Stealth Products i-Drive and the REE at the ROO 2015

.: Stealth Products and Pride Mobility :.

Hello Everyone! I just wanted to say THANK YOU to all my amazing subscribers and readers. It has been a while since my last post, but thanks for always checking in. The past several months have been busy, which is great! Access Community Therapists just launched a new website – WOOHOO! – which I was lucky to be a part of. Check it out and let me know what you think!

Also, happy belated OT month to my fellow OTs! Occupational Therapy month was in October. There was so much OT spirit out there this year and it was so exciting to see so much enthusiam over social media over the past month.

Back in September we had the REE at the ROO and Access was lucky enough to get a private inservice by Mark Scott from Stealth Products. Since I am still technically on maternity leave I was able to bring my son, ‘T’ to the REE and the inservice by Stealth. Mark was even kind enough to entertain ‘T’ with his fabulous cartoon character impressions! Thanks Mark! Anyways, back to wheelchair business!…..

It was great learning about the new i-Drive system and seeing how to use it with their head array drive control and fiber optic switch. Stealth has designed their head array with proximity sensors, which allows the system to be activated once the user is close enough to the pad without needing to physically contact it. The distance required to activate the head array is programmed with the i-Drive system. Although proximity switches are not new in this industry, this head array is particularly smooth and allows the user to have optimal control based on their individual abilities/movements.

The i-Drive system also makes it possible to program and adjust their drive controls through a smart phone or tablet rather than a specialized remote. In addition to sensitivity settings, the head array set-up with the i-Drive is particularly exciting as it can also customize channel assignments and also has “double tap assignment” and “double tap timing adjustment”. This means that any pad or switch can be programmed to control a power chair to move in any direction. Also, by holding 2 switches at the same time, can allow the user to switch directions or switch modes on their wheelchair. This is super exciting as the user only requires 2 reliable directional movements in order to control a power wheelchair to move in 4 different directions and control the modes on their chair. For example, if a client can only reliably hit the back occipital pad and the left temporal pad, by hitting them at the same time can allow the user to move in another direction such as to the right. Then, hitting it again can allow the chair to move in other direction such as backwards. Double tapping either the back or left pad can then be programmed to access the modes of the chair.This was super cool!

In addition to showing us the i-Drive, Margaret and Sydney from Pride Mobility also brought in their new Q6 Edge 2 power wheelchair, which is a midwheel drive power base. This version has notable changes to the aethetic design of the base. They’ve also created a very sturdy base with a strong footplate as you can see from Mark standing on it. In addition, Sydney informed me that Pride has improved the sensitivity of the drive. This hopefully addresses the feedback they were getting from the previous version of the Q6 Edge. Definitely worth a trial with all of these improvements!

.: REE at the ROO :.

The REE at the ROO was once again a great exhibition. It was great seeing so many familiar faces at the event and there were many new products to see. Upon walking in, I ran into Dean Robertson, who has just started a company called Access Driver Rehab Specialists. He was showcasing new hand controls from the UK that he has been working with. These are not only aesthetically pleasing, but also very functional. The hardware is quite minimal and there is also voice activated controls.

Permobil debuted their new F3 and F5 power bases. Both bases have a new distinct design and aesthetic that is different than the former Permobil lines. The F3 and F5 are front wheel drive power bases that offer a variety of power functions including anterior and posterior tilt, seat elevation and on the F5, power standing. Check out their website for more information! These chairs are definitely really cool!

I had the pleasure of meeting Russ Rolt from Active Controls again at the REE. He was showcasing the new proportional chin control joystick and new mounting hardware for the Center Drive System. Based on feedback, Active controls has made the Center Mount Drive System adjustable so that it can be brought closer to the client. The system now has a ball joint, which allows for much improved positioning capabilities. YAY! I also want to thank Bill Randall from NuVision Rehab and Russ Rolt for the sample Power Buddy. This is a power port that you can plug into your power wheelchair to charge your electronic devices like your phone or GPS. Check this product out here!

Nathan Buskell at Motion Specialties had their custom lateral tilt mechanism on display at the REE. This was a nice, smooth lateral tilt that didn’t require much force to activate. The only con, would be the placement of the handle/wheel needed to engage the lateral tilt as it is low on the wheelchair, although this is often an issue with many of the custom lateral tilts out there. A nice design overall though!

Sunrise Medical was debuting their new Quickie Xperience 2. This midwheel drive power base now has an external power seat function box that can be mounted in front of the joystick. Definitely a nice option!

The Roho Group was showcasing their Smart Check device that allows users to check the inflation of their cushion once it has been properly set. This is a fabulous device however, there has been some feedback that it can be a bit tricky to use. It is also quite expensive. If, however, it can be set-up properly, it is an invaluable tool to have with a Roho cushion.

And last, but certainly not least, Advanced Mobility had the Firefly power assist to demo at the REE. This was indeed a fun product. Easy to drive and incredibly fast, smooth and peppy! This product is being exclusively distributed by Advanced Mobility in the lower mainland. Contact them to try one out.

That’s all for today! Thanks for checking in. As always,

Seating is Super!

Cheryl

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The REE at the ROO 2014

Happy Monday Everyone! Access was at the REE..yippee! We had a blast pressure mapping people, mingling with OTs, students, clients, vendors and manufacturers.

Thanks to everyone who stopped by. It was a pleasure meeting all of you. Now, on to the equipment stuff! Here is my summary of the highlights of this year’s Expo.

