New products from Invacare, Power Wheelchair Programming Language and Nylatron Front Rigging

Happy Wednesday Everyone,

I hope you are all enjoying the beautiful weather this week. On May 6th and June 23rd, Invacare provided some super valuable inservices to the Access Team and local sales reps. Not only did we get an in depth overview of their new products, but also had a chance to learn more about programming. Power wheelchair programming jargon can be a bit confusing, to me anyways, so it was great having the opportunity to clarify what some of the language really means. A huge thank you to Jason Hrynyk for the inservice at Access and the invitation to the education day. Also, thank you to Cher Smith, OT who gave a great review of wheelchair and seating principles and programming tips at education day.

Jason brought us the Libra cushion and PSVF (posture seat visco foam) cushion for us to pressure map at the office. We used the X sensor pressure mapping system at this inservice to assess the cushions. The PSVF cushion is a really nice comfort cushion is mapped quite well as it provided good pressure redistribution as the foam allows you to submerge into it to achieve full contact with the buttocks and proximal femurs.

The Libra cushion is Invacare’s new cushion that has been designed to address skin breakdown. This is a nice stable cushion and is also quite light weight even with the gel pack at the back. From a pressure mapping perspective, when leaning side to side, peak pressures did appear, however, we do know that skin breakdown does not just occur from pressure alone. Invacare reports that this cushion has helped some clients heal their wounds. My guess is that this cushion provides a stable sitting surface and the gel at the back may be most suitable for clients who are at risk for developing wounds from either friction or shear. Just as a reminder:

Friction: Is repeating rubbing on a surface. This causes damage to the surface of the skin only

Shear: when unaligned forces push the body in one direction while another force pushes the body tissues in an opposing direction. This results in damage below the skin first.

Here is a video by KCI that describes these two concepts very well! Click here. These concepts are described in the first 2 minutes of this video.

If you get a chance to trial either of these cushions, we would love to hear your experiences!

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Jason also brought us the e-motion wheels to trial. These are nice power assist wheels that are activated through the push rim. See this brochure for more information.

At the education day, Cher Smith and representatives from Invacare and ASL reviewed some very useful terms. Here are some programming definitions that will hopefully help when you need to adjust power wheelchair driving programming for your clients:

Joystick Programming Language:

Movement of the joystick:

  • Deadband=The space in which the joystick can move before actually moving the wheelchair. (If the deadband is large then the client will need to move the joystick further away from centre to activate the driving of the wheelchair. If the deadband is short, then less movement away fron centre is required to start moving the wheelchair)
  • Throw= How much the joystick movement is required to move the wheelchair to full speed. This can be adjusted to allow clients to reach full speed without pushing the joystick to the end of its range. Similarly, it can be adjusted so that a client needs to push the joystick to the end to reach full speed.

Force of Movement:

  • Deflection= the amount of force required to move the joystick

Power Wheelchair Programming Language:

  • Power: The amount of power a wheelchair has. This cannot be changed with programming.
  • Torque: Can be better described as “acceleration”. Torque is essentially the amount of power required to accelerate. Acceleration can be adjusted with changes to the electronics to the maximum amount of power the wheelchair has.

One last thing that was shared at this education day was the Tecla Shield . This product is so cool. It’s a device that links tablets, other touch screen devices and computers to alternate access buttons, switches, or even wheelchair driving controls. So cool! Check it out!20160623_154304.jpg

Finally, here is a new and exciting innovation created by Nathan Buskell at Motion Specialties. It’s a Nylatron foot rigging post!!!! This doesn’t look that exciting from the photo, but this post is flexible. Yes, flexible! Nathan created this product using nylon plastic material called Nylatron. He designed it for clients who often break their front rigging from heavy use. This could be from constant stomping, high tone or even from hitting the front rigging and footplates on obstacles in the environment. What an amazing innovation! And to top it off, it looks nice! Not bulky at all! I was so excited! 20160726_120320

That’s all for now folks. Thanks again 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

Custom Power Wheelchair Transfer System

Happy New Year Everyone! Welcome to the first post of the year 2015! As some of you may know, we are expecting our first little one in January 2015! My husband and I just moved and life has been busy in December….hence my MIA status. I still have lots to share with you over the next year but the posts may be a bit less frequent…but hang in there! Seating will continue to be super!

As a welcome back, I thought I would share some photos from Access Community Therapists’ Wheelchair Seating & Positioning Workshop that took place on November 27th and 28th at Motion Specialties. It was another great turnout and we just wanted to say THANK YOU to our client educators for helping us out again.

