Page 20 - Mobility Management, January/February 2020

ATP Series
Midline Matters: Power Chair Controls’ Location
that is most comfortable for you,” he said. “Every one of us has a different sweet spot.” Active Controls’ Ergo ReJoy, Flowers noted, gives seating teams greater ability to find that “sweet spot.”
“We always try to get as close to the core, or the belly button, as possible to start,” Flowers said. “But what we’ve found is
that you can actually move [the controls] all around and firmly position it where anybody’s hand naturally falls in front of their body. Usually, it’s going to be within 2" or 3" of the core, and most people are going to be right in the center. However, there are some people that have shorter arms, and reaching over to the center isn’t a natural feel for them. And you really want
the person’s elbow supported by the armrest at the same time, because that also relieves the muscle usage in the trapezoid.
“If you balance the position where they drive from, you balance the position of the rest of the body.”
Guisbert’s additional concerns, beyond how functional a power chair user would be with midline controls, were the envi- ronmental accessibility restrictions that can come from having controls mounted front and center.
“For anything you do that’s awesome, there’s something that you’re hindering,” he pointed out, about midline mounting and perhaps about complex rehab technology choices in general. “For me, midline joysticks almost eliminated pulling [up] to a table.
That’s almost priceless to me — for everybody to be in the same place, whether I’m in a chair or out of a chair. If I’m eating at the table, I want [them to be able to.]. If I’m working at a workspace, they should be able to acquire that.”
Guisbert acknowledged that if a power chair user was highly functional with midline-mounted controls, he wouldn’t rule that positioning out. But he cautioned against generic questions such as “What mounting controls position should you use for cere- bral palsy clients?”, because having a diagnosis does not make everyone with that diagnosis exactly the same.
“These are all individuals,” he said. “It all depends on the family, the person, if they’re using their shoulder. If they put the joystick midline and are using their right arm, all of a sudden they might be pushing to the left a little more aggressively than they would be going forward.”
So as with everything else in complex rehab, midline mounting can be helpful to some power chair users, but each client is a case unto themselves.
And Guisbert is fine with that.
“To me, joystick users — they don’t need us,” he said of power chair consumers who can efficiently use standard controls. “I’m glad they have us, but for the people that need us the most, we’ve got to figure out where they do their best function.” m
Midline
Joystick Swing-Away Arm
• Optimal Position Memory – set each swivel point to the optimal positioning and Retract4 returns back precisely to the user’s optimal drive position each time
• Full 345° movement that allows for multi-position use
• Both right-hand and left-hand mountable
• Tension adjustment at both rotation points allows resistance to be matched to the user’s needs
800-492-7371 www.retract4.com
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18 JANUARY/FEBRUARY2020|MOBILITYMANAGEMENT
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