Page 12 - Mobility Management, February 2019

ATP Series
Standing Connections
have one of the lowest floor-to-seat heights, starting at 17.75". On the design change, Steffen Tiskus, PT, Training & Development Coordinator of Power Positioning at Motion Concepts, explained that in the X3 “the batteries are placed in a portrait configura- tion, so from whenever power wheelchairs were first introduced, the batteries would have been side by side in the battery box [which allows] for a narrower-width base. With that said, the A3, although narrower than most power bases, will be a little bit wider than the X3 for stability purposes.”
In addition to the wider base, the A3 will feature a new suspension, which Tiskus said is the biggest difference between the two devices. “It gives the end user the ability to go over smaller thresholds and allows them to access their environment, whether it be in the home or school or work.” The suspension system will also contribute added stability to the device. “Due to its unique forward locking suspension, it will provide greater stability in an active stand and drive position,” he added.
Funding Updates
Unfortunately, not much has changed in the way of funding in the last few years, as securing funding from payors continues to be a struggle for both clinicians and their clients. Despite the large body of research showing the many ways that standing
can improve the lives of wheelchair users, Medicare remains unwilling to fund standing frames and wheelchairs.
“You can say the last 12 or 24 years probably and still get the same answer, honestly and unfortunately,” Pryles said on Medicare’s unchanging stance on funding standing devices. “I think they’re doing it because they don’t really understand the benefit. It’s not like funding somebody’s heart medication. If someone is getting blood pressure medication, they understand that. You understand the medical necessity around that.”
Clinicians know all too well the struggle of making payors understand the medical necessity of standing as they work closely with clients to write letters of medical necessity. In the past two years, many clinicians have seen pressure relief and weight shifting, medical justifications that have long been used for tilt and recline devices, making their ways into standing justifications, though the correlation between standing and pressure relief and weight shifting has been known for years.
“I’ve definitely seen, within the last year and a half, an uptick in clinicians asking me to ask questions about pressure relief and studies around that sort of thing,” Perlich said. “And it’s really interesting that the most current study I know of specific to standing devices was probably back in 2010, when [Stephen] Sprigle did his load redistribution looking at variable position
10 FEBRUARY 2019 | MOBILITY MANAGEMENT
CUSTOM WHEELCHAIRS & SEATING
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