elaine viviannetoskos maotr/l© march 2016 sbs c d1 66 st lincoln center 1 72 st 1s 23 79 st 1 86 st...
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Rusk RehabilitationElaine V. Toskos MAOTR/L, ATP, CAPSClinical Specialist Seating & Mobility Program
Wheeling in the City-Accessibility and Environmental Considerations Across the Globe
Rusk RehabilitationSpecialty Programs
Rusk RehabilitationSpecialty Programs- Seating & Mobility
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3Elaine VivianneToskos MAOTR/L© March 2016
Source: Accessible Icon Project
The Centers for Disease Control and Prevention estimated that:
• One in five Americans—about 53 million people—has a disability of some kind.
• 33 million Americans have a disability that makes it difficult for them to carry out daily activities; some have challenges with everyday activities, such as attending school or going to work, and may need help with their daily care.
• 2.2 million people in the United States depend on a wheelchair for day-to-day tasks and mobility.
• 6.5 million people use a cane, a walker, or crutches to assist with their mobility. Last Updated Date: 11/30/2012
www.nichd.nih.govwww.w3.org
ISO International Symbol of AccessAccessible Icon Project
“More than 45 years after it was first
created, the handicap symbol is
getting a significant redesign,
at least in New York" (July 2014)
www.washingtonpost.com
Accessible Icon Project
Source: Accessible Icon Project
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day, Jun4, 2015
International Classification of Functioning, Disability and Health (ICF)The International Classification of Functioning, Disability and Health, known more commonly as ICF, is a classification of health and health-related domains.
As the functioning and disability of an individual occurs in a context, ICF also includes a list ofenvironmental factors.
www.who.int/classifications
ICF puts every person in a context:
functioning and disability are results of the interaction
between the health conditions of the person and their
environment.
International Classification of Functioning, Disability and Health (ICF)The International Classification of Functioning, Disability and Health, known more commonly as ICF, is a classification of health and health-related domains. As the functioning and disability of an individual occurs in a context, ICF also includes a list of environmental factors.
• The International Classification of Functioning, Disability and Health (ICF) is a framework for organizing and documenting information on functioning and disability (WHO 2001). It conceptualizes functioning as a ‘dynamic interaction between a person’s health condition, environmental factors and personal factors.’• The ICF provides a common language for disability. The international framework standard to describe and measure health and disability.• It recognizes the role of environmental factors in the creation of disability, as well as the role of health conditions (Üstün et al. 2003).• Functioning and disability are understood as umbrella terms denoting the positive and negative aspects of functioning from a biological, individual and social perspective. • ICF clarifies that we cannot, for instance, infer participation in everyday life from medical diagnosis alone. In this sense ICF is etiology-neutral: if a person cannot walk or go to work it may be related to any one of a number of different health conditions. By shifting the focus from health condition to functioning, the ICF places all health conditions on an equal footing, allowing them to be compared, in terms of their related functioning, via a common framework.
For instance, arthritis has been found to have very high frequency among people in Australia with a health condition and with a disability; that is, arthritis accounts for much of the disability in the population. In contrast, conditions such as autism, dementia, Down syndrome and cerebral palsy are much higher ranked in terms of the likelihood of severe disability (AIHW 2004).
• The ICF covers the entire life span. • Health has been defined in the WHO Constitution as ʻa state of complete physical, mental, and social well-being and not merely the absence ofdisease or infirmity’ (Constitution of the World Health Organization, WHO 1948).• The ICF provides a scientific, operational basis for describing, understanding and studying health and health-related states, outcomes and determinants.
www.who.int/classifications
ICF puts every person in a context:
functioning and disability are results of the
interaction between the health conditions of the
person and their environment.
