Page 22 - Mobility Management, May 2018

ATP Series
Cushions & Movement
technology, “when I was looking at how the fibers are woven, we wanted to use a matte finish. There are two sides of the material, so we used the matte finish side that’s not as slippery.”
But Sayre said the Stealth team also used the fabric’s weave to facilitate side transfers without affecting forward movement in the chair.
“The way the fibers are woven,” Sayre explained, “you slide a little bit easier side to side, but not forward. So when you’re doing a side transfer, you don’t slide forward out of the chair. [The fabric] helps to keep you where you need to be, in that sacral well. This makes it a little bit easier to do side-to-side transfers.”
Since the fibers don’t encourage forward movement, the fabric’s weave doesn’t contribute to sacral sitting. But if a client lacks lateral stability, and therefore wants to avoid facilitating side-to- side movement, a different fabric weave might be a better choice. As Sayre pointed out, in seating there are pros and cons that constantly need to be balanced.
“It’s about prioritizing how you use the chair, and then also prioritizing how you use the cushion and the cover,” she said.
Seating Respect
There’s a wry observation in CRT that when something goes
wrong with a seating and wheeled mobility system, the wheel- chair seat cushion is often the very first component to get the blame.
Yet, in this day of hurried evaluations, how much time is spent on cushion fitting and trials?
“I think cushions are an afterthought,” Sayre said. “The cush- ions and the backs are one of the most important systems. That’s what clients sit on. You have people sitting there for 15 or 16 hours a day.”
She would like cushions to get the same critical and individual consideration that a CRT wheelchair does. “The cushions are also complex accessories, complex devices,” she said. “You should be able to build the cushion to the person to match their needs.”
And when a consumer qualifies for a CRT wheelchair, Sayre would like seating teams to think along those same lines — that a similarly complex cushion, carefully chosen and fitted per the client’s specific needs and functional goals, would be the optimal choice.
“For complex rehab,” she said, “we should start at the skin protection and positioning level [of cushion]. It should be helping you with your skin protection, and it should be helping you with your positioning. And the cover makes a big difference, too.” m
The Challenges of Designing Cushions for Kids
********************************
For much of human history, children and adolescents were treated as younger, smaller versions of adults. Conventional wisdom in those times said the only differences between adults and juveniles was that children were physically smaller.
Now, we know there are many differences between children and grownups, and that ignoring those differences can lead to less-than-optimal outcomes.
That’s true for all sorts of product design, including wheelchair cushions for kids with significant mobility impairments.
How Kids Are Different
Jean Sayre, MSOT, COTA/L, ATP, CEAC, is VP of Quantum R&D Clinical Development for Quantum Rehab and Pride Mobility Products. As a seating specialist, she’s very familiar with wheelchair cushions designed with carved-out “wells” that are filled with gel inserts, air cells or foams of different stiffnesses.
As Stealth Products developed its
upcoming pediatric line of cushions,
Sayre said the design team focused on
the innate differences between adult and child users.
“In the past, some people have taken adult cushions and made them into pediatric sizes, but they leave that well as an
adult-sized well,” Sayre said. “What we found is that we can’t use our adult well for the pediatric population. So we have
to create a different cushion. What we’re going to be doing [with Stealth’s upcoming line] is to make it appropriate for the pediatric population.”
Growing Up Fast
“[Children] grow at a fast rate of speed,” she said. “So we have to accommodate the growth factor, as well. As adults, we might grow a little bit out with redundant tissue, but our ITs [ischial
tuberosities] and bone structure are pretty much set. We have to accommodate
the pediatric bone structure for growth because they might start out with a 2" span of the ITs, but by the time they’re teens, some of them have reached almost their full adult size. It depends on the person. Some children mature faster than others.”
Understanding the proportionate sizes of children, how they grow, and when they will grow can therefore be key to designing optimally functional wheelchair seat cush- ions for kids.
“They are different,” Sayre note of pediatric clients and their body proportions. “And that doesn’t take into account the co-morbidities of their diagnoses.” m
22 MAY 2018 | MOBILITY MANAGEMENT MobilityMgmt.com
GIRL DRESSED UP: ISTOCKPHOTO.COM/IDEABUG