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!

DSC01703

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

 

Advertisements

Belts, belts and more belts!

Happy Friday Everyone!

In BC we are gearing up for the International Seating Symposium that is being held at the Westin Bayshore in Vancouver. This is a super exciting week for those in the wheelchair seating and mobility world. I will be presenting this year along with Lindsay Alford (OT). We will be presenting an instructional session called “The Art of Balance: Function and Posture in Wheelchair Seating”. We will be introducing a clinical reasoning model that we developed. Hope to see some of you there! Here is the link to the brochure if you are interested!

Also, Access Community Therapists will be also be hosting the “Introduction to the Assessment and Management of Eating, Drinking and Swallowing Disorders: A Clinical Approach” workshop on April 28th and 29th. Register quickly if you are interested as spaces fill very quickly! Check out the website for more information.

I thought that I would post some of the positioning belts that I’ve done over the years. Positioning belts can be critical in a seating system from a postural perspective, but are often so complex to integrate into a system as they can often have an impact on the way a client functions. Since we are presenting on this very topic, I thought I would give all of you a sneak peek!14

Here is a custom pelvic support with with angular molded sub-asis pads. The sub-asis pads are secured with swing away harware. Between the sub-asis pads, there are flexible straps connected with a standard push button buckle. The purpose of this belt was to create a rigid system that the client could use when her tone was quite strong. Alternatively, when her tone was quite mild, she could leave the swing away hardware open and simply secure the buckle to allow her to move more freely in the system. Cool eh?

DSC01736Here is an example of how changing a buckle can make all the difference in the world! This client couldn’t use a positioning belt before as it would impede his ability to transfer quickly. By introducing an airplane style buckle, he was now able to use a positioning belt, which prevented him from sliding down in his seating. YAY!

DSC_0416

Semi-rigid belt with evoflex

Here is a semi-rigid pelvic support made with custom sub-asis pads. This system was made for a client who needed more rigid pelvic support but needed to fasten and un-fasten the belt independently. This belt was also done in combination with a dynamic backrest on a light-weight rigid wheelchair frame. This is a nice example of how it is possible to improve postural control while maintaining a client’s ability to function independently.

IMG_20140903_155418

Swing away hardware on arcufit

This one is a custom arcufit style belt with a swing away hardware again. The purpose of this hardware though, was to clear the belt out of the way so that the back canes could be folded down to transport the wheelchair in a trunk.

DSC_0153

Custom Rigid Pelvic Saddle

Here is a custom rigid pelvic saddle. This system was created to prevent a client with very limited hip flexion from sliding down in their seating system. Note how much anterior control was needed to keep the client up in the system in order to maintain her ability to drive and be independent in the community.

download_20141112_163011

Custom pelvic harness for comfy chair

Remember this one? This is a custom “posey” style belt used in an alternate positioning device. This system was made for a client with a lot of tone that wanted a more comfortable option. In his mobility system, he uses a semi-rigid system. This is a nice alternative that is also necessary to reduce his risk for skin breakdown in a very rigid system that he has in his wheelchair.

I hope you liked this collection of positioning belts.For those of you going to the ISS this year, see you next week!

Thanks for checking in! 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

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

Advanced Health Care and ROHO Inservice

Happy Monday everyone! In BC, we are just wrapping up the long weekend. It was rainy start to Victoria Day today, but I hope everyone had a lovely afternoon in the clear weather anyways. I’ve been MIA for a while because I just got back from New York City! Yes, that’s right, the BIG Apple! I was there with my husband for a conference as well as for some vacation time. I even brought back some photos and stories for you. I hope you like them! Before I get into that, I would love to share with you some new-ish products by the ROHO group. Shawn Aslani from Advanced Health Care Products and Andy Woodcock, Canadian Sales Manager from the ROHO group came to the Access office to give us a heads up on new products. So here you go! See below of a photo of a Roho Enhancer cushion. It is essentially a Roho cushion that has different cell heights integrated into the same cushion to offer some positioning/contouring properties. We also spoke saw the ROHO hybrid Elite cushion (sorry, no photo, but click here). This is a great option for clients who require a more stable front end for transfers or for those require more rigidity for positioning. I do caution you to do a thorough trial though as the Roho air cells are not as high as the high profile cushions, which can allow some clients to bottom out. Also, WATCH THOSE GREATER TROCHANTERS on this cushion. I’ve sometime cut the sides down or ordered a wider cushion to clear the GTs. If you are concerned, a safer option is the Roho Quadtro. You can lose stability from this cushion, but when inflated properly it can work very well. Check out the Roho Videos for inflation education. These are great resources for caregivers too!

Andy also brought in the new hardware they are using for their Agility backrests. This hardware is very, VERY  light in weight. It’s a nice design and really cuts down on the bulk without completely losing adjustability for positioning of the backrest. Most likely best for a client who can do without a lot of adjustment changes, but is not quite set for fixed mounted brackets. Shawn also brought in some Body Point products such as the Evoflex Pelvic Stabilizer. I’ve used this product quite a few times now and am really liking it. It’s nice for client’s who transfer on their own as the belt straps stay up and out of the way of the seat. It also offers a bit more positioning support than the standard body point belts. This belt also comes with a Sub-ASIS pad kit and a mounting kit. These are both great options to consider. See my post here to see how I’ve used it with a client of mine.