The Human Activity Assistive Technology (HAAT) model has four components:HumanActivity
Assistive TechnologyContext
Cook and Hussey's Assistive Technologies: Principles and Practice!By Albert M. Cook, Janice Miller Polgar
The activity is the fundamental element of the HAAT model
Activities are categorized within three basic performance areas:
ADL Work and productive activities
Play & leisure activities
The three integrated factors exist exist within the context
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The Human Activity Assistive Technology (HAAT) model has four components:HumanActivity
Assistive TechnologyContext
Occupational competence gives a dynamic context to the understanding of
human abilities and how a person changes and adapts his or her engagement in activity in response to environmental demands and
his or her own abilities
Cook and Hussey's Assistive Technologies: Principles and Practice!By Albert M. Cook, Janice Miller Polgar
The activity is the fundamental element of the HAAT model
Activities are categorized within three basic performance areas:
ADL Work and productive activities
Play & leisure activities
The three integrated factors exist exist within the context
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50 StC E
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A B C D 1
66 St Lincoln Center
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72 St1 2 3
79 St1
86 St1
96 St1 2 3
103 St1
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157 St1
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181 StA
190 StA
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238 St1
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176 St4
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174 St2 5
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2 5
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Simpson St2 5
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116 St6
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81 St–Museum of Natural History B C
86 St B C
96 StB C
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116 StB C
125 StA B C D
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135 StB C
135 St2 3
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182–183 StsB D
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174–175 StsB D
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219 St 2 5
225 St2 5
233 St2 5
Nereid Av2 5
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MyrtleWyckoff AvsL M
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Kosciuszko St
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163 ST
FR
ED
ER
ICK
D
OU
GL
AS
S B
LV
D
AD
AM
CL
AY
TO
NP
OW
EL
L B
LV
D (7A
V)
VAN WYCK EXPW
Y
SEAGIRT BLVD
BE
AC
H C
HANNEL D
R
RO
CK
AW
AY
BE
AC
H B
LVD
KIN
GS
HIG
HW
AY
82 ST
VE
RN
ON
BL
VD
BE
AC
H C
HA
NN
EL
DR
RO
CKAW
AY PT
BLV
D
HAMILTON BRIDGE
WASHINGTON BRIDGE
CROSS BRONX EXPWY
BAYCHESTER AV
9 AV
10 AV
11 AV
GR
AN
D A
V
SpuytenDuyvil
Riverdale
UniversityHeights
MorrisHeights
Harlem125 St
Melrose
Yankees-E153 St
Tremont
Fordham
Botanical Garden
WilliamsBridge
Woodlawn
Wakefield
LongIslandCity
9 St
14 St
23 St
33 St
Christopher St
Hunterspoint Av
Woodside
Mets–Willets Point
Flushing
ForestHills
JamaicaKewGardens
Hollis
Auburndale Bayside DouglastonGreatNeck
LittleNeck
MurrayHill
Broadway
Inwood
LocustManor
FarRockaway
East NY
Nostrand Av
MarbleHill
WTC
VANCORTLANDT
PARK
BRONXZOO
PELHAMBAY
PARK
ORCHARDBEACH
CENTRALPARK
WASHINGTONSQUARE PARK
METROPOLITANMUSEUMOF ART
RANDALLSISLAND
JAVITSCENTER
RIVERBANKSTATE PARK
INWOODHILL PARK
FORT TRYONPARK
UNITEDNATIONS
WTC Site9/11 Memorial
FLUSHINGMEADOWSCORONA
PARK
PROSPECTPARK
BROOKLYNBOTANICGARDEN
FORT GREENEPARK
GREEN-WOODCEMETERY
LAGUARDIAAIRPORT
JFKINTERNATIONAL
AIRPORT
JAMAICABAY
WILDLIFEREFUGE
GATEWAYNATIONAL
RECREATIONAREA–
JAMAICA BAY
EASTRIVERPARK
BROOKLYNBRIDGEPARK
KISSENAPARK
CUNNINGHAMPARK