Active Controls was at the REE again this year. See my post from last year here! Luckily, we had a preview to their new equipment before the REE thanks to Bill Randall at NuVision Rehab. Active Controls was again showcasing their innovative Center Drive System, which connects to a series of different joysticks. The photos below are a few that caught my eye this year. The yellow joystick is called the MicroGuide. This joystick only requires 40 grams of force to activate the control. It was a super nice design that stays in place when in use. This is great for stability when driving. The supportive pads on the sides were also quite nice. Russ Rolt from Active Controls informed us that these were moveable and adjustable. He even told us about a case study where the pads were moved to block the joystick from driving to one side. This was used for the client with CP, who could only steer towards the right. With the pad in place, he was able to drive forwards and back by using the hand supports as a barrier. A nice application and great idea! Below I also have a photo of the Switch-it Touch Drive 2. I’ve written about this product before, but this was my first time trying it out. It was a nice product, but for the right client. It requires a bit more movement through the hand as you need to drag your finger across the screen, then hold to activate the control. Russ mentioned that it often worked best for clients used to using a touch screen for other activities.

Active Controls also allowed us to demo their new head array control with their Center Drive System mounted at the back of a wheelchair. The Center Drive System mounted at the back allowed for easy trials. It was also a very sturdy mount. Russ also showed us the Joybar mounted at the back as an attendant control. By having a receiver at the front and back, you could easily switch a joystick from client use, to attendant control.

So last, but definitely not least, Active Controls has a new Chin Control joystick that is set up with their Center Drive System. This was a very nice product. It worked well with the mounting and was very stable. Check out their website for videos and more information on their innovative products.

Also present at the REE was Symmetric Designs, which is a local manufacturer based on Salt Spring Island, BC. They were showcasing their Free Form Back. This impressive design is available in 4 sizes and comes with a breathable spacer fabric cover. The unique design of this backrest allows for the individual brackets to be twisted and moved to accommodate a client’s contours or provide correctional forces wherever required. What’s nice about this product is that the adjustments can be made anytime. The best feature of this product is that it is so breathable. So many clients, who require a lot of contouring report being quite hot in these systems. This would be a nice option for a client like this.

At the Ability Health Care booth, they were displaying a custom power system that they created, for a client of mine! This system was designed to allow a client with Achondroplasia to transfer independently. This system will be set up with a custom backrest and cushion. Keep checking in to see the final product!

Ability Health Care was also showing off their new carbon fiber backrests. With these backrests, clients will initially be set up with a custom molded plastic back. Once the shape and design is perfected, a carbon fiber backrest can be made off of the shape of the plastic back. Carbon fiber cannot be changed once it is formed and therefore the plastic back must be a perfect fit before moving on to the carbon version. Of course, the benefit of the carbon fiber is its light weight…and aesthetic!

Another new product on the market is the Rifton HTS or Hygiene, Toileting System. I just set this product up for a client of mine with CP who needed a commode with a very low seat to floor height for transfers. It is a nice design that is super easy to adjust. The family loved it because they could adjust and remove the seating components as needed. Motion Specialties had this product at the REE this year.

Dynamic Health Care Solutions had a few new items. Vicair has come out with a new design for their air cells. YAY! The edges of the cells are now rounded and they have redesigned the cells with a different material to prevent them from deflating. They have also re-designed their backrest hardware and brackets. The design is quite nice as the mounting bracket itself is quite small with lots of adjustment. Motion Composites has also released an HD/Heavy Duty version of their Helio. The key to the design is the carbon fiber cross-brace, which makes this folding manual very light-weight and sturdy.

Priority Posture Systems Ltd was showing off their custom dynamic footrests. This was designed by Dave Cooper and is currently being used at Sunny Hill Health Centre. This product is ideal for those with Spastic CP who have difficulty with leg positioning and protection. Ideally, these are set-up with shoe holders, which allows the client to kick down, out and forwards. Other products on the market are limited to just an up and down motion, which generally is not adequate for many clients with significant tone and strong movement patterns.

Priority Posture Systems Ltd was also displaying their custom/off the shelf cushion for single foot-propelling clients and their raised toilet seat with cut out with silicone coating. These products are priced lower than a typical custom product, but were made with a universal design in mind. The cushion is a nice design with ischial block, full femur support for the client’s affected side, and slanted cutout for the foot-propelling side. Please contact James Cooper, if you would like more information on these products.

Westech Health Care Ltd is now distributing Ranger Wheelchairs. Ranger has just released the Batam rear wheel drive power base that has been made to be even more compact than their Express model. Check it out!

Sunrise Medical has made some changes to their more popular manual wheelchair models. The Quickie Iris for example now has several improvements including covered rockers to prevent debris from collecting in the spaces, new front rigging mounting, new pin style for the rockers and new matte colours!

The Quickie 2 also has the new front rigging mounting as well as a new light weight wheel rim option at no charge!

Advanced Health Care (AHC) was also showcasing some products with the Roho Group. The t-zone mattress, was being displayed. Here is a picture of it as I didn’t have one the last time I announced it.

Finally, here is the Blake Medical backrest. I announced this product last year after the REE, but I somehow missed it the last time. Here it is this year! The backrest is lined with their comfort gel, which makes for a very nice, soft AND comfortable backrest.

That’s all for today folks! Thanks for checking in!

Seating is Super!

Cheryl

REE at the ROO

Hello Everyone! Welcome to my very first post! The Rehab Equipment Expo at the Richmond Olympic Oval (REE at the ROO) was held on Monday, September 9th, 2013.  The entrance fee was only $2, which was waved if you arrived by transit, shuttle, biked or carpooled, so, definitely worth a visit!  The venue was great and the exhibit booths were informative with lots of equipment to see and demo.  I always enjoy browsing the equipment and trying things out.

