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Equipment Needs Margo Prim Haynes, PT, DPT, MA, PCS

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Presentation on theme: "Equipment Needs Margo Prim Haynes, PT, DPT, MA, PCS"— Presentation transcript:

1 Equipment Needs Margo Prim Haynes, PT, DPT, MA, PCS
Mary Rose Franjoine, PT, DPT, MS, PCS 2009

2 Overview Seating Systems Mobility Equipment
Optimal orientation in space Key seating angles Support surfaces Mobility Equipment What are we want to accomplish with our seating system

3 Developmental Factors
Emergence of sitting – with neutral pelvis Mobility of the lumbar spine Development of postural control for trunk stability Upright active sitting posture Developmental Issues that Influence Seating system

4 Seating Assessment General Information Medical History Social History
Daily Positioning Transportation Current Equipment Function Musculoskeletal Eval

5 Posture & Movement Assessment for Equipment
Supine & Sitting Evaluation Posture Alignment : trunk and pelvis: pelvic tilt, obliquity, pelvic rotation, kyphosis, lordosis Alignment of LE: flexion, extension, adduction, abduction, internal rotation, and external rotation Movement In Supine In Sitting Transitions

6 Impact of Posture and Movement in Assessment for Equipment
Current Equipment Positioning Transition Client and family satisfaction Use-ability Skilled – independent Requires some assistance Dependent

7 Seating Assessment Critical Areas
Seating angles Seat to back angle Seat to calf rest angle Calf rest to footplate angle Optimal orientation in space Support surfaces Transition in and out of equipment Client and family expectations (goals) of equipment Motor planning abilities

8 Mat Assessment Pictures

9 Knee Extension in Sitting
Pictures

10 Knee Range of Motion Supine
Pictures

11 Pelvic Mobility in Sitting
Pictures

12 Lower Extremity Movement Effect on Pelvis/Spine
Knee extension and hip flexion can effect the pelvis and lower spine

13 Key Seating Angles General Considerations
Support hips in maximum (optimal) flexion while allowing the pelvis and spine to remain in neutral alignment Support lower leg so the knees are in a comfortable degree of knee flexion with sufficient slack in the hamstrings while allowing neutral pelvic alignment Support ankle at the angle which allows for alignment of the ankle joint structures and supports the LE

14 Key Seating Angles Specific Considerations
Seat to backrest angle Variables Seat to calf rest angle Calf rest to footrest angle

15 Optimal Orientation in Space General Objectives
Influence degree of muscle readiness Maximize function in most upright position Maximize physiological functions Respiration Digestion Elimination Maximize postural alignment and control

16 Optimal Orientation in Space Specific Considerations
Postural Control for function Alignment Optimal position to activate BOS Movement for function Comfort Endurance

17 Support Surfaces Surface of the seat, back, and positional components create the interface between the user and the seating system Properties of these surfaces directly impact the systems overall effectiveness

18 Support Surfaces Specific Properties
Surface contact area Planar Simple Contour Generalized Contour Aggressive Contour Surface flexibility External support

19 Frame Styles Important to have Seating Specialist on team to determine frame style Frames have features that make the difference between independence and dependence

20 Frame Styles Stroller Manual wheelchair Recliner wheelchair
Side folding frame Rigid frame Recliner wheelchair Tilt in space wheelchair Tilt and recline wheelchair

21 Power or Manual Control unit Environmental Interfaces
Head Hand Foot Parental override Environmental Interfaces “Bells and Whistles” Power recline Power Tilt in space Elevate Stand

22 Frame Features Backposts Seat rails Footrest hanger styles Footplates
Armrests Rear wheels Forks/caster blocks Headrest Mobility

23 Goals of Seating Optimize Function
Maximize postural alignment Minimize postural supports Pressure relief Accommodate deformity Accommodate joint limitation Relieve pain/improve comfort Reduce influence of stiffness

24 Outcome of Seating Enhance function Encourage independence
Free upper body for function Facilitate interactions Peer Environment

25 Successful Seating Includes
Thorough assessment Precise problem solving Unique application of technology

26 Equipment Needs Margo Prim Haynes, PT, DPT, MA, PCS
Mary Rose Franjoine, PT, DPT, MS, PCS 2009

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