MARINEPARK
FLOYDBENNETT
FIELD
JUNIPERVALLEY
PARKFOREST
PARK
RIVERSIDE PARK
HUDSON RIVER PARK
HIGHBRIDGEPARK
JACOBRIIS
PARK
LIBERTYISLAND
ELLISISLAND
NEW YORKTRANSIT MUSEUM
southbound only
except
n-bound
southbound
southbound only
6
Sexcept
7
2 3 and north-bound 4 5
BROOKLYN
MANHATTAN
QUEENS
THEBRONX
FINANCIALDISTRICT
BATTERY PARK CITY
CHINATOWN
LITTLE ITALYSOHO
TRIBECA
GREENWICHVILLAGE
CHELSEA
WESTSIDE
UPPEREASTSIDE
UPPERWESTSIDE
EASTHARLEM
HARLEM
WASHINGTONHEIGHTS
EASTVILLAGE
LOWEREAST SIDE
NOHO
RIVERDALE
KINGSBRIDGE
HIGH-BRIDGE
FORDHAM
TREMONT
MORRISANIA
THE HUB
HUNTS POINT
RIKERSISLAND
MOTT HAVEN
SOUNDVIEW
PARKCHESTER
CITYISLAND
BAYCHESTER
CO-OPCITY
EASTCHESTER
ASTORIA
LONGISLAND
CITY
ROOSEVELTISLAND
JACKSONHEIGHTS
CORONA
FLUSHING
HILLCREST
FRESHMEADOWS
JAMAICAESTATES
JAMAICA
HOLLIS
QUEENSVILLAGE
KEWGARDENS
KEWGARDENS
HILLS
RICHMONDHILL
FORESTHILLS
REGO PARK
MIDDLEVILLAGE
GLENDALEWOODHAVEN
OZONEPARK
HOWARD BEACHEASTNEWYORK
OCEAN HILL-BROWNSVILLE
CANARSIE
EASTFLATBUSH
MIDWOOD
BENSONHURST
FLATBUSH
PARKSLOPE
REDHOOK
GOVERNORSISLAND
CARROLLGARDENS
FLATLANDS
ROCKAWAYPARK
BREEZYPOINT
SHEEPSHEADBAY
BRIGHTONBEACH
CONEY ISLAND
BAY RIDGE
BOROUGHPARK
SUNSETPARK
BROOKLYNHEIGHTS
WILLIAMSBURG
FORT GREENE
GREENPOINT
BEDFORD-STUYVESANT
CROWNHEIGHTS
BUSHWICK
RIDGEWOOD
MASPETH
DUMBO
NAVYYARD
MTA
Sta
ten
Isla
nd R
ailw
ay
Grasmere
St. George
Tompkinsville
Stapleton
Clifton S51
Old Town
Dongan Hills
Jefferson AvGrant City
S51/81
New Dorp
Oakwood Heights S57
Bay Terrace
Great KillsS54 X7 X8
Eltingville
Annadale S55
Huguenot S55 X17 X19
Prince's Bay S56
Pleasant Plains
Richmond ValleyNassauS78
AtlanticS78
Tottenville S78
RICHMOND TERRACE
VICTORY BLVD
VA
ND
ER
BIL
T A
V
ARTHUR KILL RD
STATEN ISLAND EXPRESSWAY VERRAZANO-NARROWS BRIDGE
FOREST AV
HY
LA
N
B
LVD
HYLAN BLVD
AR
TH
UR
KIL
L R
D
WE
ST
SH
OR
E E
XP
WY
RIC
HM
ON
D A
V
SILVERLAKEPARK
SNUG HARBORCULTURAL CENTER
COLLEGE OFSTATEN ISLAND
SEAVIEW
HOSPITALSTATENISLANDMALL
NEWSPRINGVILLE
PARK
LA TOURETTEPARK
GREATKILLSPARK
CLOVELAKESPARK
STATENISLAND
PORTRICHMOND
WEST NEWBRIGHTON
MARINERSHARBOR
FOXHILLS ROSEBANK
CASTLETONCORNERS
BULLSHEAD
CHELSEA
WESTERLEIGH
TODTHILL
NEWDORPBEACH
WOODROWROSSVILLE
CHARLESTON
ARDENHEIGHTS
FRESHKILLS
RICHMONDTOWN
TOTTENVILLEBEACH
The subway operates 24 hours a day, but not all lines operate at all times. Call our Travel Information Center at 511 for more information in English or Spanish (24 hours) or ask an agent for help in all other languages (6AM to 10PM).
To show service more clearly, geography on this map has been modified.
visit www.mta.info
Key
December 2014
Full time servicePart time service
All trains stop (local and express service)
Local service onlyRush hour line
extension
Free subway transferFree out-of-system subway transfer (excluding single-ride ticket)
Terminal
Bus or AIRTRAINto airport
Accessiblestation
Additional expressservice
Normal service
Commuter rail service
Bus to airport
StationName
A B
New York City Subwaywith bus and railroad connections
Police
M60
© 2014 Metropolitan Transportation Authority
This map depicts weekday service.On weekends and late nights, these routes change:
Auburndale
Weekends
Late nights (midnight to 6am, daily)
42 St
No service-use CDQ
Delancey St/Essex St–
Metropolitan Av
Jamaica Center–Chambers St
57 St/7 Av–Coney Island
Dyre Av–Bowling Green
No service-use ADQ
No service-use A
Localservice
Local inBrooklyn
Local, 207 St–Far Rockaway.
Euclid Av-LeffertsBlvd Shuttle
Myrtle Av–Metropolitan Av
Shuttle
No service-use 7
Localservice
57 St/7 Av–Coney Island
local
Local via LowerManhattan
36 St–95 St,BrooklynShuttle
Dyre Av–E180 StShuttle
148 St–Times Sq/42 St
Local, Woodlawn–New Lots AvSkips Hoyt St
1904Of 468 stations in NYC subway system only 82
can be accessed by wheelchair users
www.mta.info
10
11
12
Subway
SubwayAutoGate
Atlanta
Subway
13
14
15
Subway
Subway“Rumble strips” along the platform edge are required by ADA.