Advanced Mobility was debuting their JACO by Kinova, a joystick controlled robotic arm. Kinova was founded in 2006 and is a Canadian based company. This robotic arm consists of six axes of movement and even has a 3-fingered hand. The product was inspired by the creator’s family members who had Muscular Dystrophy. This isn’t by any means a cheap product, but the functional benefits for a client would be unparalleled. With the right funding, this product would make a huge difference in someone’s life. I will definitely be keeping this one in mind!

Active Controls Rehab Solutions had an exhibit booth and were showing off their new Center Drive System. This product definitely caught my eye at the Expo this year. This product can work with most power wheelchair bases (except for Invacare bases) and is essentially a joystick that can be removed and plugged back into place quickly and easily. The mount for the Center Drive System can be set up in various positions however, at the expo, the system was set up at the center of the seat and behind the backrest as an attendant control. The tiller style joystick (or “JoyBar”) was a creative design that would definitely be appealing to clients who like the scooter style drive, but require more supportive seating from a power wheelchair base. The Center Drive System can be even be paired with a variety of different joystick options including the Switch-It drive controls, which have a variety of great products including the Touch Drive 2, the Micropilot miniature joystick and integrated tray and switch drive controls. The pads/hand supports on both sides of the joystick are quite nice as well. Very soft and comfortable. I am definitely looking forward to trying these products out with a client!

Body Point also had a few new items. On their chest harness they have designed a clip at the front of the chest harness that can swivel while its secured. This is a nice design as it will help to keep the harness in place over the chest and shoulders. At their booth, they were also showing off their new commode/shower chest straps. The material of these chest straps were antimicrobial and were also perforated for quick drying. The material was soft to touch. I will definitely be trying these out soon.

The ROHO group has a new backrest called the Agility back system. This is a nice design with Roho air cells down the center of the back and along the laterals. Great for pressure relief along the spinous processes and along the ribs on the laterals.  The backrest has some mild midline guidance and would likely benefit a client needing lower lateral contact. There is also a milder contoured backrest with air cells only along the back. Although this back is quite simple, extra foam can likely be added for better contouring, support and control. The back of the backrest can also be customized with colour panels, which is a nice option for the user.

Vicair has also come out with a backrest. The NXT VC backrest is a moderately contoured backrest with Vicair air cells that can be moved around to different sections in the backrest (similar to their cushions).  Moving the air cells around will allow for accommodation as well as increased contact and support at different parts of the trunk/spine while still providing pressure relief. Definitely a different and interesting concept for a backrest that could definitely work with some clients. Like the cushions, for clients who have sensation, this product will likely work best if they prefer the feel of the Vicair cells. I’ve been finding that some clients love the feel of the air pockets while others don’t prefer them.

Ride Designs has created new mounting hardware for their backrest. This is a nice design that allows for more flexibility with regards to positioning. What’s particularly unique about this hardware is that it allows the backrest to be mounted forward from the canes. Standard mounting hardware does not usually allow for this. Overall, this hardware is streamlined and has a nice clean aesthetic.

Ability Health Care has been making custom fabricated ABS backrests. These backrest have worked well for many clients with severe spinal curvatures that are difficult to control and support with a commercial backrest. These backrest are light weight and ideal for manual wheelchair users who don’t want to add a lot of weight to their system but require the support and control to function and manually self-propel. These backrests are made by taking a cast of the client’s back. Once the cast is set, the ABS is heated and molded to the cast shape. What makes these backrest special are that they can be mounted at any height, position or orientation. If funds are available, these backrests are a great option.

Quantum Rehab has launched a new Tru Balance 3 Rehab seat. This seat is priced on the higher end but offers power tilt, recline, seat elevation, and articulating footrests. The sides of the seat and armrests are designed to allow various mounting options for seating components and assistive technology.

The FreeWheel is a removeable wheel that can be secured to a manual wheelchair with a rigid footrest. It is designed to manage rough or uneven terrain. Clients that have this product often take this when traveling as it enables them to  manage terrain like cobblestone sidewalks or even sand (apparently)! It is quick to put on and take off, which makes this product incredibly versatile.

The Smart Drive is a product by Max Mobility. It’s a new power assist device that mounts to the back of a manual wheelchair and can be removed when it isn’t needed. Other power assist systems are set-up through the wheels. If a client wanted to remove these, they would need to bring another set of standard wheels with them, which isn’t practical. Clients with products like the Magic Wheels (power assist wheels) will often leave them on at all times. What’s nice about the Smart Drive, is the ability for the client to set-up and remove the system as needed.

The TiLite AERO T is a light weight aluminum rigid frame manual wheelchair. The dual tube style has been used here to achieve a lighter weight without sacrificing strength and durability. I was asked to feel the weight of 3 different sized tubes and it was clear that the narrowest tube was far lighter than the other wider tubes. The total weight of this base is 12 lbs.

This new wheelchair is called “Elevation” and has been designed by Instinct Mobility. PDG is now distributing this product, which is quite exciting. This is an incredibly unique manual wheelchair that has 10 inches of dynamic seat dump and elevation and 30 degrees adjustment to the back angle. Essentially, this wheelchair allows a client to move from sitting to standing by simply engaging a lever located on the seat rails of the chair. (Note: There is a video of this on the Instinct Mobility website). This wheelchair has been designed primarily for clients with paraplegia but modifications can be made to the placement of the levers to make it possible for clients with other functional abilities to use it.  Although this manual rigid wheelchair is heavier than others on the market, the functional and medical benefits of this system are significant. Definitely worth a trial with the right client.

Priority Posture Systems Ltd. are now fabricating alternate positioning devices or “comfy chairs”. The foam in these comfy chairs are custom carved to meet a client’s unique or complex postural needs. These systems can also include a dynamic tilt option and elevating legrests that are operated by hand levers (similar to manual wheelchair tilt systems). These systems are quite aesthetically pleasing and are upholstered in the fabric of the client’s choosing.

