Page 17 - Mobility Management, October 2018

noticed some people are migrating to adjustable tension [backs], especially if they have to dress in their chair and they like to extend over the top. A lot of higher-level cervical injuries will use adjustable tension upholstery to allow themselves to sink back in between the back canes, and that way, it almost acts like a trunk support or a lateral support.”
Anderson closes his back angle “because what really feels good for my back is when I’m able to extend over the top of the back a little bit so I get a little bit of lordosis in my lower spine. It gives me a little bit better balance. That works really well for me.
“The back height on my chair is about 13.5". It’s actually a pretty normal height, just looking at the average height on orders that come through our facility. But it’s very low considering how tall I am [Anderson is 6'9"]. It’s quite uncomfortable for me to have something touching my back up higher; I’m just not used to it. And I like to have [the backrest] end in my mid to lower back so I can curve up over the shelf. It helps with my balance.”
He also uses “an Ergonomic Seat; I love it because it allows me to only move forward so far. I don’t have a lot of trunk control, and as you’re moving, you tend to move around in the chair. The seat keeps me from moving forward too much and having to stop to reposition.”
“Stability creates performance,” said Jim Black, Invacare’s
MobilityMgmt.com
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Director of Product Management & Marketing, on the impor- tance of a good seated foundation. Black was 19 when he sustained a spinal cord injury that resulted in paraplegia. “What tends to happen with a bad fit is because of weaknesses, people tend to slide into balance. Their pelvis will slide forward, and when your pelvis slides forward, your head follows so you create that kyphotic posture. That’s how you’re creating balance, how you’re increasing your center of mass.
“If you put 2" of extra width [into the seat] to fit a coat in
for the winter, if somebody is weak, they’ll slide on that weak side because they have space. They’re going to use that space
to slide, and that in turn will cause scoliosis or a posture of somebody dipping down. We think of a chair’s center of gravity as the wheels, but the center of gravity is your backrest and the relationship to where your wheels are. When I move my backrest forward and back, that’s really my balance point. So we need
to understand where those points are to create a more efficient balance and stability.”
Kim Davis, MSPT, ATP, Clinical Rehab Manager for Sunrise Medical’s northeast region, said she remembers a metaphor that Ramage told her about seating: “I don’t know if he’s the original author, but what Brad told me for folks who are getting ultra- lightweight rigid chairs — especially who are more at his injury
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