Page 19 - Mobility Management, July 2019

For seating, that precision is applied
to positioning systems and components, and to the wheelchair’s seat cushion and backrest. Seat cushions for complex rehab clients are designed to fit several different segments (and HCPCS codes), including skin protection, positioning, skin protec- tion and positioning, and adjustable versions of those types. Aftermarket back- rests are available in different heights and with different intensities of contouring
to offer more support or less support and positioning as needed.
When seating and positioning is discussed, the bulk of the conversation tends to center on the cushion or backrest itself. But cushion and backrest covers — that most direct interface between the client and the seating — can also affect how successful a seating system ultimately is.
Mobility Management asked Susan Cwiertnia, PT, MS, Director of Medical at VARILITE, about the importance of seating covers.
The Goal of Covers
Covers seem to be such a small detail in
a seating system, but Cwiertnia indicated that covers can actually achieve a number of goals, starting with protecting what’s underneath.
Cwiertnia said. “It is also important for individual comfort level. Some wheelchair users get uncomfortable and overheat while sitting in their chair because of the seating system. This is especially true for some users that need more positioning support that envelops their body, like a deep contoured back support or custom-con- toured seating system.
“The elderly and other individuals can have reduced ability to dissipate heat due to blood vessel or neurological changes.”
Covers Are Not Created Equal
Because cushion and backrest covers have different jobs to do, they are designed differently using different materials.
“Covers can be made from materials
to promote passive air flow to assist with temperature management, such as a spacer knit material or larger-pored reticulated foam,” Cwiertnia said. “Often, the covers are made to work specifically with the orig- inal cushion they were designed for, so it is important to use the manufacturer’s cover.
Seating Update: Revised Wheelchair Seating Standards Get ANSI/RESNA Approval
The newly revised ANSI/RESNA Standard for Wheelchairs, Vol. 3, has been approved for publication.
In a news announcement, RESNA said the American National Standards Institute (ANSI) has approved the revision and publication of the document, which was the result of five years of collaboration among wheelchair seating experts.
“This newly expanded volume not only
includes improvements and clarifications, it also offers new test methods for charac- terizing wheelchair seating support surfaces,” RESNA said in the announcement.
The revised standards, said the Standards Committee on Wheelchair and Related Seating (WRS), “are created by the people who need them and use them, including clinicians, engineers, academics, manufacturers, regulators, and end users – ‘stan- dards by us and for us.’”
The committee noted the standards’ “stakeholder-based approach,” which “ensures relevance and clarity, so that the standards can provide a common language and approach to seating, and be beneficial in differentiating between the scores of seating options available.”
The documents include the following sections:
• Section 1: Vocabulary, reference axis convention and measures for body postures
and postural support surfaces.
• Section 2: Determination of physical and mechanical characteristics of seat cush-
ions intended to manage tissue integrity.
• Section 3: Determination of static, impact and repetitive load strengths for
postural support devices.
• Section 6: Determination of the changes in properties following simulated
extended use of seat cushions.
• Section 12: Envelopment testing of seat cushions with dual semispherical indenter.
“As new standards are published by ISO (International Organization for Standardization), they are considered for inclusion in future volumes,” the committee said in the news announcement. Revisions are currently underway to integrate the ISO microclimate and flammability methods. If you are interested in joining these efforts, please lend your critical voice to this important work!”
The RESNA Standards Committee on WRS is chaired by Kara Kopplin. Evan Call is the Vice Chair, and Patricia Karg is the Secretary. The revised standards document can be purchased on the RESNA site (www.resna.org). For more information on
the WRS standards committee, visit www.resna.org/standards/wheelchair-seating/ wheelchair-and-related-seating. m
A newer development
in cover technology is the use of specialized materials made to decrease friction and shear — Susan Cwiertnia
“Covers have many functions,” she said, “and one of the most important for both seat cushions and back supports is to protect
the cushion inside. The cover protects from dirt, moisture, ultraviolet light exposure and other elements that can degrade cushion materials or impact their function for skin protection and positioning.”
A second goal is to help to manage the temperatures at the cushion/client interface.
“Temperature management is important because increased temperature leads to higher risk of developing pressure injuries,”
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