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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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

Standing Power Wheelchair with Added Seating Modifications

Happy Easter Everyone! I hope you were able to enjoy the long weekend. This weekend I was able to catch up on some much needed rest and errands. For once, I actually feel ready for the week to begin. So, to give you a start to the week, check out this power wheelchair I set up with the help of Motion Specialties! It’s a Ranger Express (rear wheel drive) power wheelchair with standing function. There are a few other manufacturers that offer the standing function, such as Permobil and Levo. The Ranger Express was chosen for this client because it was a rear wheel drive power base, the clients’ driving preference (most are usually front wheel drive) and because of the style and positioning of the knee blocks (which best suited this client during the trials). The stander function on power bases is a great addition, but involves a few considerations. Some of these considerations include access to funding (these things are expensive!), the ability of the client to move into a standing position from sitting (not as straight forward as it may seem….lots of positioning considerations here!) and safety (bone density issues, cognition and safety awareness). In addition, with regards to the base itself, many of them have a lower max speed and are set up with a front wheel drive, which some clients may not be used to.

In order to make this base work for my client, several modifications were required. This client had a backrest that she used in her power wheelchair and in her manual wheelchair. This meant that the backrest needed to be removeable from the new power base. Her backrest was made using a foam-in-place insert to accommodate her back contours. This insert was set up in a Jay 2 backrest shell. Typically, backrests are mounted and bolted on to the back plate of the Ranger wheelchair, preventing it from being removed.  Nathan, the technician from Motion Specialties, therefore designed a track-like system that allowed the backrest to be removed by sliding the back onto the plate instead. In addition, to maintain the appropriate amount of seat depth, Nathan essentially needed to move the whole back plate further back on the base…not a quick job by any means! You can see this below where Nathan is wearing green and Bill Randall, sales representative is wearing purple. I promised to post a flattering picture so hope you both are happy with this one! =)

Further customization was needed to increase the “shearing” of the backrest when the wheelchair went into standing. When we trialed the initial set-up with the client, the backrest moved up too high causing the laterals to move up too far up and into the client’s axillas. Nathan then made a custom bracket that allowed the backrest to move downwards more when using the standing function. See below:

The last few customizations included grip tape for the footplate and ankle huggers to prevent the client’s feet from losing positioning and moving into standing, a custom Body Point chest strap with custom auto style buckle sewn in by Nathan, and added velcro under the armrests to secure the chest strap when not in use. This was necessary to ensure the client’s ability to use the stander independently.

The modifications that were made by Nathan and Bill really made this system work for my client. Thanks so much for all your hard work! It really did make a difference for this client! The standing function itself was selected for the health benefits as well as to improve my clients’ independence and level of function. Here is a link to a resource by RESNA outlining some of the benefits of wheelchair standing devices. Hopefully this will help with your justification letters! Also, an exciting announcement! Access Community Therapists Ltd, is offering a wound/pressure management course called “The Pressure is On ” in June. It’s a two day practical course on wound assessment, pressure mapping and intervention. We will be hosting it on June 6th and 7th at Advanced Mobility Products in Burnaby, BC. Click on the link or visit the Access website to register. Jo-Anne Chisholm, OT, Joanne Yip, OT and Heather McMurtry, RN, WOCN will be the main instructors and I will also be there assisting with the break out sessions. Register soon as space does fill up quickly!

Thanks for checking in today! I hope you enjoyed the case and hope to see you at the pressure course!

Seating is Super!

Cheryl