The i2i is a Stealth Products head and neck positioning system. I have used this product a couple of times and it has worked very well for clients with head and neck flexion, extension, side flexion or rotation deformities. This product is great but must be trialed to determine whether a client can tolerate such rigid control.

There were so many great new products at the REE this year. One product that I missed, but heard about afterwards was the Blake Medical Geo-Matrix Silverback Backrest. This backrest apparently integrates the blake gel for added pressure relief and comfort. Definitely a product I wish I didn’t miss. I will have to get a picture of this one soon to show all of you!

Thank you for checking in today. Seating is Super!

Cheryl

EVENTS & COURSES

 .:  MOTION SPECIALTIES GRAND OPENING  :.

Motion Specialties had their grand opening at their new location on North Fraser Way in Burnaby. It was a fun event with equipment demo sales, a power wheelchair obstacle course, contests and prizes and some great manufacturer exhibit booths. FYI, they will be honoring their special demo prices for the next couple weeks. So, if you have a client with limited funding, contact Motion ASAP to see if they have anything available that might work for a client of yours! I love looking at demo equipment as I often have clients who need equipment that may not be eligible for funding. At a discounted rate, however, some funders may be willing to provide funds if the needs are there. On another note, here are a few seating related highlights from the event!

NXT (pronounced “Next”) by Dynamic Health Care Solutions displayed their new lateral supports. Its a swing away style lateral support that has an additional anterior pad. This is a neat design and the hardware is quite adjustable in length. Because of the rigidity of the anterior support, it might be an option for a client who requires more support than chest strap can provide. In the second picture, note that there is a blue lever that releases the swing away mechanism. This was a really innovative mechanism that could be easier for some clients to release themselves. This would need to be trialed to determine suitability of course, but still a really neat idea!

NXT also debuted 3 new foam cushions: the Bio Fit, the Nu Fit and the Kul Fit. These are mild contoured foam cushions. All of the cushions are made with foam with antibacterial properties. The Bio Fit has a layer of Blue Visco Gel foam that helps to reduce heat build up and also has perforations for increased comfort and softness at the seat area. The Nu Fit cushion is similar in feel to the Bio Fit, but only has a soft foam overlay rather than the gel infused foam overlay. The last cushion was the Kul Fit cushion. This was a very interesting cushion as it was made out of breathable reticulated foam. This foam is quite spongy in feel and allows liquids to pass right though it. This would be great for a client with incontinence issues and needs to wash their cushion frequently. It was quite comfortable to sit on and was a firmer cushion relative to the others. I would be interested in pressure mapping this one for sure.

Motion Composites has a new carbon fiber manual wheelchair called the Veloce. This is a very light (8 kg or 18 lbs) folding frame wheelchair with a sporty, streamlined design. It is a chair that is designed to fall between the manual folding frames and a rigid manual. This wheelchair was easy to maneuver and self-propel.  I definitely have clients that manually self-propel, but still need a mobility device that can be folded for transport so, this might be a great option for them! I also really liked the flip up style footplate. This design is not available on most rigid frame wheelchairs, which can be an issue for some clients who need to stand to transfer. Although this isn’t a rigid wheelchair, the weight and design of the wheelchair might make this wheelchair somewhat comparable. I’m looking forward to trialing this one soon to see how it really performs.

Invacare brought 3 cushions to demo at the grand opening. The first was the Matrx PSVF cushion or “Posture Seat Visco Foam” cushion. This is a super soft foam cushion with some mild contouring. This cushion was designed specifically for optimal comfort. They also had the new Stabilite cushion, which had a “Thinair” bladder for added pressure relief. This cushion also had rigidizers on the sides that help to prevent the cushion from slinging on an upholstered seat. This was a firm, but comfortable cushion that had a mild to moderate contour. The last cushion was the Matrx Flovair, which had the “Thinair” bladder as well as a fluid gel overlay. The fluid gel is meant to reduce shear, while the “Thinair” bladder is meant to reduce peak pressures. The Flovair and Stabilite cushions were reported to pressure map better than the Matrx Vi line. I have yet to pressure map these myself, but I could see these cushions working well for a client requiring a firm supportive surface for sitting, some contouring, but also would benefit from added pressure relief.

Invacare also had their powered Aquatec Ocean E-VIP commode on display. This is an ideal commode for caregivers as the seat elevates making it much easier for peri care. They also debuted their “Special Soft Seat“. This is a new product, not to be confused with their “soft seat”. This product would be ideal for clients who require extra pressure relief due to either high risk for skin breakdown or long bowel routines.

.:   SEATING AND POSITIONING WORKSHOP  :.

Access Community Therapists held the “Seating and Positioning in the Community: Practical Applications” workshop at Motion Specialties in Burnaby on September 27th and 28th. Despite the torrential rains on Friday and Saturday, it was a great turn out and we had a lot of fun practicing landmarking, mat and sitting assessments and even got to work with some volunteer clients.  Here are some photos from the day. FYI, we are hosting the course again on November 29th and 30th. If you would like to register for the course, check out the Access website.

.:  REE AT THE ROO :.

Hello Everyone! Welcome to my very first post! The Rehab Equipment Expo at the Richmond Olympic Oval (REE at the ROO) was held on Monday, September 9th, 2013.  The entrance fee was only $2, which was waved if you arrived by transit, shuttle, biked or carpooled, so, definitely worth a visit!  The venue was great and the exhibit booths were informative with lots of equipment to see and demo.  I always enjoy browsing the equipment and trying things out.

