STEPtember for The Cerebral Palsy Association of BC

Hello Everyone,

It’s September already! This post is a bit different than my other posts. You see, Access Community Therapists is participating in “STEPtember” this month, which is a fundraising campaign for The Cerebral Palsy Association of BC. My colleagues and I will be attempting to take 10,000 steps per day this month in support of this amazing cause. Today was the first day and I only managed to take 4100 steps so I am already behind. This is a cause that is so important to us at Access as we work with so many people with CP and other developmental disabilities. If you could spare a few moments and a few dollars towards this cause, I would be forever grateful. Here is the link to the Steptember website. Feel free to search my name “Cheryl Hon” and donate!

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Thanks everyone for checking in. Seating is Super!

Cheryl

 

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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

Access Pressure Workshop and Seating Tips and Tricks!

Happy Friday Everyone! Last week Access Community Therapists and Advanced Mobility Products hosted a workshop called “The Pressure is On: A Model of Practice for Occupational Therapists”. This was a 2-day intensive and interactive workshop on wound prevention, assessment, management and treatment. The workshop instructors included Jo-Anne Chisholm (OT), Joanne Yip (OT), Heather McMurtry (RN, WOCN), Lindsay Alford (OT) and Cheryl Hon (Me!!..I’m an OT). It was a great workshop with a great turn out!

On the first day, we focused on an interdisciplinary model of practice for wound care and treatment. The images below capture some of the days events. Wound prevention equipment, cushions, mattresses and wound dressings galore! We also focused on preventing under and over prescription of medical equipment for wounds. This is such a big issue when it comes to wound care and prevention. The second day was all about Pressure Mapping. We even had help from some client educators who helped us practice pressure mapping skills and interpretation. Thanks again to everyone who was able to make it!

Now, onto some fun seating tips and tricks! I thought that I would share some of my recent seating mods, accessories and ideas. Perhaps these might work for some of your clients! Here we go!

Below is a wheelchair and seating system that was set-up by Jody Mair from Motion Specialties. This client had CP and required an arcufit belt for pelvic stability. Pelvic laterals were not an option for her because of the way she transferred and moved in her wheelchair. A swing away mount was used on her pelvic belt as her family needed to fold the back canes down in order to fit it into their vehicle. Without this mount, the back canes would not fold down far enough. Although swing away brackets were not as strong as solid brackets, for this client it was sufficient.

Next! A custom pelvic harness for an alternate positioning device/comfy chair. This comfy chair was custom fabricated by Russ Bain at Ability Health Care and the harness was made by Chad Kania. This comfy chair had power tilt and was made with custom carved foam cushions. The client that used this system had extremely limited hip flexion, significant postural deformities and was prone to skin breakdown due to constantly moist and fragile skin. Due to limited hip flexion, keeping this client in an upright position was extremely difficult. On his manual wheelchair, he had a foam-in-box seating system with a custom molded pelvic bar. We didn’t want to do the same in his comfy chair as this was meant for him to be positioned upright, but in a more relaxed position. So, this is what we did! A mesh fabric, posey-style pelvic harness that was secured with 2 clips on the sides. The mesh fabric was breathable to prevent moisture build up. The harness itself helped to prevent sliding down in the system, but was soft to prevent pressure and to enhance comfort.

Here is a custom mounted cup holder and stylus holder that was fabricated by Wahbi Ghanbur at Advanced Mobility Products. This system was made for a client with Quadriplegia. This client uses a stylus in the community to reach and access buttons (such as elevator buttons) and pin pads in the community. If you haven’t noticed, most pin pads at store check-outs have a “security cover” over the buttons. For someone with Quadriplegia (or anyone who has difficulty isolating finger movements), these are next to impossible to access. The stylus is an effective tool here, IF it can be easily accessed by the person of course! So here was my solution to the problem: a custom mounted holder for the stylus! The cover at the top is actually made of soft rubber to prevent the stylus from falling out.

Here is a rather simple solution for feet on wheelchairs. GRIP TAPE! YAY for grip tape! I use grip tape quite often on footplates as it often helps to prevent feet from sliding off or out of position. This was a rather nice application of grip tape on a manual rigid wheelchair. As you can see, there is no actual plate, but wrapping the grip tape around the tubes was a nice way to keep the tape in place. This was also done by Wahbi at Advanced Mobility Products.

And last but definitely not least, here are some custom modifications that were designed and fabricated by Ed Bell at Advanced Mobility Products for a home weight machine. This system was made for a client with paraplegia who used a manual rigid frame wheelchair for mobility. The custom adaptations involved a custom thigh bar that was similar to those flip down bars on a chair lift at the ski hills or the flip down bars on an amusement park ride like the Coaster at the PNE. This helped to keep the client and wheelchair on the ground when using the weights and pulleys. In addition to this, the system also had custom clamps that secured to the front rigging of the wheelchair. This was needed to keep the front end of the wheelchair down and in place to prevent the client from flipping backwards when using the weights.

I hope you enjoyed some of my tips and tricks! Have a great weekend everyone!

Seating is Super!

Cheryl

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

Attendant Power Assist! The Viamobile

Hello Everyone! Happy Wednesday! Can you believe August is coming to an end? My, my this summer has gone by quickly! I have a few exciting announcements to make. Access Community Therapists Ltd has two upcoming courses: The Pressure is On: An Interdisciplinary Approach to Pressure Management in the Community on November 7th and 8th and Wheelchair Seating & Positioning: Practical Applications on November 28th and 29th. To register, please visit the Access website and fill out the registration form. Both courses are highly interactive and offer hands on experience with clients. Check out some photos of the seating course here! Hope to see you there!

