CMC ATP Seating & Mobility Assessment 3 — Questions and Answers
Question 1: A client with C5 tetraplegia wants to self-propel a manual wheelchair. Which rear wheel position change would MOST improve propulsion efficiency?
- Move wheels forward and lower axle position (Correct answer)
- Move wheels rearward and raise axle position
- Move wheels forward and raise axle position
- Move wheels rearward and lower axle position
Correct answer: Move wheels forward and lower axle position
Moving the rear axle forward and lower places the wheel in optimal position relative to the shoulder, reducing the arc needed and improving propulsion efficiency.
Question 2: During the mat assessment, the ATP observes that the client's hamstrings are extremely tight. How should seat depth be adjusted to accommodate this?
- Increase seat depth to provide maximum thigh support
- Decrease seat depth to prevent posterior pelvic tilt caused by hamstring pull (Correct answer)
- Keep seat depth standard and use a reclined backrest
- Use a solid foot plate elevated to full extension
Correct answer: Decrease seat depth to prevent posterior pelvic tilt caused by hamstring pull
Tight hamstrings pull the pelvis into posterior tilt when the knee is extended; reducing seat depth allows the knees to flex, relieving hamstring tension.
Question 3: What is the primary purpose of a tilt-in-space feature on a power wheelchair?
- To improve the client's line of sight for environmental access
- To redistribute pressure and reduce the risk of pressure injuries (Correct answer)
- To increase the seating system's adjustability for different positions
- To lower the center of gravity for improved stability on ramps
Correct answer: To redistribute pressure and reduce the risk of pressure injuries
Tilt-in-space redistributes pressure away from the ischial tuberosities to the back and thighs without changing the seat-to-back angle.
Question 4: A lateral trunk support is being positioned for a client with scoliosis. At what anatomical level should the concave-side support typically be placed?
- Above the apex of the curve to push the spine toward midline
- At the apex of the curve to provide corrective force (Correct answer)
- Below the apex of the curve to provide a lever arm correction
- At the iliac crest level regardless of curve apex
Correct answer: At the apex of the curve to provide corrective force
Lateral supports are placed at the apex of the curve to provide the most effective corrective or accommodative force at the point of maximum deviation.
Question 5: Which of the following best describes the '90-90-90 rule' in seating?
- Hips, knees, and ankles each at approximately 90 degrees of flexion (Correct answer)
- Back recline of 90 degrees with footrest at 90 degrees below horizontal
- Seat tilt of 90 degrees forward from vertical
- Trunk, thigh, and lower leg each at 90 degrees to the floor
Correct answer: Hips, knees, and ankles each at approximately 90 degrees of flexion
The 90-90-90 rule refers to positioning the hips, knees, and ankles at approximately 90 degrees to promote neutral joint alignment.
Question 6: A client with ALS is transitioning from a manual to a power wheelchair. What factor is MOST critical to address early in the power mobility assessment?
- Aesthetic preference for chair color and style
- Anticipating disease progression when selecting drive control access sites (Correct answer)
- Ensuring the chair fits through all doorways currently in the home
- Maximizing the chair's top speed for community mobility
Correct answer: Anticipating disease progression when selecting drive control access sites
ALS is progressive, so the ATP must anticipate future loss of motor function and plan for alternative access methods from the start.
Question 7: What is the MOST appropriate clinical reason to prescribe a seat elevator feature on a power wheelchair?
- To enable the user to reach high shelves and communicate at eye level (Correct answer)
- To reduce transportation weight by elevating the seat for folding
- To lower the user for easier floor-to-chair transfers
- To increase stability when driving on uneven terrain
Correct answer: To enable the user to reach high shelves and communicate at eye level
A power seat elevator raises the user to reach objects at height and facilitates eye-level social interaction, improving independence and participation.
CMC ATP Seating & Mobility Assessment 3
A client with C5 tetraplegia wants to self-propel a manual wheelchair.
Which rear wheel position change would MOST improve propulsion efficiency?