Advanced Mobility was debuting their JACO by Kinova, a joystick controlled robotic arm. Kinova was founded in 2006 and is a Canadian based company. This robotic arm consists of six axes of movement and even has a 3-fingered hand. The product was inspired by the creator’s family members who had Muscular Dystrophy. This isn’t by any means a cheap product, but the functional benefits for a client would be unparalleled. With the right funding, this product would make a huge difference in someone’s life. I will definitely be keeping this one in mind!

Active Controls Rehab Solutions had an exhibit booth and were showing off their new Center Drive System. This product definitely caught my eye at the Expo this year. This product can work with most power wheelchair bases (except for Invacare bases) and is essentially a joystick that can be removed and plugged back into place quickly and easily. The mount for the Center Drive System can be set up in various positions however, at the expo, the system was set up at the center of the seat and behind the backrest as an attendant control. The tiller style joystick (or “JoyBar”) was a creative design that would definitely be appealing to clients who like the scooter style drive, but require more supportive seating from a power wheelchair base. The Center Drive System can be even be paired with a variety of different joystick options including the Switch-It drive controls, which have a variety of great products including the Touch Drive 2, the Micropilot miniature joystick and integrated tray and switch drive controls. The pads/hand supports on both sides of the joystick are quite nice as well. Very soft and comfortable. I am definitely looking forward to trying these products out with a client!

Body Point also had a few new items. On their chest harness they have designed a clip at the front of the chest harness that can swivel while its secured. This is a nice design as it will help to keep the harness in place over the chest and shoulders. At their booth, they were also showing off their new commode/shower chest straps. The material of these chest straps were antimicrobial and were also perforated for quick drying. The material was soft to touch. I will definitely be trying these out soon.

The ROHO group has a new backrest called the Agility back system. This is a nice design with Roho air cells down the center of the back and along the laterals. Great for pressure relief along the spinous processes and along the ribs on the laterals.  The backrest has some mild midline guidance and would likely benefit a client needing lower lateral contact. There is also a milder contoured backrest with air cells only along the back. Although this back is quite simple, extra foam can likely be added for better contouring, support and control. The back of the backrest can also be customized with colour panels, which is a nice option for the user.

Vicair has also come out with a backrest. The NXT VC backrest is a moderately contoured backrest with Vicair air cells that can be moved around to different sections in the backrest (similar to their cushions).  Moving the air cells around will allow for accommodation as well as increased contact and support at different parts of the trunk/spine while still providing pressure relief. Definitely a different and interesting concept for a backrest that could definitely work with some clients. Like the cushions, for clients who have sensation, this product will likely work best if they prefer the feel of the Vicair cells. I’ve been finding that some clients love the feel of the air pockets while others don’t prefer them.

Ride Designs has created new mounting hardware for their backrest. This is a nice design that allows for more flexibility with regards to positioning. What’s particularly unique about this hardware is that it allows the backrest to be mounted forward from the canes. Standard mounting hardware does not usually allow for this. Overall, this hardware is streamlined and has a nice clean aesthetic.

Ability Health Care has been making custom fabricated ABS backrests. These backrest have worked well for many clients with severe spinal curvatures that are difficult to control and support with a commercial backrest. These backrest are light weight and ideal for manual wheelchair users who don’t want to add a lot of weight to their system but require the support and control to function and manually self-propel. These backrests are made by taking a cast of the client’s back. Once the cast is set, the ABS is heated and molded to the cast shape. What makes these backrest special are that they can be mounted at any height, position or orientation. If funds are available, these backrests are a great option.

Quantum Rehab has launched a new Tru Balance 3 Rehab seat. This seat is priced on the higher end but offers power tilt, recline, seat elevation, and articulating footrests. The sides of the seat and armrests are designed to allow various mounting options for seating components and assistive technology.

The FreeWheel is a removeable wheel that can be secured to a manual wheelchair with a rigid footrest. It is designed to manage rough or uneven terrain. Clients that have this product often take this when traveling as it enables them to  manage terrain like cobblestone sidewalks or even sand (apparently)! It is quick to put on and take off, which makes this product incredibly versatile.

The Smart Drive is a product by Max Mobility. It’s a new power assist device that mounts to the back of a manual wheelchair and can be removed when it isn’t needed. Other power assist systems are set-up through the wheels. If a client wanted to remove these, they would need to bring another set of standard wheels with them, which isn’t practical. Clients with products like the Magic Wheels (power assist wheels) will often leave them on at all times. What’s nice about the Smart Drive, is the ability for the client to set-up and remove the system as needed.

The TiLite AERO T is a light weight aluminum rigid frame manual wheelchair. The dual tube style has been used here to achieve a lighter weight without sacrificing strength and durability. I was asked to feel the weight of 3 different sized tubes and it was clear that the narrowest tube was far lighter than the other wider tubes. The total weight of this base is 12 lbs.

This new wheelchair is called “Elevation” and has been designed by Instinct Mobility. PDG is now distributing this product, which is quite exciting. This is an incredibly unique manual wheelchair that has 10 inches of dynamic seat dump and elevation and 30 degrees adjustment to the back angle. Essentially, this wheelchair allows a client to move from sitting to standing by simply engaging a lever located on the seat rails of the chair. (Note: There is a video of this on the Instinct Mobility website). This wheelchair has been designed primarily for clients with paraplegia but modifications can be made to the placement of the levers to make it possible for clients with other functional abilities to use it.  Although this manual rigid wheelchair is heavier than others on the market, the functional and medical benefits of this system are significant. Definitely worth a trial with the right client.

Priority Posture Systems Ltd. are now fabricating alternate positioning devices or “comfy chairs”. The foam in these comfy chairs are custom carved to meet a client’s unique or complex postural needs. These systems can also include a dynamic tilt option and elevating legrests that are operated by hand levers (similar to manual wheelchair tilt systems). These systems are quite aesthetically pleasing and are upholstered in the fabric of the client’s choosing.

