Page 11 - Mobility Management, April/May 2020

The Balance Equation
At the core of any wheelchair evaluation for a client who has lost one or more limbs is their sense of balance. Children growing up with congenital limb loss, due to their limbs not fully developing in utero, develop their own sense of balance. This trait makes it easier for children to transition to a chair as they get older, says Angie Kiger, M.Ed, CTRS, ATP/SMS, who serves as the Clinical Strategy and Education Manager for Sunrise Medical.
“It’s kind of a different ballgame,” Kiger said. “Because they were born not knowing their limbs were there, they actually learn and create their own sense of balance as they become mobile inde- pendently. When they’re working on their core as they’re growing, it’s a bit different than someone who lost their limbs later in life.”
Compare that experience to the wheelchair transition made by Special Forces veteran and Sunrise Medical client Mark Holbert, who lost both legs and some fingers on his right hand after stepping on an IED during his 2010 tour in Afghanistan. Holbert, now an active wheelchair user who prefers a folding-frame ultralightweight manual chair, has had to try out several products to figure out the right solution for his lifestyle.
Due to his injuries, Holbert’s right leg was amputated above the knee, while his left side amputation goes up to his hip.
“For me to off-weight the pressure and try not to get pressure
sores, that was the biggest need for me,” Holbert told Mobility Management. “I tried multiple seats and different kinds of cushions, and I was constantly getting pressure sores left and right, and that’s being out of the [prosthetic] socket.”
Holbert also experienced issues with balance when he wore his lower limb prostheses while in his chair.
“When I was in a socket, it was bad if I had a cushion that was pre-shaped foam because then my whole balance of sitting up straight was off,” he added. “Now I had my prosthetics interfering with the cushion.”
The best solution for Holbert, in his prosthetic devices and out, was an air-celled cushion. He is now able to sit on the softer, more adjustable surface all day without developing the painful and dangerous pressure injuries that can plague people with limb loss. But the air cushion presents some unique balance challenges of its own, Holbert and Kiger noted.
“Mark has got a super strong upper body, and so transfers for him, even though he is missing most of the left leg, are easier,” Kiger said. “Sometimes people will report the full air-cell cushion can be difficult to navigate because it doesn’t provide them the firm support that a foam cushion may provide them.”
Switching to the air cushion from a foam solution made it harder for Holbert to balance his upper body as he tried to propel
WE GO WAY
BEYOND
THE CHAIR.
Our chairs are one of a kind. So are our employees, like Zach. We make it our mission to go above and beyond so that every client gains the independence and self-reliance they deserve. Clients like Jane. To read Jane’s story, visit NSMLetsGetMoving.com.
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