“Enabling the Disabling Environment: Paraplegia” (adult)

Jayna Vaccaro

OT 5162

March 21, 2005

Description of Disabling Condition: Paraplegia

Motor and Sensory impairments at the thoracic, lumbar, or sacral segments of the spinal cord

Due to damage of the neural elements inside the vertebral canal

Results in impairment of the trunk, legs, and pelvic organs (dependent on lesion location)

(Trombly, 2002)

Task Analysis

Occupation: Preparing a meal (IADL: complex activities or tasks that a person does to maintain independence in the home and community) (Trombly, 2002)

Description: Using the kitchen space to safely prepare a meal.

Preparing a meal is one example of a valuable activity to maintain independence as an adult with paraplegia.

Safety: A person in a wheelchair will encounter barriers in the kitchen environment due to being seated at a lower height, but various solutions can improve upon these and help the person feel comfortable and safe while cooking.

Key Performance Components

Sensorimotor: Coordination/Praxis Range of

Motion/Muscle Tone Visual Perception (depth perception, figure-

ground, position-in-space)

Strength/Muscle Tone Proprioception

Stereognosis Kinesthesia Pain Response Balance/Posture Touch Pressure Hearing R/L Discrimination

Key Performance Components

Cognitive: Attention Recognition Sequencing Initiation Problem Solving Orientation Concept Formation

Psychological/Psychosocial: Role Performance Self-Expression Mood/Affect Behavior Perception Thought Content

Performance Contexts

Physical Environment– Kitchen

Social Environment– Expectations of significant others

Ex: Cooking for family members, friends, co-workers

Potential Barriers– Entry accessibility, stove, knobs on stove, sink,

cabinets, and design of refrigerator.

Barrier: Width of door frame does not allow accessibility to kitchen

Solution: ADAGG Accessible Doorway

Wider doorway allows a person in a wheelchair to be able to access their kitchen.

Doorways shall have a minimum opening of 32 inches.

ADAGG 4.13.5

www.access-board.gov/

Barrier: Height of Kitchen Cabinets

Solution: Adjustable Kitchen Cabinets

By pressing a button, any individual can adjust the cabinets to their specific needs.

Cabinets can lower to meet a standard height counter or one that is 34 inches.

Automatic shut-off safety feature.

Cost: $1,150

http://www.blvd.com/storefront/

Barrier: Depth of Kitchen Cabinets

Solution A: Pull-out Shelves

Enables user to obtain items from front and back of shelves.

Can safely reach items without having to bend over in a wheelchair.

Cost: Begins at $26.95 per shelf at kitchenshelves.com

Solution B: Lazy Susan

By installing this in the lower cabinets, it is another solution for hard to reach products.

Shelf heights can be adjusted on the lazy susan.

Fits cabinets of 24 to 31 inches.

Cost: $46.35

http://www.shelvesthatslide.com/

Barrier: Accessibility of Kitchen Sink

Solution: Adjustable Sink

Press a button and the sink raises and lowers to optimal heights.

28-36 inches (can be used from seated position)

Knee-space beneath the sink benefits a user in a wheelchair.

Cost: $995

http://www.assis-tech.com/products.htm

Barrier: Refrigerator Door Handle Accessibility

Solution: Side-by-Side Refrigerator with full-length door handles

Adult with paraplegia in a wheelchair will have access to both sides rather than having difficulty reaching freezer.

Has roll-out baskets on both sides for obtaining hard-to-reach items.

Shelves within can raise and lower for various heights.

Cost: $1992

http://www.abtelectronics.com/

Barrier: Accessibility of Stove

Solution: Stove-top with front knobs and staggered burners

Staggered burners allow user to safely reach all areas of stove.

Front knobs provide easy accessibility.

Cost: Varies from $200-$1600 at Sears.com

Barrier: Height of stove hinders user to visualize cooking

Solution A: Attach an angled mirror above the stove

Mirror enables a person in a wheelchair to visualize cooking from all heights.

Helps the user to feel safe while cooking.

Cost: $39.95

www.sammonspreston.com/

Solution B: Adjustable Cooktop

By pressing a button, user can lower the stove to match their needs.

Provides knee-space so that a person in a wheelchair can roll under to cook.

Cost: $995

http://www.assis-tech.com/products.htm