The i2i is a Stealth Products head and neck positioning system. I have used this product a couple of times and it has worked very well for clients with head and neck flexion, extension, side flexion or rotation deformities. This product is great but must be trialed to determine whether a client can tolerate such rigid control.

There were so many great new products at the REE this year. One product that I missed, but heard about afterwards was the Blake Medical Geo-Matrix Silverback Backrest. This backrest apparently integrates the blake gel for added pressure relief and comfort. Definitely a product I wish I didn’t miss. I will have to get a picture of this one soon to show all of you!

EQUIPMENT

.:  JAECO  :.

I would like to share with you a product called the JAECO. This product is really cool and was shown to me by James Cooper from Priority Posture Systems Ltd. James has the only demo model of this product in Western Canada and I was super excited to see it in action! The JAECO is essentially a dynamic orthosis or exoskeleton that can enhance a client’s upper limb function by assisting them against gravity. The system can be mounted on a wheelchair or even a table top and is secured to the client’s arm with strapping. The JAECO can be adjusted to meet the client’s needs through the number of blue elastic bands added onto each part of the system. Check out the photos below!

James has informed me that he has set up this product for clients with various conditions including Muscular Dystrophy and Spinal Cord Injury (Quadriplegia). It has helped clients with a variety of functional activities including eating and drinking independently and even with work based activities such as computer work or other table top tasks. As you can imagine, a product like this could greatly improve a client’s independence and function. Definitely an interesting product worth a trial for the right client!

.:REAR WHEEL DRIVE POWER WHEELCHAIRS:.

Access was fortunate to have the opportunity to have an inservice with KCI at Motion Specialties. They brought in their new mattress technology called the AtmosAir. This mattress consists of SAT (or “Self-Adjusting Technology”)cells that essentially self-adjust to the weight and level of load from the client. Click here to see more about this product. This is a product that is marketed as a “no maintenance mattress”. Definitely a neat product worth a trial and a pressure mapping session at some point to see how it measures up to others.

Motion Specialties also provided us with an inservice on Rear Wheel Drive Power Mobility. This was a great inservice with lots of valuable information.  Many of our clients who live in rural areas across the Province rely heavily on rear-wheel-drive bases as they are better able to manage the terrain and weather. Here is a synopsis of our session:

1) Invacare Storm Series: Torque SP, Arrow and Ranger X:

  • Torque: plastic polymer suspension (yellow plastic at rear castors)
  • Ranger X and Arrow have spring shock suspension (yellow coil at reach castors)
  • Ranger X: Bariatric (400lb weight capacity)
  • Frame: frame width is 26.5″, with two lengths: short: 28.5 and long: 31.5
  • Speed: Torque and Arrow: 6.5mph, Ranger X: 5mph
  • Lowest STF height (no tilt): 17.75″
  • Pricing starts at: $8909
  • Personal impression from trial: Generally speaking, I find Invacare wheelchairs to have a very smooth, intuitive drive. This could be great for a client who may need an easier to drive and learn to drive wheelchair. It is also a fairly quiet power wheelchair. For clients who prefer a lot of power and torque, this may not be the first choice, however, overall a nice ride.

2) Quantum Rival:

  • Points of interest: the base is quite long compared to others. Replaced the R4000
  • Frame: width is 25.25″, length is 36″ (which is 5″ longer than the Torque)
  • Suspension: Active Track ATX with rear spring suspension
  • Speed: 6 mph, with high speed available (up to 7.5 mph)
  • Lowest STF height (no tilt):16.5″ (lower than Torque)
  • Pricing: starts at $8406
  • Unfortunately, we didn’t get to trial this one as there weren’t any at Motion at the time. This chair is however, marketed as a “rugged” power base. Feel free to let me know if you have any impressions of your own!

3) Sunrise Xplore:

  • Points of interest: This base has a lowest STF height. Also, rear wheel is forward biaised for it has 6 wheels on the ground for stability
  • Frame: width is 25.5″ and the length is 36″
  • Suspension: Very soft suspension (same as the Experience), meant to absorb vibrations.
  • Speed: 6.5 mph
  • Lowest STF height: 15.25″ without tilt and 17″ with tilt
  • Pricing: starts at $9650 (NOTE: This base is on the higher end. Also, repairs to the Experience and Xplore can cost more than an Invacare base due to the cost of parts. This is important to note for Ministry funded clients who may want to upgrade with personal funds. If the repairs cost more than the funded wheelchair, the client could be responsible for the difference in cost for the repairs)
  • Personal Impressions from Trial: This power base was quite smooth but peppy! It was also quite intuitive, but the drive can be quite a shock if you aren’t used to a quick start. Would be good for clients who prefer this kind of drive.

4) Sunrise Quickie 646:

  • Points of interest: This is an aggressive power base. Rear wheels are forward biaised so that the rear anti-tippers contact the ground.
  • Frame: width is 25.75″ and length is 33.5″
  • Suspension: Rockshox suspension that can be adjusted based on client weight and ride preference
  • Speed: 8.5 mph
  • Lowest STF height: 18″ without tilt
  • Pricing: $11,275 (this is the most expensive of the bunch)
  • Personal Impression from Trial: This was another very peppy power base. I found this base to be quite “jerky”, but still intuitive enough to drive. Definitely a base for a client needing a more aggressive base. This base also has a very high speed compared to the others. Considering the price, this base would be ideal for a client really needing the extra power and speed, who can tolerate or prefers a more aggressive drive.

