Question

A physical therapist is teaching a patient with a spinal cord injury to negotiate a 4-inch curb with a manual wheelchair. The MOST appropriate instruction for the therapist to give the patient is:

A. "Hook your arms around the push handles and descend backwards"
B. "Ascend backwards with the large wheels first"
C. "Ascend in a wheelie position by lifting the front casters"
D. "Place the front casters down first during descent"

Answer 1

The most appropriate instruction for a patient using a manual wheelchair to negotiate a 4-inch curb is to ascend in a wheelie position by lifting the front casters.

Step-by-step explanation:

For a patient with a spinal cord injury learning to navigate a 4-inch curb with a manual wheelchair, the most appropriate instruction provided by the physical therapist should focus on safety and the most effective technique for the specific situation. Given the choices, the correct instruction would be:

C. "Ascend in a wheelie position by lifting the front casters"

When ascending a curb, it is generally safest and most effective to approach the curb facing it, perform a wheelie to lift the front casters onto the curb, and then push the large rear wheels up and over. This method requires balance and strength, but provides the patient with more control and reduces the risk of tipping the chair. This technique highlights the importance of developing balance, strength, and endurance in physical therapy, which a physical therapist would continually monitor as exercises are introduced to enhance these capabilities.