1. "מעיין פיזיותרפיה"- כל הזכויות שמורות1 OFIR SEAT CUSHION Preventing slipping and pressure wounds in a wheel chair

2. "מעיין פיזיותרפיה"- כל הזכויות שמורות2 Background: Millions of disabled people around the world with various degrees of disabilities are confined to wheel chairs. The less control they have of their seating position – more likely they will develop pressure wounds and other pathologies. (Ulcer,Decubitus)

3. "מעיין פיזיותרפיה"- כל הזכויות שמורות3 Background A common event we encounter working with disabled people, is the gradual slipping down in the wheel chair due to lessened/lack of control of the lower body.

4. "מעיין פיזיותרפיה"- כל הזכויות שמורות4 Background Slipping down - Causes great discomfort Hinders patients activities Leads to a “slump position” – Increases pressure on the Sacrum and increase risk of pressure wounds. Increases Kyphosis, hindering chest expansion which leads to a decrease in breath Efficiency and ventilation. Increases friction and shear forces on soft tissues which may result in pressure wounds -even more so with patients who suffer from bad/lack of bladder control

5. "מעיין פיזיותרפיה"- כל הזכויות שמורות5 Backgrounds - Some patients do not suffer from any physical disability but have a cognitive dysfunction which may results in unawareness of their sitting position. Coupled to a physical disability the problem increases exponentially.

6. "מעיין פיזיותרפיה"- כל הזכויות שמורות6 Background - As the angle between pelvis and back seat increases we witness – An increase in the distance between back and back seat. An increase of torque leading to slipping and increase in shear forces operating on soft tissues. OUR GOAL –Preventing slipping in the wheel chair.

7. "מעיין פיזיותרפיה"- כל הזכויות שמורות7 The Solution must address two major issues: Friction – which will prevent slipping Pressure dispersion– which will decrease risk of pressure wounds Meticulous market research have shown that there is no “reasonably priced” solution. A problem which especially affects medium/large scale institutions.

8. "מעיין פיזיותרפיה"- כל הזכויות שמורות8 A manager’s Dilemma “With decreasing and strict financial budget should I purchase expensive cushions for the selected few or buy cheap, low grade cushions for the Majority”.

9. "מעיין פיזיותרפיה"- כל הזכויות שמורות9 Our Goal creating high quality affordable seat cushions. Providing Any institution the ability to deliver high grade product to Any patient in a wheel chair.

10. "מעיין פיזיותרפיה"- כל הזכויות שמורות10 OFIR Seat Cushion Creates proper slope and anchoring of the pelvis in the seat of the wheel chair by using two surfaces. Hard foam – located in the front of the cushion,preventing skidding Soft foam - located in the back of the cushion, dispersing pressure

11. "מעיין פיזיותרפיה"- כל הזכויות שמורות11 Thickness Optimization In designing the cushion,one needs to balance a few factors Thicker foam – Positive effect Increases effectiveness preventing pressure wounds. Negative effects - Cost - Using more foam increases the product’s price. Physical difficulties -A thicker cushion increases the care giver’s difficulty in placing the patient. A change in the height ratio between the back seat/handles and cushion may Lead to instability and discomfort. Careful research have shown that optimum cushion’s height is 8.5cm (10cm in the thigh area).

12. "מעיין פיזיותרפיה"- כל הזכויות שמורות12 Pressure dispersion comparisons : Compared to current leading products “OFIR Cushion” was found to be more effective* in Pressure dispersion due to- Use of high quality materials. Extra dense Visco Elastic foam. The following is an XSensor imaging of “OFIR Cushion” compared to other products *The comparison was made only on one patient thus cannot be published as valid research.

13. "מעיין פיזיותרפיה"- כל הזכויות שמורות13 Pressure Comparison legend A “brighter” and “hotter” area means higher pressure – measured in PSI. Do notice the data regarding peak pressure and Average pressure on the right. OFIR Cushion is displayed in the upperOFIR Cushion is displayed in the upper right quadrant. right quadrant.

14. "מעיין פיזיותרפיה"- כל הזכויות שמורות14 t empur Regular Visco elastic foam OFIR seat cushion

15. "מעיין פיזיותרפיה"- כל הזכויות שמורות15 Next slide shows a comparison between “OFIR Cushion” and “Flo- Tech” cushion. Pressure dispersion comparisons:

16. "מעיין פיזיותרפיה"- כל הזכויות שמורות16

17. "מעיין פיזיותרפיה"- כל הזכויות שמורות17 Quality and Durability OFIR Cushion is protected by a Patent No.: US8,167,326 b2. OFIR Cushion is built to last, with high grade materials - Extra dense Visco Foam.

18. "מעיין פיזיותרפיה"- כל הזכויות שמורות18 Stabilizing bottom surface made out of PALFOAM™ which allows enhanced Flexibility and durability. Cushion cover is made of Zaion – a new composite material that is fluid repellent, anti-bacterial and burning inhibitor. Quality and Durability

19. "מעיין פיזיותרפיה"- כל הזכויות שמורות19 In Conclusion OFIR Cushion is highly cost effective and will improve both patients health and quality of life. In addition to decrease of potential work load of care giver’s, it is the best available comprehensive solution for medium/large institutions.

20. "מעיין פיזיותרפיה"- כל הזכויות שמורות20 Guidelines and limitations The Cushion might not prevent slipping due to Increased Extensor Tone - In this case we advise a Tilt in Space solution. The Cushion’s effectiveness preventing slipping may decrease in chairs with low foot rest – When knees are below seat’s height.

21. "מעיין פיזיותרפיה"- כל הזכויות שמורות21 Guidelines and limitations Low quality of back rest may result in patients slumping into a kyphotic position and PPT. Solution – a back lumbar pillow which increases back EXT and Anterior Pelvis Tilt (APT) - Thus decreasing weight load of the buttocks moving it toward the thighs. A back lumber pillow can be purchased in addition to “OFIR Cushion”.

22. "מעיין פיזיותרפיה"- כל הזכויות שמורות22 Standards and Modifications “OFIR Cushion” is available with standard lengths of 40/45/50 cm Costume made cushions are available for different prices. A new “Crescent shape” design – extra durable for wheel chair’s “wear and tear” is now available.

23. "מעיין פיזיותרפיה"- כל הזכויות שמורות23 OFIR Cushion The future Standard for a comfortable affordable and safe Cushion.

24. "מעיין פיזיותרפיה"- כל הזכויות שמורות24 We are available at : physioyan@gmail.com physioyan@gmail.com physioyan@gmail.com www.carit.co.il www.carit.co.il thank you, Maayan Eizinger, Physiotherapist. TeleFax – 972-15397920390 Cellular - 972-523438976