So, here is a system that was finished right before Christmas last year (2014). It was a custom transfer system that was fabricated on a Permobil M300 base. This base was provided by Fran Wilson, Sales Representative from Self Care Home Health Products. Chad Kania, Seating Technician, from Ability Health Care created the transfer system and built the custom seating system. This system was made for a client with Achondroplasia (Dwarfism). The goals of the system were to:

1) To improve her comfort and positioning
2) To improve her ability to transfer independently
3) To improve her ability to function independently in and around her home

Prior to this, this client had an 18″ wide x 18″ deep, standard power wheelchair with basic seating. She required the use of a step stool to get into it and sat in the system with her legs completely extended and made no contact with the backrest. This was causing her back pain as she essentially sat completely unsupported. Also, in order to get into the system itself, she needed someone to help her get the step stool every time she needed to transfer.

The biggest obstacle was of course….FUNDING! With some good old fashioned OT letter writing, this system was eventually cost shared by the Ministry of Social Development and Social Innovation and Community Living BC. MSDSI funded the wheelchair base and seating (The Permobil M300 with tilt and the seating system), while CLBC funded the power transfer system. YAY!

The seating system consisted of a foam-in-place backrest with fixed, flat, trunk laterals. The seat was made from carved foam. It was made with a custom drop at the front to allow for a bend at the clients’ knees. Pelvic laterals were also used to guide the clients’ pelvis into the system when she transferred.

Once the foam-in-place backrest and seat were fabricated, trialed, trimmed down and upholstered, here is what it looked like:

Once the seating was completed, custom armrests were made. The standard armrests were used as transfer aids. Custom mounting of the joystick was also needed to get it into a optimal position for driving. In addition, the foot platform was created with a roller blade wheel was installed at the bottom to prevent the system from scratching the wood floors in the home.

Since this system was delivered to the client, she has been using it for a variety of activities around her home such as:

i) Getting her coat out of the closet independently
ii) transferring in and out of bed independently
iii) using the sink in the bathroom
iv) getting to the table for meals and snacks independently
v) opening and closing doors independently

Hearing about all of these functional activities was like an OT dream! Here is a video of the system. This should help with visualizing how this system actually works!

Hope you enjoyed this post and thanks for checking in!

Seating is Super!

Cheryl

Seating Innovation! Carbon Fiber Custom Backrest and Custom Power Wheelchair Switch

Happy Thursday Everyone! Today I wanted to share some new seating products with you. Ability Health Care has begun fabrication of custom molded carbon fiber backrests. These backrests are super lightweight and have been based off of their custom plastic backrests that have worked very well for many clients. These backrests are ideal for manual wheelchair users who require a lightweight back support. The shape of the backrest is taken by plaster casting a client’s back and forming the backrest off of that cast. The only downside of this backrest is that poor Chad Kania, the seating technician at Ability Health Care has been taking the carbon fiber particles with him home. Apparently they can be quite itchy! =)

Another seating innovation I would like to share with you is a video by Wahbi Ghanbur from Advanced Mobility. He has made a flexible switch that is super sensitive to touch and can be mounted below the joystick handle on a power wheelchair…or likely anywhere else. In this video, the switch has been programmed to change the modes on the system. Check this out!

If you are interested in any of these great products please contact Ability Health Care for the backrest and Advanced Mobility for the switch directly! Thanks for checking in today!

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

Video Game Controller ?! Nope! A Power Wheelchair Joystick Control!

Happy Thursday Everyone! and Happy Thanksgiving to our neighbours in the States! I hope that there are some good sales for all of those Black Friday shoppers out there. Today, I thought I would introduce a very cool product on the market. It’s called the “Drive Station” power wheelchair control that is essentially made from a video game controller. This product is made by Switch-It Inc and has two mini proportional joysticks as well as “action and direction pad buttons”. The client can use the proportional joysticks or the buttons to drive a power wheelchair. This is a very cool product that was originally designed for war veterans with Acquired Brain Injuries. Apparently, they found that some of these injured war veterans had more success learning to use the Drive Station control in comparison to a standard joystick. Perhaps because the system was quite intuitive and familiar…

I have not trialed this product with any war veterans, however, I have recently trialed this product with a client with Muscular Dystrophy with Motion Specialties. What’s quite nice about this drive system is that it can be placed at midline and the client can use either their left or right hand to drive. This is a great option for clients who may fatigue quickly with one hand as they can easily switch to their other hand if needed. Also, if using the proportional joysticks becomes too difficult, the buttons on the Drive Station also can be used to drive the wheelchair. Some things to consider with this product, however, are that the proportional joysticks do have a bit more resistance than the go-to HMC Mini Joy. In addition, if the Drive Station is not mounted on a fixed mount, it could slide out of reach for some clients or be set-up in the wrong position for optimal access. I am currently still working on a custom seating system with Ability Health Care for this client. Once seating system and the custom mounting of this control is completed, I will definitely share the pictures with you so stay tuned!

Thanks for checking in today!

Seating is Super!

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