CMC ATP Seating & Mobility Assessment 2 — Questions and Answers
Question 1: During a mat assessment for a wheelchair user with spinal cord injury, the ATP finds a flexible pelvic obliquity. What is the MOST appropriate intervention?
- Accommodate the obliquity with a contoured cushion and level seating surface
- Correct the obliquity using a firm, flat seat insert
- Use a solid seat insert with a wedge to accommodate the drop side (Correct answer)
- Refer the client for surgical correction before seating intervention
Correct answer: Use a solid seat insert with a wedge to accommodate the drop side
A flexible obliquity can often be accommodated using a wedge under the lower side to level the pelvis and improve alignment.
Question 2: Which muscle group weakness most commonly contributes to posterior pelvic tilt in seated wheelchair users?
- Hip flexors
- Hip extensors and abdominals (Correct answer)
- Hip adductors
- Knee extensors
Correct answer: Hip extensors and abdominals
Weak hip extensors and abdominals allow the pelvis to rotate posteriorly, causing a sacral sitting posture.
Question 3: A client presents with high muscle tone and extensor thrust. Which seating intervention is MOST likely to reduce the thrust?
- Reclining the backrest to 90 degrees
- Increasing seat-to-back angle to open hip angle beyond 90 degrees (Correct answer)
- Using an anterior seat slope (seat tilted forward)
- Applying a chest harness only
Correct answer: Increasing seat-to-back angle to open hip angle beyond 90 degrees
Opening the hip angle beyond 90 degrees can reduce extensor tone by inhibiting the extensor thrust reflex pattern.
Question 4: What does the term 'windswept deformity' describe in the context of seating assessment?
- Asymmetrical hip rotation with both femurs displaced to one side (Correct answer)
- Severe forward head posture with cervical kyphosis
- Bilateral hip flexion contractures greater than 30 degrees
- Lateral trunk lean combined with scoliosis
Correct answer: Asymmetrical hip rotation with both femurs displaced to one side
Windswept deformity refers to one hip in adduction/internal rotation while the other is in abduction/external rotation, with both femurs shifted to one side.
Question 5: When measuring seat depth for a wheelchair, what landmark is used as the posterior reference point?
- Posterior superior iliac spine (PSIS)
- Ischial tuberosities (Correct answer)
- Greater trochanter
- Coccyx
Correct answer: Ischial tuberosities
Seat depth is measured from the ischial tuberosities to the popliteal fossa, minus 1–2 inches clearance.
Question 6: An ATP is assessing a client who reports increased spasticity since receiving a new wheelchair cushion. What is the MOST likely cause?
- Cushion is too soft, causing postural instability
- Cushion is positioning the pelvis in excessive anterior tilt
- Cushion pressure relief is inadequate, causing pain that triggers spasticity (Correct answer)
- Cushion height has altered the footrest position, changing hip angle
Correct answer: Cushion pressure relief is inadequate, causing pain that triggers spasticity
Pain from inadequate pressure relief is a known trigger for increased spasticity and should be evaluated first.
Question 7: Which assessment tool is specifically designed to measure functional seating skills and postural control in wheelchair users?
- Berg Balance Scale
- Seated Postural Control Measure (SPCM) (Correct answer)
- Functional Independence Measure (FIM)
- Modified Ashworth Scale
Correct answer: Seated Postural Control Measure (SPCM)
The Seated Postural Control Measure (SPCM) evaluates both alignment and function specifically in the seated position.
CMC ATP Seating & Mobility Assessment 2
During a mat assessment for a wheelchair user with spinal cord injury, the ATP finds a flexible pelvic obliquity.
What is the MOST appropriate intervention?