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

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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

Wheelchair Accessible Vanity for Spinal Cord Injury Client

Happy Thursday Everyone! I just got back from Terrace, BC last week and have been looking forward to sharing something very special with you! A custom wheelchair accessible vanity and adapted make-up set-up. This system was made for a client with quadriplegia and was created from scratch by Chad Kania at Ability Health Care. Actually, Chad used to build custom furniture before he entered the seating technician profession. Knowing this,  I knew he would do an amazing job at building a set-up like this one. This vanity was partially funded  by the BC Rehab Foundation through GF Strong. Thank you to them for approving such a project.

This vanity had so many neat components to it. Such as a powered, height adjustable function, a cut out at the front to allow for better access, a custom elbow support for stability during make-up application, a custom mascara holder/applicator, a moveable mirror for close up make up application, and a hair dryer mount on a gooseneck post. The hair dryer will be plugged into the wall with an x10 module that will be accessed through a separate switch. As you can see from the pictures, all of the make up brushes, and hair brushes have been modified with universal cuffs and the containers have been mounted onto a wooden board with velcro for easy access.

This project was such a fun one. It was so exciting to help my client gain independence with this part of her life.

I will now leave you with a photo of my flight leaving Terrace. It was another great trip. Until next time!

Seating is Super!

Cheryl

 

 

Custom Modifications to Commercial Seating

Hello Everyone! I hope everyone had a great long weekend. I thought I would share some custom modifications to commercial wheelchair seating products. Often we use custom fabrication techniques to meet a client’s complex postural needs, however, it’s important to remember that commercial products can also be modified in a variety of different ways. Modifying equipment that a client already has can be a very cost effective option. Often times, simply making custom additions or changes with regards to set-up can make a huge difference to a client’s posture, comfort and function. The client that I was working with here has C5 Quadriplegia. He has a power wheelchair and commercial seating products but was feeling like he was collapsing forward through his trunk. This was affecting comfort, physical appearance and his ability to work on his computer. Another issue was that if his trunk fell forwards onto his lap when traveling in the community he wasn’t able to reach his tilt switch on his joystick. This was a concern as he needs to tilt back to re-position himself back upright independently. After completing a seating assessment and review, the following changes were made to his system: The custom modifications here, were completed by Wahbi at Advanced Mobility Products Ltd. The photos below are of a Jay 3 Backrest. Foam (I love foam!) was added to the lumbar region to improve contouring and support. In addition, the top of the backrest was heated and flared back to allow for more clearance for the client’s scapulae and upper back. Once the top of the backrest was flared, the headrest mount was spaced out to clear the top of the backrest.

The client’s armrest were also raised by 3 inches. This required custom armrest post extensions that were fabricated by Advanced Mobility.  This allowed the client to support himself  more upright by propping with his elbows. An Action gel overlay was added for pressure relief at his elbows. These were secured with velcro and could be removed by the client so that he can use them at his computer desk. The gel was originally covered, however, this made them too slippery.

In order to address the issue with access to the tilt function, a buddy button was added to the bottom of his seat pan. When this client fell forwards onto his trunk, he was easily able to reach under the seat pan to access the tilt switch. This made a significant difference for him as he would no longer need to wait for help if he ever lost positioning when traveling in the community independently.

This client also uses the back canes to hook his arms onto for support. The back canes here were cut, angled out and re-welded to allow the client hook his arms around the back with more ease. Thanks again to Advanced Mobility for the great custom modifications. I hope you enjoyed reading about this case today. I would love to hear about your creative modifications to the seating systems you are working on. Please feel free to comment or post about anything interesting you have done out there. I would love to hear about them! Thanks again for checking in.

Seating is Super!

Cheryl