exam Course
Chapter 1: The Mat Assessment: Components
The mat assessment includes evaluating multiple components, including client muscle tone, muscle strength, range of motion, reflexes, movement patterns, and postural control. Each component impacts the client’s seated posture and must be assessed and documented.
Chapter 2: The Mat Assessment: Supine
In supine, client range of motion, muscle tone, flexibility, and alignment are evaluated while eliminating the impact of gravity on posture. The supine evaluation helps determine the upper-leg-to-trunk angle in seating that allows the pelvis to remain in neutral alignment.
Chapter 3: The Mat Assessment: Sitting
Next, the client is examined sitting on the edge of the mat table, with postural support provided by the clinician’s hands and body. This positioning helps determine where and how much support is required to maintain an upright and aligned posture.
Chapter 4: The Mat Assessment: Translation to Wheelchair Seating System
The support required to maintain an upright seated posture on the edge of the mat table is similar to the necessary support in a wheelchair seating system. The body angles that optimize trunk and head control define the wheelchair seating system angles.
Wheelchair Positioning: The Pelvis Course
Chapter 1: Positioning the Pelvis: Posterior Pelvic Tilt
A posterior pelvic tilt is typically seen in combination with a kyphotic trunk and can lead to weight-bearing on the sacral area. Strategies for reducing a posterior tilt include preventing forward movement of the ischial tuberosities (ITs), posterior movement of the upper pelvis, and an appropriately angled pelvic positioning belt.
Chapter 2: Positioning the Pelvis: Anterior Pelvic Tilt
An anterior pelvic tilt is typically seen in combination with lumbar lordosis. Strategies for reducing an anterior pelvic tilt include an appropriately angled pelvic positioning belt and reducing the lordosis, as possible.
Chapter 3: Positioning the Pelvis: Pelvic Rotation
Pelvic rotation occurs when one anterior superior iliac spine (ASIS) is forward of the other and can be seen in conjunction with spinal rotation. Strategies for reducing pelvic rotation include direction of pull of the pelvic positioning belt and limiting movement of the IT on the forward side and movement of the posterior pelvis on the rearward side.
Chapter 4: Positioning the Pelvis: Pelvic Obliquity
Pelvic obliquity occurs when one side of the pelvis is higher than the other and is often seen in conjunction with lateral spinal flexion. Strategies focus on pressure distribution and are highly dependent on whether the obliquity can be reduced.
Wheelchair Positioning: The Trunk Course
Chapter 1: Positioning the Trunk: Kyphosis
Kyphosis can occur at various levels of the spine and may be reducible or nonreducible. Reducible kyphosis is addressed by providing appropriate anterior, posterior, and lateral trunk support. Nonreducible kyphosis is accommodated through pressure distribution and by positioning the head over the pelvis through an open seat-to-back angle and/or tilt in space.
Chapter 2: Positioning the Trunk: Lordosis
Lordosis can be seen at various levels of the spine but is most often seen at the lumbar area in conjunction with anterior pelvic tilt or at the neck, seen as hyperextension of the cervical area. If this is reducible, anterior and posterior support are used at appropriate angles to reduce the lordosis. If this is nonreducible, adequate pressure distribution is required.
Chapter 3: Positioning the Trunk: Rotation
Trunk rotation is often seen in combination with lateral flexion. If reducible, anterior support is required on the forward side in conjunction with posterior trunk support. If nonreducible, the priority is to ensure the client is facing forward.
Chapter 4: Positioning the Trunk: Lateral Flexion
Lateral flexion of the spine is often seen with distortions of the rib cage. Three-point lateral control is often required to reduce this tendency.
Wheelchair Positioning: The Extremities Course
Chapter 1: Positioning the Lower Extremities: Hip Challenges
Excessive hip flexion that cannot be reduced requires a more closed seat-to-back angle. If the upper legs are forced downward, the pelvis will be pulled into an anterior tilt. Excessive hip extension can lead to a posterior pelvic tilt and requires interventions including a more open seat-to-back angle and dynamic seating. Excessive hip adduction is often seen in conjunction with hip extension and internal rotation. Excessive hip abduction can lead to a seat and wheelchair frame that are wider than the client’s requirements at the hips.
Chapter 2: Positioning the Lower Extremities: Knee and Foot Challenges
Excessive knee flexion can lead to caster interference with the footplates and impact transfers and ADLs. Excessive knee extension can lead to loss of position and stability and an increase in the overall turning radius of the wheelchair base. If the ankle or foot is not in a neutral alignment, pressure distribution is affected. If the foot does not remain on the footplate, pressure distribution, stability, safety, and function are all compromised. Strategies to address these challenges will be provided.
