Page 14 - Mobility Management, May/June 2022

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of the ISS [International Seating Symposium] Webinars, talked about repairs and how repairs leave people stranded.
“I don’t want this to come out wrong, but we have to figure out, as an industry, how to ensure that quality is the number-one priority when we’re putting wheelchairs out for our clients. Quality and not cost, because we know that a lot of it is driven by cost and price.”
Current funding policies force seating teams and riders to select chairs that aren’t necessarily the consumers’ first choice, Hamstra added. “It’s all driven by reimbursements. So I think that’s where we have to get users educated on advocacy so they’re able to have access to the better technologies.”
She cites Medicare policy that prevents beneficiaries from selecting a frame made of materials that are considered upgrades.
“Medicare used to allow [beneficiaries] to upgrade [ultralightweight wheelchair frames to other materials, such as carbon fiber or titanium],” she said. “You can’t upgrade anymore.”
Hamstra added that while a carbon fiber or a titanium option is commonly called an “upgrade,” she prefers a different term. “I use the words ‘enhanced materials’ whenever I’m talking
about titanium or carbon fiber,” she explained. “It’s not an upgrade. It is an enhanced material.
“Aluminum is basic. It meets the basic need or the
minimum medical requirement. So an aluminum chair in the ultralightweight category meets the minimum basic requirements of what the funding source has to provide. When you’re reading funding guidelines, they’re going to give you the minimum criteria.”
But other materials, Hamstra said, have properties that lead to better performance and function, such as vibration damping. “There are so many studies talking about how detrimental
vibration is to people,” she noted. “There are studies looking at whole-body vibration, talking about how basic wheelchairs are not meeting the need for [preventing or limiting] it.”
Vibrations transferred to the rider with every roll over a flooring transition, crack in the sidewalk, curb or uneven surface can cause a number of unwanted reactions, such as spasticity.
“Or [riders] may have hardware in their spine; so many of them have had [spinal] fusion,” Hamstra said. “They’ve got spasticity, they’ve got hardware, they’ve got pain.
“A lot of times, they have a higher pain threshold [vs. able- bodied people]. Their bodies may not interpret pain the same way that someone who doesn’t have a neurological or some other sort of impairment does, but it’s affecting them in other ways. Maybe they have an intense amount of fatigue, because of all of that vibration that is going up into their body.”
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