Volume 3, 2021 Clinical Reasoning, Competency in a Faster Paced World: Can Wheelchair Prescription be Effective and Efficient?


Author Cheryl Hon, B. A., M. OT                          

Credit: .2 CEU

Seating and Positioning



Clinical reasoning has been studied across health disciplines and is the foundation for client outcomes.  Whether it is prescribing an exercise program, walking aid, a piece of bathroom equipment or medication or procedure, all these decisions require sound clinical reasoning. In a faster paced world, the acquisition and development of clinical reasoning skills has changed. Wheelchair and seating equipment innovations have enabled clinicians to work through the prescription and delivery process efficiently. The vast array of new products has also greatly improved the lives of clients living with disabilities. The availability of commercial seating equipment has changed practice and although there are many benefits, there are also disadvantages. This article examines some of the organizational and personal factors affecting the development of clinical reasoning from the perspective of an occupational therapist working in complex wheelchair and seating prescription. Upon reflection, she determines that the most difficult aspect of seating prescription is translating clinical data such as interview information and range of motion data from the physical assessment into actual equipment characteristics.  The writer describes and details 2 clinical reasoning algorithms and a clinical reasoning pathway created to help clinicians translate assessment results into equipment parameters to facilitate a practice model that is both efficient and effective.

Learning Outcomes:

The participant will be able to list 3 adverse effects of whole-body vibration (WBV) on the health of a manual wheelchair user

The participant will be able to list 3 strategies for design on a manual wheelchair that manufacturers have employed in an attempt to reduce the transmission of whole-body vibration to the manual wheelchair user.

The participant will be able to list 4 examples of common surfaces that wheelchair users encounter that can impart vibration to the wheelchair and user.

Cheryl Hon, B. A., M. OT, is an Occupational Therapist who works at Access Community Therapists in Vancouver, British Columbia Canada. Cheryl works primarily in complex wheelchair seating and positioning prescription for clients with a range of disabilities in the community. She has presented numerous times on the topic of wheelchair seating and positioning and pressure injury prevention and management with her colleague Lindsay Alford and is keen to develop new ways of thinking about wheelchair seating prescription and education. She is a mom of two young children and wife to a supportive and inspiring husband. She credits her mentors Jo-Anne Chisholm, Joanne Yip and the other therapists at Access Community Therapists for informing her practice and supporting her learning and professional development in this fast moving and ever-changing clinical world.