Now, for some fun facts about New York! We went to the Museum of Modern Art (aka MoMA) to take in some of the most iconic pieces by Van Gogh, Monet, Picasso and even Andy Warhol. During our exploration of the museum, we ran into this! The Accessible Icon Project! This project was focused on re-designing the International Symbol of Access into a more active image of a wheelchair user. I was so excited to see this at MoMA. New York is filled with older, narrow buildings with narrow hallways, narrow walkways, tons of stairs and minimal ramping. I have to say though, I did notice some changes at some of the newer tourist attractions. For example, at the 9/11 memorial, the corners of the memorial are undercut/slanted to allow for a wheelchair user to come up close to the fountain’s edge. Although the edges of the fountain were still quite high, it did make the fountain much easier to view.  On a side note, the 9/11 memorial was a truly moving and heartwrenching sight. I still remember where I was when I heard about the whole thing. We both definitely appreciated the opportunity to pay our respects at the site during our trip. Also,  the 9/11 museum opens tomorrow. We just missed it, but would have loved to have seen it. Not sure if I could have handled it though…..

On a happier note, I will leave you with a picture of the skyline of NYC from the Top of the Rock.

Thanks for checking in again!

Seating is Super!

Cheryl

The 30th International Seating Symposium

Hello Everyone! The 30th Annual International Seating Symposium started on Tuesday at the Westin Bayshore in downtown Vancouver. This conference is held every 2 years in Vancouver and is a fabulous event for anyone interested in wheelchair seating and mobility. The conference consists of a huge exhibition hall, poster presentations, pre-symposium courses, paper presentations and instructional sessions. So far it has been a great event with some truly inspirational speakers. Although it has been a long couple days, I thought I would post some of the new/newer products that I have had a chance to check out so far.

The first product I would like to present to you is the Progeo manual rigid wheelchairs. These are carbon fiber wheelchairs that are lightweight and incredibly streamlined in their appearance. Dave Elder from Advanced Mobility Products brought these wheelchairs to my attention. The Progeo wheelchairs were made in Italy and are not quite yet available in Canada. Hopefully soon though as these chairs look quite promising!

Stealth Products has developed a new “Mini Proportional Joystick” (which is a nice, easy to remember name). The shape, size and design of this product really stood out to me. The flat top with the built up sides made it easy to position and rest my index finger over top. When directing the joystick, the built up edges really helped to maintain positioning and steer with accuracy. Often times with other joysticks on the market, it can be difficult for clients to keep their fingers in place as they can often slip off the small topper. Stealth informed me that they can also rubber coat their joystick for added grip, which was definitely a nice feature. Different levels of resistance in this joystick are also available.

Stealth displayed their iDrive Diagnostic system that can be used to calibrate their joystick.  Another issue with other products on the market are that they are at times difficult to orient properly for the client. This can at times make trials quite difficult.

Comfort Company will be releasing a new backrest called the Acta-Relief Back very soon. This backrest is quite innovative, light weight and easily adjustable. The product consists of a metal frame with what they call Boa Reels that are tightened by rotating a dial called the Boa Closure System. Think of when you adjust the time on your watch; you pull out the watch crown (yes, it’s called a watch crown and yes I did happen to google this!) to release the cables/Boa Reels, then click it back in and turn until you have the desired level of support/tension. Et voila! You’ve adjusted the backrest to the back contours of your client! The cover also has a nice stretchy material integrated along the midline of the backrest. This is meant to allow for comfort and pressure relief along the spinous processes. This back was quite comfortable when I tried it out myself! I really liked how it could be adjusted to a client’s back contours. The ease of adjustability was a plus as well!

Advanced Health Care Products (AHC) had a few new items at this years symposium as well.  Body Point was showing off their new mounting extensions for the Evoflex pelvic stabilizer. I’ve used this product once before and found that it was a bit difficult to mount and position in the right position for the client without some added customization. With this new extension/mounting kit, these issues will likely be resolved. The only issue might be remembering to order this extra pieces when specifying the Evoflex. The Roho Group also displayed their Agility backrests, which integrates their famous Roho air cells into either the whole back or parts of the back. Definitely a backrest that I keep in mind to trial. The Roho Group very kindly hosted myself and the Access Community Therapists Ltd group in the evening after the symposium. It was a lovely event at the Fish House in Stanley Park. It was a pleasure meeting the Roho team! Thanks again for a great evening!

Ki Mobility will be releasing a new tilt in space manual wheelchair. This is a nice looking base with a high degree of adjustability. In Canada, it is projected to fall somewhere in the middle of the cost hierarchy (possibly somewhere falling in between the cost of an SR 45 and an Iris), however, this has yet to be confirmed. The selling points of this base is the smart tilt function, which is a smooth tilt mechanism that does not require weight in the chair and its reported durability. They pitch this base as a heavy duty, durable base that is meant to withstand a heavy user or client who presents with strong movement patterns. There are options for dynamic back canes as well as dynamic footrests. Although it is always hard to say how a new wheelchair base will compare to others, or stand up over time;  it does seem like it could be a strong competitor in the market!

Unfortunately, it is getting quite late and it will be an early start tomorrow morning at the ISS. That means that I will have to share the rest of my photos with you in my next post. I hope you found these points helpful though! Thanks again for reading and checking in!

Seating is Super!

Cheryl

Motion Specialties Grand Opening

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

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

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

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

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

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

I hope this post was helpful for anyone who wasn’t able to make it. Thanks again for checking in!

Seating is Super!

Cheryl