Chapter 3: Positioning the Upper Extremities: Destructive Postures and Uncontrolled Movements
Some clients using wheelchair seating systems assume destructive upper extremity postures, which can lead to loss of range or compromise shoulder integrity. Other clients may have uncontrolled upper extremity movements. This can lead to injury of the client or others, difficulty getting through the environment (such as through doorways), and lack of stability.
Chapter 4: Positioning the Upper Extremities: Self-Abusive Behaviors and Shoulder Instability
Some clients using wheelchair seating systems display compulsive self- or other-abusive behaviors involving the upper extremities. This can lead to injury of the client and others as well as impact overall function. Seating strategies can be used to limit abusive behaviors, which can, in turn, allow the client to focus on functional activities. If the client has shoulder subluxation or dislocation, the arm must be well supported to prevent further loss of shoulder integrity.
Wheelchair Positioning: Tying It All Together—A Series of Case Studies Course
Chapter 1: Case Study #1
This case study will illustrate the wheelchair seating assessment process, including identifying client-specific seating challenges, problem-solving potential interventions, and finally, matching this information to product options and features. This case centers on a 15-month-old named Gabriel and emphasizes the importance of early intervention.
Chapter 2: Case Study #2
This case study will illustrate the wheelchair seating assessment process, including identifying client-specific seating challenges, problem-solving potential interventions, and finally, matching this information to product options and features. This case centers on a 19-year-old named Tom with cerebral palsy and complex seating requirements.
Chapter 3: Case Study #3
This case study will illustrate the wheelchair seating assessment process, including identifying client-specific seating challenges, problem-solving potential interventions, and finally, matching this information to product options and features. This case centers on a 10-year-old named Zoe with Rett syndrome and emphasizes the importance of addressing daytime and nighttime positioning.
Wheelchair Positioning Chart Text And Links
Section 2
Wheelchair Power Mobility 11 ItemsWheelchair Power Mobility Assessment: Determining Readiness Course
Chapter 1: Is Independent Mobility That Important?
This chapter will present the goals of determining if a child is ready for a power mobility device. Current and relevant research demonstrating the developmental benefits of early mobility will be reviewed. Finally, barriers to power mobility provision will be discussed.
Chapter 2: Motor Criteria
This chapter will present strategies for determining a child’s motor readiness to use a joystick, including motor requirements for this task. Strategies for determining motor readiness to use switches for driving a power mobility device will also be addressed.
Chapter 3: Cognitive Criteria
Power mobility use requires specific mobility concepts, including cause and effect, stop and go, directional concepts, problem-solving, and judgment. This chapter will present definitions and examples of each of these cognitive criteria.
Chapter 4: Pre-Assessment
This chapter will review strategies to simulate power mobility using a manual mobility base to determine and develop readiness for a power mobility device. A case study will be used to illustrate this technique.
Power Chair Configuration Considerations Course
Chapter 1: This Isn’t Your Grandma’s Wheelchair
This chapter will present definitions and clinical indicators for consumer-level and CRT-level power wheelchairs. CRT-level power wheelchairs support a wide range of seating systems and driving methods and allow for control of other features through the driving method.
Chapter 2: Drive-Wheel Configuration
This chapter will present front-, mid-, and rear-wheel drive configurations. The relationship between drive-wheel position, driving efficiency, and driving method will be discussed.
Chapter 3: Tracking Technologies
The chapter will present tracking technologies, which improve power wheelchair driving efficiency. Clinical benefits of this technology, and a summary of a tracking study, will be presented.
Chapter 4: Suspension
This chapter will review power wheelchair suspension as a part of the wheelchair frame. Clinical benefits will be discussed.
Wheelchair Power Mobility Assessment: Power Seating Course
Chapter 1: Power Tilt
This chapter will present a definition, clinical indicators, and justifications for the power tilt seat function on a power wheelchair. Power tilt provides many clinical benefits, including shifting the client’s weight. Anterior, posterior, and lateral tilt will be addressed.
Chapter 2: Power Recline
This chapter will present a definition, clinical indicators, and justifications for the power recline seat function on a power wheelchair. Power recline provides many clinical benefits, including client weight redistribution. This chapter will also address power elevating leg rests, which are frequently used in combination with power recline.
Chapter 3: Power Stand
This chapter will present a definition, clinical indicators, and justifications for the power stand seat function on a power wheelchair. Power stand provides many clinical benefits, including extending functional reach.
Chapter 4: Power Seat Elevating Devices
This chapter will present a definition, clinical indicators, and justifications for power seat elevating devices on a power wheelchair. Power seat elevate provides many clinical benefits, including facilitating transfers.
Wheelchair Power Mobility Assessment: Proportional Driving Methods Course
Chapter 1: Standard Joysticks
This chapter will present a definition, clinical indicators, and information about mounting standard joysticks on a power wheelchair. It will also address specific placement, including angles, to best match a client’s needs.