SubwayCourtesy campaign
16
17
18
Subway
Atlanta
SubwayGaps between platform and cars are wide and uneven.
Subway
19
20
21
Subway/RailwaySwitzerland- MobiLift
Subway/Railway
Japan
22
23
24
Subway/Railway
Taxi
London has 100% wheelchair-accessible taxis including landmark BlackTX4 & swivel seat transfer assist.
There are 572 yellow taxis and 809 green borough NYC taxis that can take wheelchairs That is just 4.2% and 14% of the fleets, respectively.
TaxiThe $0.30 surcharge to each trip in a yellow taxi to assist in achieving the Cityʼs goal of a 50% wheelchair accessible taxi fleet by the year 2020.
No matter the question, the answer is always money!
25
26
27
Taxi
Taxi
www.EZlitecruiser.com
TaxiTaxi with meter for low vision
28
29
30
BusAll MTA buses are fully ADA-compliant.
Zurich- Tram
Bus
31
32
33
Bus
Access-a-RideThe MTA offers a door-to-door option for disabled persons, Access-A-Ride.
Access-a-Ride
34
35
36
Access-a-Ride
www.evrider.comStand N Ride
Appropriate equipment is the right equipment for that person for the activity.
Appropriate equipment may or may not be complex.
www.troxelhelmets.comGrand Prix Classic
Pavements, Curb cuts & City streetsWheeling in the city
SoHo Orlando
37
38
39
City Strong
Wheeling in the CitySeating Functions needed to augment mobility
Low VisionTactile Guidance Pavements
40
41
42
Used to provide tactile input thru the feet.Vibration and sound thru a walking cane.Friction & vibration thru wheelchair wheels.
Low Vision
Guidance PavementsWho does it Better?
JapanThe paving was first introduced in a street in Okayama city, Japan, in 1967.
GreeceDon't need to speak it to decipher the comments in red!
43
44
45
Guidance Pavements
Indianapolis
RampsRatios 1:12 ADA- Public & Government Buildings
2:12 Private & Residential 3:12 Unoccupied
RampsPre War Buildings
46
47
48
Ramps
Ramps
49
50
51
Ramps
Ramps
52
53
54
Bathing
Sliding Transfer Bench with Swivel Padded Seat Sammons Preston
Bathing
MultiChair 6000- Nuprodx
55
56
57
MultiChair 6000 w/tilt - Nuprodx Tub Transfer System- Shower Buddy
Bathing
Custom iBar MultiChair 6000- Nuprodx
58
59
60
Accessibility
Accessibility
Travel
61
62
63
Travel
http://mywheelchaircaddy.com
SeQual Eclipse concentrator packwww.oxygenconcentratorstore.com
wheelchair caddy
Travel
The next best thing!
Travel
64
65
66
City moms
Activity 24/7 Perspective
My favorite things...
67
68
69
Instructions
Repairs
My favorite things
My favorite things
9
4
21
3
8
5
6
7
ADDITIONAL MEASUREMENTS FOR BARIATRIC CLIENTS
Current weight:____________ Weight history:____________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
1. Back of knee /calf to back of buttocks (seat pan depth) ____________
2. Back of knee/calf to thoracic-lumber trunk (for seat depth) ____________
3. Seat pan to under forearm (armrest height) ____________
4. Seat pan to top of gluteal tissue (lower aspect of back support height) ____________
5. Width at toes (lateral aspect) ____________
6. Width from lateral calf to lateral calf (at widest aspect) ____________
7. Overall hip width ____________
8. Lateral elbow to lateral elbow ____________
9. Back of head scapula ____________
My favorite things
70
71
72
My favorite things
Guldmann ramp kit
Guldmann threshold ramp
My favorite things
aggreko-cable protectors
Rubber 5”rise ramp kitwww.1800wheelchair.com
My favorite things
Guldmann portable ramp
73
74
75
My favorite things
DecPac mini
PVI Slide Rule
My favorite thingsCarabiner clips
My favorite things
zip ties
kwiktwistwww. kwiktwist.com
Schwalbe Marathon Reflective- Kevlar City Tirewww.wiggle.com
76
77
78
My favorite things
Sugruwww. amazone.com
Self- Fusing Tapeswww.amazon.com
My favorite things
gloves for lifehttp://glovesforlife.com
My favorite things
Detecto portable wc scaleswww.detecto.com/
79
80
81
Medline Disposable 6-Point U-Slingswww.1800wheelchair.com
My favorite things
HoyerInvacareMedline
Prism Comfort recline slingwww.prismmedical.ca
My favorite things
My favorite things
Capacita-The Accessible Game Controllerwww.DIYAbility.org
82
83
84