Belts, belts and more belts!

Happy Friday Everyone!

In BC we are gearing up for the International Seating Symposium that is being held at the Westin Bayshore in Vancouver. This is a super exciting week for those in the wheelchair seating and mobility world. I will be presenting this year along with Lindsay Alford (OT). We will be presenting an instructional session called “The Art of Balance: Function and Posture in Wheelchair Seating”. We will be introducing a clinical reasoning model that we developed. Hope to see some of you there! Here is the link to the brochure if you are interested!

Also, Access Community Therapists will be also be hosting the “Introduction to the Assessment and Management of Eating, Drinking and Swallowing Disorders: A Clinical Approach” workshop on April 28th and 29th. Register quickly if you are interested as spaces fill very quickly! Check out the website for more information.

I thought that I would post some of the positioning belts that I’ve done over the years. Positioning belts can be critical in a seating system from a postural perspective, but are often so complex to integrate into a system as they can often have an impact on the way a client functions. Since we are presenting on this very topic, I thought I would give all of you a sneak peek!14

Here is a custom pelvic support with with angular molded sub-asis pads. The sub-asis pads are secured with swing away harware. Between the sub-asis pads, there are flexible straps connected with a standard push button buckle. The purpose of this belt was to create a rigid system that the client could use when her tone was quite strong. Alternatively, when her tone was quite mild, she could leave the swing away hardware open and simply secure the buckle to allow her to move more freely in the system. Cool eh?

DSC01736Here is an example of how changing a buckle can make all the difference in the world! This client couldn’t use a positioning belt before as it would impede his ability to transfer quickly. By introducing an airplane style buckle, he was now able to use a positioning belt, which prevented him from sliding down in his seating. YAY!

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Semi-rigid belt with evoflex

Here is a semi-rigid pelvic support made with custom sub-asis pads. This system was made for a client who needed more rigid pelvic support but needed to fasten and un-fasten the belt independently. This belt was also done in combination with a dynamic backrest on a light-weight rigid wheelchair frame. This is a nice example of how it is possible to improve postural control while maintaining a client’s ability to function independently.

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Swing away hardware on arcufit

This one is a custom arcufit style belt with a swing away hardware again. The purpose of this hardware though, was to clear the belt out of the way so that the back canes could be folded down to transport the wheelchair in a trunk.

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Custom Rigid Pelvic Saddle

Here is a custom rigid pelvic saddle. This system was created to prevent a client with very limited hip flexion from sliding down in their seating system. Note how much anterior control was needed to keep the client up in the system in order to maintain her ability to drive and be independent in the community.

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Custom pelvic harness for comfy chair

Remember this one? This is a custom “posey” style belt used in an alternate positioning device. This system was made for a client with a lot of tone that wanted a more comfortable option. In his mobility system, he uses a semi-rigid system. This is a nice alternative that is also necessary to reduce his risk for skin breakdown in a very rigid system that he has in his wheelchair.

I hope you liked this collection of positioning belts.For those of you going to the ISS this year, see you next week!

Thanks for checking in! Seating is Super!

Cheryl

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4 thoughts on “Belts, belts and more belts!

  1. Hi Cheryl, thanks for this post. I use pelvic belts and it was great to see the selection you have here. Have fun at the symposium, we have similar events in Europe. I find buckles hard to use because of my CP (spastic quad) especially anything that requires pressure, like a clasp you push from both sides. I am really interested in the Bodypoint range of belts and want to switch from a 2 point belt to a 4 point one. I prefer padded belts . Are the sub asis pads basically like extra padding on top of a padded belt? What area would they support? I can’t adjust a belt myself from the front at all because of lack of coordination and strength so think a rear adjust belt would be better so a caregiver can adjust it. would a rehab latch clasp be helpful for me? The clasp I have on my current belt at the moment is like the standard push button ones and the metal part of the belt is a flat shape. I still find this hard to use.
    I like the Stayflex trunk harness (also Bodypoint). Given a cargiver must open/ close/ adjust it, is a rear pull harness or front pull harness more appropeiate? What are the differences between the two types and which is best for spastic quad CP with fluctuating tone?

    • Hello chaneladdict81, sorry haven’t responded until now. To answer your question about sub asis pads, they are positioned right below the ASIS on both sides of the pelvis and are meant to make the belt more angular to provide more control. It often helps to reduce the tendency to rotate through the pelvis and hence lose positioning. I’m not sure which belt would work for you as I would need to do a full assessment. Same with he chest harness. It’s so hard to recommend equipment by a diagnosis as everyone is so different. Sorry about this! I would suggest asking your local therapist about these to see if something similar might work well for you. Thanks for checking in and for your message! Cheryl

      • Hey Cheryl! Thanks for the reply, not to worry that it is late- it has come at the perfect timing really as I am still trying to sort this out. I am not in Canada, but if I were I would see you. I had a positioning evaluation just under a month ago and was able to see the sub asis pads, and some Bodypoint harnesses. I am talking to local dealers about the possibility of more trials. So far, my recs are a 4 point belt and Pivot Fit harness, Bodypoint Ankle Huggers. I am kind of hoping to get more assessment from a sizing point of view seeing as that is an issue.

        As I need a new powerchair, cushion and possible new backrest, it is a matter of finding someone who can mount the product well to the chair I will buy as well as my current one, and fit it well to me which is mission impossible almost as I need complex positioning of every part of my body.

        Next step will be control options for my chair: I need to have the chair driven and guided by another person because spastic quad CP and hydrocephalus mean I cannot use a conventional joystick because of very tight muscles in my hands arms fingers and wrists. I have pain and lack of sensitivity so I cannot exert much pressure or grade the movement or amount of pressure.

        Have tried various joystick adaptations: small ball, large ball and dome shape but nothing works. Maintaining a joystick command via conventional means is extremely difficult and physically draining for me, and I do not have the level of independence I would like to have given my age, hobbies and lifestyle.

        A head array was suggested, but so far I have had problems trialling any alternative controls as a trial is tricky because they cannot just be ordered in and need to be tailored to the user. I am currently 34 years old and find it frustrating that my only means of moving around in my powerchair are by having someone else control it- I would like to be able to control it myself more independently however that is even if it is just for a few minutes before my attendant takes over. As you’ll appreciate, controlling the chair oneself is empowering and independence for the user.

        Advice about where and how I could trial before purchase? Most people I have talked to want me to just purchase outright and controls are so individual they need to be tailored to the person.

      • Hi Cheryl, just to say I have subscribed to your YouTube channel and really like your videos, they are the most informative I have found. A sub ASIS belt was suggested for me from a point of view of a better fit and protection around the area and also because I have a VP shunt for hydrocephalus, and the end of the drainage catheter ends around there. I wanted more protection aside from just a padded belt. Pelvic rotation is a huge problem for me, as is trunk stability.

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