Happy Thursday Everyone! and Happy Thanksgiving to our neighbours in the States! I hope that there are some good sales for all of those Black Friday shoppers out there. Today, I thought I would introduce a very cool product on the market. It’s called the “Drive Station” power wheelchair control that is essentially made from a video game controller. This product is made by Switch-It Inc and has two mini proportional joysticks as well as “action and direction pad buttons”. The client can use the proportional joysticks or the buttons to drive a power wheelchair. This is a very cool product that was originally designed for war veterans with Acquired Brain Injuries. Apparently, they found that some of these injured war veterans had more success learning to use the Drive Station control in comparison to a standard joystick. Perhaps because the system was quite intuitive and familiar…
Drive Station control connected to Quantum 6000Z power wheelchair electronics
Drive Station power wheelchair control with custom fabricated seating….stay tuned!
I have not trialed this product with any war veterans, however, I have recently trialed this product with a client with Muscular Dystrophy with Motion Specialties. What’s quite nice about this drive system is that it can be placed at midline and the client can use either their left or right hand to drive. This is a great option for clients who may fatigue quickly with one hand as they can easily switch to their other hand if needed. Also, if using the proportional joysticks becomes too difficult, the buttons on the Drive Station also can be used to drive the wheelchair. Some things to consider with this product, however, are that the proportional joysticks do have a bit more resistance than the go-to HMC Mini Joy. In addition, if the Drive Station is not mounted on a fixed mount, it could slide out of reach for some clients or be set-up in the wrong position for optimal access. I am currently still working on a custom seating system with Ability Health Care for this client. Once seating system and the custom mounting of this control is completed, I will definitely share the pictures with you so stay tuned!
Thanks for checking in today!
Seating is Super!
Happy Wednesday Everyone! I wanted to share with you a custom fabricated Thoraco Lumbar Sacral Orthosis (TLSO) that was fabricated by Alan Keith Valley Orthocare in Surrey, BC. This back brace was made for a client with C5 complete spinal cord injury. This client had very limited trunk control and had been using a custom fabricated ABS backrest for a while with a chest strap, however, due to the flexibility of her spine, these components still did not provide adequate control and support. This made it difficult for the client to establish appropriate sitting balance for functional activities, it made it difficult to manually self propel in a manual wheelchair and also resulted in constant and severe nerve pain.
This TLSO was fabricated by casting the client’s trunk in the desired position. Alan Keith, Orthotist, then fabricated the brace from the contours taken from the cast. Several follow-up appointments were made to adjust and tweek the brace. For example, the bottom of the TLSO was trimmed back to allow the client to lean forwards for transfers and for off loading for pressure relief. The top of the brace was flared for added comfort. Sheepskin pads was added as the client was developing redness at the back of the pelvis over her PSIS. In addition, foam pads were added to allow for additional clearance of the spinous processes, which were also prone to pressure if the brace moved slightly out of place. See the photos below.
Back of custom fabricated TLSO, opening for clearance of spinous processes
Sheep skin patches for reduced shearing at back of pelvis, additional foam added for further clearance of spinous processes
Solid front panel with flared top
Overall, the client using the brace has reported improvements with regards to nerve pain, sitting balance, ability to self-propel and function. It is important to note that if a TLSO is suitable for a client, the wheelchair seating must be adjusted to accommodate the brace. Also, it is important to note that a TLSO only really provides support and control for the trunk. What I found was that although the TLSO worked beautifully for this client, we ended up lacking support and control at the pelvis, which was resulting in the client falling into posterior pelvic tilt and falling into obliquity (right side higher). I will now be exploring custom cushion options with this client and will likely be trialing a Ride Custom cushion as this will likely be the best way to maintain her pelvic positioning while also preventing the risk for skin breakdown.
Thanks for checking in today!
Seating is Super!
Hello Everyone! I hope everyone had a great long weekend. I thought I would share some custom modifications to commercial wheelchair seating products. Often we use custom fabrication techniques to meet a client’s complex postural needs, however, it’s important to remember that commercial products can also be modified in a variety of different ways. Modifying equipment that a client already has can be a very cost effective option. Often times, simply making custom additions or changes with regards to set-up can make a huge difference to a client’s posture, comfort and function. The client that I was working with here has C5 Quadriplegia. He has a power wheelchair and commercial seating products but was feeling like he was collapsing forward through his trunk. This was affecting comfort, physical appearance and his ability to work on his computer. Another issue was that if his trunk fell forwards onto his lap when traveling in the community he wasn’t able to reach his tilt switch on his joystick. This was a concern as he needs to tilt back to re-position himself back upright independently. After completing a seating assessment and review, the following changes were made to his system: The custom modifications here, were completed by Wahbi at Advanced Mobility Products Ltd. The photos below are of a Jay 3 Backrest. Foam (I love foam!) was added to the lumbar region to improve contouring and support. In addition, the top of the backrest was heated and flared back to allow for more clearance for the client’s scapulae and upper back. Once the top of the backrest was flared, the headrest mount was spaced out to clear the top of the backrest.
Top of JAY 3 Backrest with custom flared top
The client’s armrest were also raised by 3 inches. This required custom armrest post extensions that were fabricated by Advanced Mobility. This allowed the client to support himself more upright by propping with his elbows. An Action gel overlay was added for pressure relief at his elbows. These were secured with velcro and could be removed by the client so that he can use them at his computer desk. The gel was originally covered, however, this made them too slippery.
Custom armrest height extension tubes
Action gel overlay (removeable)
In order to address the issue with access to the tilt function, a buddy button was added to the bottom of his seat pan. When this client fell forwards onto his trunk, he was easily able to reach under the seat pan to access the tilt switch. This made a significant difference for him as he would no longer need to wait for help if he ever lost positioning when traveling in the community independently.
Buddy button used for power tilt access
Switch mounted under seat pan
This client also uses the back canes to hook his arms onto for support. The back canes here were cut, angled out and re-welded to allow the client hook his arms around the back with more ease. Thanks again to Advanced Mobility for the great custom modifications. I hope you enjoyed reading about this case today. I would love to hear about your creative modifications to the seating systems you are working on. Please feel free to comment or post about anything interesting you have done out there. I would love to hear about them! Thanks again for checking in.
Seating is Super!
Hello Everyone! Here is a video on common postural terms used in wheelchair seating assessment. Although some of you may use variations of these terms, hopefully this video still helps as a quick reference! Please feel free to send me any feedback on these videos or even requests for other video topics. I would be happy to try put something together if it can be helpful to anyone out there. Thanks again to my talented friends, Desy Cheng, Kyle Hay and Jeremy Jude Lee at Vanmedia.
Thanks for checking in today! Seating is Super!