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Equipment Needs

This overview provides information on seating systems, optimal posture, support surfaces, and mobility equipment for assessing seating needs. It includes assessments, critical areas, key seating angles, and the impact of posture and movement on equipment assessment.

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Equipment Needs

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

  2. Overview • Seating Systems • Optimal orientation in space • Key seating angles • Support surfaces • Mobility Equipment

  3. Developmental Factors • Emergence of sitting – with neutral pelvis • Mobility of the lumbar spine • Development of postural control for trunk stability • Upright active sittingposture

  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 AnglesGeneral 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 AnglesSpecific Considerations • Seat to backrest angle • Variables • Seat to calf rest angle • Variables • Calf rest to footrest angle • Variables

  15. Optimal Orientation in SpaceGeneral 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 SpaceSpecific 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 SurfacesSpecific 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 • Side folding frame • Rigid frame • Recliner wheelchair • Tilt in space wheelchair • Tilt and recline wheelchair

  21. Power or Manual • Control unit • 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 SeatingOptimize 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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