Chapter 2: Compact and Heavy-Duty Joysticks
This chapter will present a definition, clinical indicators, and information about mounting heavy-duty joysticks on a power wheelchair. Heavy-duty joysticks are sometimes used for clients who exert a great deal of force on the joystick, which would otherwise lead to damage.
Chapter 3: Mini Proportional Joysticks
This chapter will present a definition and clinical indicators for mini proportional joysticks on a power wheelchair. Mini proportional joysticks require significantly less travel and force to activate, making these appropriate for many people with muscle weakness.
Chapter 4: Mini Proportional Joystick Mounting
Mini proportional joysticks are often used at the chin or hand. Various mounting options for either location will be presented, along with clinical indicators for each.
Joystick Decision Tree Text And Links
Mini Proportional Joystick Comparison Chart Text And Links
Wheelchair Power Mobility Assessment: Nonproportional Driving Methods Course
Chapter 1: Nonproportional Driving Methods
This chapter will present a definition and introduction to nonproportional, or digital, power wheelchair driving methods. Proximity and fiber-optic switches, clinical indicators, and mounting options will be presented.
Chapter 2: Head Control
This chapter will present driving methods that require good head control, including GyroSet, Magitek, and RIM. Head arrays that require fair to good head control will also be presented in the context of clinical indicators.
Chapter 3: Sip ‘n Puff and Switch Control
This chapter will present sip ‘n puff control and four switch arrays to provide independent mobility for clients who fit the clinical indicators for each. Any type of switch and switch site can be combined to meet an individual’s needs.
Chapter 4: When Nothing Else Works
When nothing else works, it is possible to drive a power wheelchair with only one, two, or three switches. Specific options and clinical indicators will be presented. Eye gaze as a driving method will be included.
Non-Joystick Driving Methods Decision-MakingTree Text And Links
Head Array Comparison Chart Text And Links
Wheelchair Power Mobility: Mobility Training Course
Chapter 1: Mobility Training Evidence
This chapter will present evidence on the quantity and quality of mobility training. Research demonstrates that even children with significant and multiple impairments may be successful with power mobility, given mobility training.
Chapter 2: Training Mobility Concepts: Stop and Go and Directional
This chapter will present mobility training strategies to optimize stop-and-go and directional skills in driving a new power wheelchair. Goals of mobility training will also be discussed.
Chapter 3: Training Mobility Concepts: Problem-Solving and Judgment
This chapter will present mobility training strategies to optimize problem-solving skills and judgment in driving a new power wheelchair. Many children have not had life experiences that aid in development of judgment, and further training may be required.
Chapter 4: Addressing Behavioral Issues
This chapter will present common behavioral issues seen in pediatric power wheelchair drivers. Turning behavioral issues into learning opportunities will be discussed, as will general safety issues.
Wheelchair Power Mobility: Advanced Features Course
Chapter 1: Power Wheelchairs Can Do More Than Drive!
This chapter will present clinical advantages of accessing power wheelchair functions through the driving method, including reverse, speeds, power seating, interfaced assistive technology devices, Bluetooth mouse emulation, and infrared transmission.
Chapter 2: Bluetooth and Power Wheelchairs
This chapter will define Bluetooth and present how power wheelchairs with Bluetooth capabilities can be paired with smartphones, tablets, computers, and some communication devices to provide control through the driving method. Clinical considerations will also be discussed.
Chapter 3: Interfacing
This chapter will present how to interface an external assistive technology device to provide control through the power wheelchair driving method. Clinical considerations will be discussed.
Chapter 4: Smart Technologies
This chapter will present emerging technologies that make power wheelchairs smarter. New technologies include warning systems, obstacle and drop-off avoidance, speed and navigation assistance, and even health data tracking.
Section 3
Supplemental Materials and Readings 1 ItemSeating and Wheeled Mobility: A Clinical Resource Guide Text And Links
Instructors
Michelle L. Lange
OTR/L, ATP/SMS
CEU approved
17
total hours*
of accredited coursework.
Medbridge accredits each course individually so you can earn CEUs as you progress.
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Browse PlansFrequently asked questions
Everything you need to know about Certificate Programs.
Accreditation Hours
Each course is individually accredited and exact hours will vary by state and discipline. Check each course for specific accreditation for your license.
When do I get my certificate?
You will receive accredited certificates of completion for each course as you complete them. Once you have completed the entire Certificate Program you will receive your certificate for the program.
Do I get CEU credit?
Each course is individually accredited. Please check each course for your state and discipline. You can receive CEU credit after each course is completed.
Do I have to complete the courses in order?
It is not required that you complete the courses in order. Each Certificate Program's content is built to be completed sequentially but it is not forced to be completed this way.
How long do I have access to the Certificate Program?
You will have access to this Certificate Program for as long as you are a subscriber. Your initial subscription will last for one year from the date you purchase.
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