Name of the Procedure:

Common Name: Pediatric Rigid Wheelchair with Adjustable Seating System
Technical/Medical Term: Wheelchair, pediatric size, rigid, adjustable, with seating system (HCPCS Code: E1235)

Summary

A pediatric rigid wheelchair with an adjustable seating system is a specialized mobility device designed for children. It provides support and mobility for children who have difficulty walking or cannot walk at all. The “rigid” means it has a solid frame that doesn’t fold, while “adjustable” indicates that the seat, leg rests, and other components can be customized to fit the child’s needs.

Purpose

Medical Conditions Addressed:

• Cerebral Palsy
• Muscular Dystrophy
• Spina Bifida
• Severe injury or trauma affecting mobility

Goals/Expected Outcomes:

• Enhance mobility and independence
• Provide adequate postural support
• Prevent complications such as pressure sores
• Facilitate participation in daily activities and social interaction

Indications

Symptoms/Conditions:

• Children with significant mobility impairment
• Lack of trunk control or postural stability
• Requirements for specific seating adjustments due to deformities or growth

Patient Criteria:

• Pediatric patients requiring long-term wheelchair use
• Individuals with customizable seating needs due to their unique physical condition

Preparation

Pre-procedure Instructions:

• Obtain measurements for custom adjustments
• Bring any current mobility devices or aids for comparison

Diagnostic Tests/Assessments:

• Physical and Occupational Therapy evaluation
• Posture and seating assessment
• Medical history and mobility assessment

Procedure Description

Step-by-Step Explanation:

1. Measurement: Custom measurements are taken of the child's body.
2. Custom Build: The wheelchair is constructed based on these measurements with an adjustable seating system.
3. Fitting: The child is fitted into the wheelchair, making necessary adjustments for comfort and functionality.
4. Education: Instructions are provided to caregivers on how to adjust and use the wheelchair.

Tools, Equipment, Technology:

• Measuring tools (tape measure, angle gauges)
• Adjustable pediatric rigid wheelchair frame
• Custom seating system components

Anesthesia/Sedation:

• Not applicable

Duration

• Fitting and adjustment typically take 1-2 hours over one or more sessions.

Setting

• Outpatient clinic or specialized wheelchair service center

Personnel

• Physical Therapist
• Occupational Therapist
• Assistive Technology Professional (ATP)
• Medical Equipment Supplier

Risks and Complications

Common Risks:

• Initial discomfort
• Improper fit leading to postural issues

Rare Risks:

• Development of pressure sores
• Skin irritation from materials

Management of Complications:

• Regular follow-up for adjustments
• Immediate reporting of discomfort or skin issues

Benefits

• Improved mobility and independence
• Enhanced comfort and fit
• Prevention of pressure sores and other complications
• Better participation in daily and social activities

Recovery

Post-procedure Care:

• Regular monitoring and adjustments
• Training for child and caregivers on proper use

Recovery Time:

• Immediate use but may take a few days to weeks to fully adapt
• Follow-up appointments for adjustments

Alternatives

Other Options:

• Folding manual wheelchairs
• Power wheelchairs
• Strollers for children with special needs

Pros and Cons:

• Folding wheelchairs: More portable but less stable
• Power wheelchairs: Easier mobility but more expensive and less durable for children
• Strollers: More lightweight but less supportive and customizable

Patient Experience

During Procedure:

• Expected to sit for measurements and adjustments
• May experience mild discomfort during fitting

After Procedure:

• Increased mobility and comfort
• May require some adaptation period to new seating
• Pain management not typically necessary beyond minor adjustments for comfort