5) Permobil C350:

  • Points of interest: This chair has one of the better suspensions and is a quiet base. The style of the base is also more subdued in design.
  • Frame: 24.5″ wide, 36″ long
  • Suspension: Shock Absorbing Suspension System with coil shocks on from swing arms and rear anti-tippers
  • Speed: 5mph, this is a slower base compared to the rest, but Permobil will be making the high speed option of 6.5mph a standard feature in the future…
  • Lowest STF height: 18″ without tilt
  • Pricing:$7675, this is the cheapest power base of the bunch!
  • Personal Impression from Trial: This is a very quiet and smooth ride. Probably the smoothest and quietest base of the group. Clients who like a quiet, smooth and intuitive ride with a modern looking base will definitely prefer this base. Unfortunately, many rear wheel drive power wheelchair users generally prefer a more powerful, “torquey” drive. This is probably not the base to choose for a client needing to manage rough terrain.

6) Sunrise P222SE:

  • Points of interest: This is a tippy power base, but is also quite fast. It’s an older model base, but clients who still have them, really love them.
  • Frame: 24.5″ or 25.5″ wide, 31.5″ long
  • Suspension: Fiberglass leaf spring positioned length wise under the seat frame
  • Speed: 8.5 mph
  • Lowest STF height: 18″ without tilt
  • Pricing: $8295, not an expensive base (a bit more expensive than the permobil without tilt. This base is much more expensive if tilt is needed as it jumps up to $14,120 with tilt)
  • Personal Impression from Trial: This base was very very peppy. It’s a small looking base that packs quite a bit of punch! Not the best suspension of the bunch, but with the top speed hitting 8.5 mph, I can see why some clients are sticking with this base. Considering it is a bit tippy, I would definitely be selective with who I would trial this base with.

7) Ranger Express and 904S:

  • Points of interest: The Express comes in a compact base option, however, this compact base also has a lower weight capacity. The 904S is a customizable base that is often used by power soccer players.
  • Frame: Express: 25.5″ wide x 32″ long, Compact version is 23.5″ wide x 31″ long,  904S: 24.5″ wide x 32″ long
  • Suspension: Express: Rigid front frame and low torsion rear suspension   904S: Front Articulating Beam and no rear suspension
  • Speed: Express: 6.5 mph, Compact: 7 mph, 904S: up to 9 mph
  • Lowest STF height: 17″ without tilt
  • Pricing: Express $8798, 904S $9898
  • Personal Impression from Trial: I find that Ranger bases have a very distinct and memorable drive. These are very zippy bases that also pack a lot of punch. They are also relatively smooth and intuitive drives as well. Ranger is a local business that will often make custom modifications and additions based on the needs and wants of the clients using these bases. This makes them a great option for clients using their chairs for a variety of functions including sports like power soccer.

.: QUICKIE IRIS vs. QUICKIE SR45:.

The SR 45 has been out for about a year or so and has been marketed as a lower end version of the Quickie Iris, which is one of the best tilt-in-space manual wheelchairs available on the market. The Quickie Iris is a great base to work with as there is so much adjustability, flexibility and real estate on the frame, which makes it easier to mount  seating components and is also great for setting up full custom fabricated seating systems.

As for the the SR45, this wheelchair replaced the Tilt FX , which had a similar rotation in space mechanism  as the Iris but was not the same quality as their “Intelligent Rotation in Space Technology”. This technology has now been added to the SR 45 as well as many more features that are similar to the Iris. Despite the marked improvements made on the SR 45 model and the added “Intelligent Rotation in Space Technology” on this model, Sunrise has also decided to  price this model in close range to the PDG Fuze T5o, the Orion II or even the Invacare Concept 45. So now the question is, what’s the difference between these two wheelchairs? Since the SR45 is so much cheaper than the Iris, but has the same tilt technology and very similar features, funders may lean towards a more economical model. In any case, here is a quick break down of the differences:

QUICKIE SR 45:

–  0-45 degrees of tilt (no other ranges available and cannot add anterior tilt for transfers or eating/swallowing positioning)

Weight capacity is 265 lbs, with no heavy duty option, max width is also 20 inches.

75 degree front rigging, no available contracture hangers (might be an issue for clients with very tight hamstrings)

Lowest seat-to-floor height is 14 inches (keep in mind for clients who need a specific seat-to-floor height for standing transfers or access issues)

-Limited colour selection

-Base is made in Mexico and is made of  steel (Although the weight differences are minimal, this model is likely a slight be heavier)

-Base price is $2795.00

QUICKIE Iris:

Free growth kit (for width growth) within the first 5 years

Dynamic back option available on this model only

Variety of tilt ranges, with the standard range being 0-55 degrees.

Weight capacity is 250 lbs, also has a heavy duty option with a weight capacity of 350 lbs 

Various front rigging options

Lowest seat to floor height is 12.5 inches

-Larger colour selection

-Base is made in California and is aluminum

-Base price is $4075.00

Overall, the improvements made on the SR45 are great. Although it may make justifying an Iris a bit more difficult, it is a great economical option in comparison to other available models on the market.  I hope this breakdown is helpful for all of you. I would like to thank Carla Carrico from Motion Specialties, Jeff Ducklow from Ability Health Care and Tara from Sunrise Medical for helping me break down the differences between these two wheelchairs.

.:DRIVE STATION:.

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…

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!

.: TLSO :.

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.

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.

.:   CUSTOM REACHER   :.

I would like to share with you a very special tool that was fabricated by Chad Kania at Ability Health Care. It’s a custom reacher!! I realize that this isn’t exactly a seating modality, but it’s such a neat device that I really needed to share it with you! This device was fabricated from scratch! It is a super light weight aluminum reacher that was made for a power wheelchair user who needed a device that could be used to pick things up from the floor and be used as a device to open heavy drawers and access items in drawers that were out of reach. Here is an image of the reacher.