Now, onto some new rehab stuff! I just set-up an attendant power assist on a manual tilt-in-space wheelchair called the VIAMOBILE (by invacare). There actually isn’t much information online about this product, which was surprising to me. The system is comprised of a remote handle that turns the system on and off and powers the motor to either roll forwards or backwards. When the system is turned on, the centre wheel drops onto the ground. This offloads the rear wheels, which can tilt the system a bit forwards. Luckily we were working with a tilt-in-space wheelchair. That way, the client can be tilted slightly when the system is on.  Here are some photos of the system:

Invacare has just revised this product and it is now super easy to remove and set-up. I love that it can be so easily removed. My client who needed it, manually-self propels indoors, but lives in a very hilly neighborhood and his caregivers were having a lot of trouble getting him around the community. Because he manually self-propels, we needed to keep the wheelchair light. By removing the motor of the viamobile when indoors allowed us to do that. The viamobile was set up on a Quickie Iris manual tilt wheelchair. See some images below.

This system is by no means cheap. Many funding agencies such as Ministry will not fund this system. You may have to look for private funds for a system like this, which is definitely a downside. On a brighter note, an attendant power assist can be extremely useful to prevent caregiver injuries as well as to enable your clients to get out more often in the community. Definitely worth while, if you can find funding. This system was set-up by Jody Mair and Nathan Buskell at Motion Specialties. Thanks to you both for setting this up! Until next time!

Seating is Super!

Cheryl

Rear Wheel Drive Power Wheelchairs

Hello Everyone, Happy belated Lunar New Year to all of you! I apologize for my month long hiatus. It has been a busy few weeks for my family. Right after the holidays, my dog, Halle, had to go in for dental surgery. Then, soon after, my grandma was admitted to hospital for a suspected TIA and aspiration pneumonia. It has been a busy and stressful month, but I am happy to share that things are looking better and my 94 year old “popo”, who is recovering well.

I have not forgotten to collect information, photos  and interesting new products and cases to share with you though. These will be posted as soon as possible as I can’t wait to share them. Also, I just wanted to say thanks to everyone who has been taking the time to read and contact me about the blog.  It has been a pleasure hearing from you!

Alright! So back to business! A couple weeks back, 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.

I would like to thank Jodi Mair and Carla Carrico for setting up these inservices for us. They were great as usual! Also, Motion Specialties asked if I could share this special opportunity. March of Dimes has set up a program called the March of Dimes Canada Retrofit Vehicle Initiative for people needing vehicle modifications up to $15,000. Motion Specialties is able to do a variety of vehicle modifications and are hoping that someone may be able to benefit from this rare funding opportunity. Applications are due by February 14th, so please pass this on to anyone who may benefit from this program. Here is the link below with more information.

  MARCH OF DIMES: FUNDING FOR VEHICLE MODS: check it out!   http://www.marchofdimes.ca/EN/news/whatsnew2014/Pages/March-of-Dimes-Canada-Retrofit-Vehicle-Initiative.aspx  

I hope you found this post helpful! Thanks for checking in today!

Seating is Super!

Cheryl

Workshops, Whitehorse and Wheeling

Hello Everyone! Happy Monday! Last week was a busy week for Access Community Therapists Ltd. We 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.

After the workshop, Jo-Anne Chisholm and I left for Whitehorse, YT. Yes, that’s right! Whitehorse in the Yukon Territories! Access Community Therapists does a seating clinic up there every 2-3 years. It’s an exciting and busy week. It feels almost like a seating marathon of sorts! On this trip, the technicians from Priority Posture Systems Ltd came with us to fabricate the seating systems and to complete various seating modifications for clients with quite complex needs. Unfortunately, I didn’t have a chance to take many photos on this trip, but here is one system that we did. 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.

I’ve been meaning to post this up for a while now. Sorry for the delay! 2 weeks ago, we received a short presentation By Krista Best and Kate Keetch (Associates of Bill Miller from UBC) on wheelchair skills and the importance of teaching our clients how to improve their wheeling skills. Although most of the clients we see are long time wheelchair users, I definitely saw the benefit in wheelchair skills training. The benefits to our clients included things like, improved community access, shoulder preservation and improved posture and positioning when wheeling. During the presentation, we were offered a chance to try doing a wheelie. To keep us, or I should probably say “me” safe, 2 bricks were used to prevent the wheelchair from moving or rolling away, and an orange safety strap was secured to the crossbar for added security. This is what it looked like!

For more information on wheelchair skills, visit www.wheelchairskillsprogram.ca. This is a great website with assessment/training forms and research on wheelchair skills.

Thanks for reading! Seating is super!

Cheryl

Review of 5 Mid-Wheel Drive Power Wheelchairs

Hello Everyone!  Last week, 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.

UPDATE: Invacare in Canada is now cleared to sell power mobility without restrictions! YAY! congrats! Excited to see the new versions of this base soon! -May 18, 2016

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.

Thanks for reading!  Seating is Super!

Cheryl

Wheelchair Seating Anatomy 101

Hello Everyone! Here is a short video on wheelchair seating surface anatomy. This video provides an overview of relevant anatomical landmarks required for seating assessment. Although there are several other landmarks that are relevant during your assessment, this is a quick cheat sheet for your reference! Enjoy!

Thanks for watching! Seating is Super!

Cheryl

Video by Vanmedia

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