The total length of the reacher was 36 inches long, which was specific to the client’s needs.

The reacher could be pulled apart and folded in half at the middle. This made it easier for the client to bring it with them in the community.

The handles and latch were also custom fabricated. The latch allowed the client to pick up an item on the floor and keep the item secured to the reacher while the client pulled the item up within reach. The plastic used to fabricate the reacher was light weight, but also sturdy and durable.

Here is a photo of the end of the reacher. The black part of the reacher is actually rubber coated for better grip. Also, note the hook on the end. This hook was used to open drawers by hooking onto the handles while the client used their power wheelchair to pull the drawers open. There is also a magnet at the end of the reacher.

.:   CUSTOM CARVED FOAM SEATING SYSTEM   :.

This is a carved foam seating system that was fabricated in Whitehorse, YT by James Cooper from Priority Posture Systems. It’s a planar foam “I” shaped backrest with asymmetrical swing away trunk laterals and carved cushion with ischial block and built in pommel. This system also has an arcufit-style positioning belt and i2i headrest. What was quite interesting about this case, was that we originally spec’d a foam in place backrest. Unfortunately, when trying to fabricate the system, the foam in place could not hold the clients’ posture. We instead needed to proceed with a planar foam back, which provided much more support and control.

.:   REVIEW OF 5 MID-WHEEL DRIVE POWER WHEELCHAIRS   :.

Access Community Therapists Ltd received an equipment inservice by Motion Specialties (Centric Health). We compared 5 mid-wheel drive power wheelchairs, received a ton of amazing information on each chair, and were actually able to trial each of the bases ourselves. Here is a brief summary and comparison based on this review as well as for some of our own overall impressions from the trial.

PERMOBIL M300

The Permobil M300 is a very nice looking power wheelchair base. The design is streamlined and great for clients looking for a clean, simple yet modern looking base. Clinically, I have been finding that many younger clients have been drawn to this base because of the aesthetics and other features. This base comes with a 3 year warranty on motors and the gear boxes. It has one of the lowest seat to floor heights with power tilt function (17 1/2 inches). It is however, a more expensive power wheelchair if any upgrades are added. That being said, the Permobile actually comes out to be the cheapest base without power tilt access through the joystick as this requires upgraded electronics. During the driving trial, this wheelchair was very smooth. It had a much softer ride than some of the others and also had a very quiet motor. I had one client trial this power base and he reported that he loved driving this base into class as the sound of the motor didn’t seem to disturb others or draw attention to himself.

QUANTUM Q6 EDGE

Quantum Rehab has just reduced their prices on the Q6 Edge and is now cheaper than their Q6000Z model.  While most other power wheelchairs require an electronics upgrade to get tilt through the joystick, this feature comes without a price upgrade. This base is likely best suited for an “urban wheelchair user” or clients who use their wheelchairs mostly at home. The reason for this is that the top speed is only 5 mph in comparison to 6 mph, which is offered by all of the other bases. This power wheelchair also comes with smaller batteries and is not an aggressive wheelchair. Some clients have reported some difficulty driving this power base because the programming and drive of the base is not as intuitive as some of the others. Based on the drive trial we did, this base was not as responsive as the others.  It is definitely a base that requires a thorough trial before prescription.

INVACARE TDX SP

The Invacare TDX SP was reported by Motion Specialties to be “the bench-mark wheelchair for setting up the standard for mid-wheel drive power wheelchairs”. Over the past 6 years, this product has done very well in the market. This power base has a narrow total external width of 24″ with intuitive drive controls. During the trial, this base was responsive and had a nice smooth drive.  Clinically, I have found that many clients prefer the drive style of this base when compared to some others. Some clients have reported to me that they are able to maneuver this power base well in their homes and are also able to manage terrain in the community. At present, Invacare is undergoing a review with the U.S Food and Drug Administration (FDA) and have temporarily stopped the manufacturing process of their power bases. This means, that at present, the supply of power bases is limited to what has already been produced. Ordering of specific options, features and colours is limited at this time, but they report that they should be up and running in the spring of 2013, however, there are no guarantees.

SUNRISE QUICKIE QM 710

The Sunrise Quickie QM 710 is a new power wheelchair that features a “Spider Track Suspension”. According to Motion Specialties, this suspension allows the base to “articulate well up ramps and thresholds”. During the driving trial, this base was quite powerful. It had an intuitive drive and quick acceleration speed. My colleagues and I, quite enjoyed this power base as it was a very smooth drive. For funding purposes, this power base requires solid justification due to it’s higher price point. The cost to repair this base is also higher compared to others in the market. This is something to keep in mind if, for example, a cheaper base is funded by an agency like the Ministry of Social Development and Social Innovation (MSD), but the client decides to pay for the upgrade to this base, that agency, like MSD may not pay for the cost difference required for the repairs.

SUNRISE QUICKIE XPERIENCE

The Quickie Xperience is a rugged and powerful wheelchair base. It has a G3 coil spring suspension, which has been “reported to be one of the best in the market”, as indicated by Motion Specialties. This power base is perceived to be most expensive option however, when it is specified with upgraded electronics and a power tilt system, the price comes out to be somewhere in the middle compared to its competitors. This base comes with the lowest seat to floor height 16″ of the group. Because of this, for certain funding agencies, this base can only be justified based on the required low seat to floor height. During the drive trial, this power base was quite smooth and fast. It had a quick acceleration and was quite intuitive to drive. The repairs on this base, like the QM 710, are more expensive relative to others on the market.

I hope this review was helpful to you. If you required more detailed specifications on these power wheelchairs or other power wheelchair bases, Motion Specialties has great “Therapist Resources” page that can be accessed by simply creating an account with them. Check out their website at http://www.motionbc.com.