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Seating and Mobility Solutions for Bariatric Consumers of all Ages PowerPoint Presentation
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Seating and Mobility Solutions for Bariatric Consumers of all Ages

Seating and Mobility Solutions for Bariatric Consumers of all Ages

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Seating and Mobility Solutions for Bariatric Consumers of all Ages

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  1. Seating and Mobility Solutions for Bariatric Consumers of all Ages Presented by Jane Fontein PDG Vancouver, BC, Canada Stephanie Tanguay Motion Concepts Detroit, MI, USA Kathy Fisher Shoppers Home Health Care Toronto, ON, Canada

  2. Introduction • History … 20” chair • Get whatever chair is wide enough • Run a marathon in high heels

  3. How to contact us Stephanie Tanguay stanguay@motionconcepts.com Jane Fontein jfontein@pdgmobility.com Kathy Fisher kfisher@shoppershomehealthcare.ca

  4. Shapes Pear shape - more stable - gluteal shelf Apple shape - fluctuates - recline Bariatricrehab.com

  5. Wheelchair and Seating Issues What are the issues that you have found that are challenging when dealing with bariatric clients? Seating Issues: Size options Availability for evaluation Weight capacity Back Supports Mobility Issues: Having a bariatric chair available the correct size Mobility Transportation Weight of equipment Measuring Doorways - accessibility Availability for evaluation Weight capacity Anything else?????

  6. The seating assessment process • Pre Mat Assessment/Interview • - true weight • - weight history • The Mat Physical Assessment • Set objectives/ goals • Determine product parameters • Possible product options • Trial of equipment • Prescription and letter of necessity • Delivery and fitting • Follow up

  7. Created by: Stephanie Tanguay Jane Fontein

  8. Measurement Tools www.wheelchairsquare.com Callipers can make measurements easier and reduce errors. They need to be long enough to accommodate the client

  9. Measuring demonstration

  10. Severe swelling of the genitalia (lymphedema based, resulting from bariatric status) can limit functional seat depth and presents a unique need for tissue support.

  11. Clinical Reasoning Worksheet

  12. Goals for bariatric manual mobility and seating • Chair that fits • Easy mobility – by client or care giver • Adjustable for change in weight • Adjustable for fitting ( difficult to measure and or change over time) • Transportable • Safe • Accessibility • Accept seating • Provide seating

  13. Mobility Assumption • “ because of the additional weight the chair is difficult to move”

  14. Wheelchair Physics 101 Law of wheelchairs The location of the centre of gravity of the person within the wheelchair determines the ease of mobility and the stability of the wheelchair. ( not the weight of the person) The objective: is a trade off between stability and mobility that meets the needs of the person using the wheelchair.

  15. Wheelchair Physics 101 Rear wheels Should take majority of the weight Front wheels or castors Directional

  16. Wheelchair Physics 101 As the Centre of gravity (c of g) moves back with respect to the rear wheels, the chair becomes easier to move but less stable. As the c of g moves forward the chair becomes harder to move but more stable

  17. Maneuverability Seating issues: Maneuverability of the chair Posture Footrests ( Break issue)

  18. Maneuverability Typical Posture

  19. Maneuverability Difficult for the staff to maneuver and tilt the wheelchair

  20. Maneuverability Look at where the weight is located!

  21. Maneuverability

  22. Wheelchairs in General • Inexpensive – like standard chair – upholstery • Same in bariatric

  23. Bariatric Centre of Gravity • Rear wheels forward reduces load on casters and makes rear wheels easy to reach • Casters forward reduces caster load and improves stability Pierre

  24. Bariatric Centre of Gravity

  25. Kevin is a 41 year old man with Transverse Myelitis at the T7 level Current weight 410lbs Mobility Issues: Difficult to push – developing shoulder and elbow pain Outside mobility limited (unable to do wheelies) Change in weight

  26. Mobility

  27. Power Base Stability • Anterior vs. Posterior • Centre of Mass • Addition of Power Seat Functions

  28. Weight Capacity • Ole weighs 715 pounds Weight capacity is critical but not the only property that should be addressed

  29. Adjustability Matters • Original measurement was 38” wide • Upon delivery … Oops! She measured 26” • “Width adjustable!” Suzanne

  30. Seat Depth • Difficult to measure • Changes over time • Multiple users

  31. Transfers • Height of the chair is critical for transfers • Foot propulsion

  32. Front Rigging

  33. 38” wide wheelchair, with centre mount front rigging

  34. Rigid Frame Vs folding • High Strength • Lighter weight • Improved tracking • Easy to push or self propel Folding does not necessarily mean transportable Jay in a 28” wide chair

  35. Transportation

  36. Seating features • Back support – contact • Positioning of the lower extremities • Weight capacity • Dimensions

  37. Barbara • Weight greater than 400 lbs. • Current chair 24” wide, 18” deep Challenger. • Hip width 28.5” • Max. width for house access 30.5” • Funding: Medicare/Medicaid

  38. New Chair: Big Bounder • 28” wide • 22” deep • Solid back posts • Custom back • 28” wide x 8” • Weight upgrade • to 700 lbs

  39. Gloria • Initial pelvic fracture secondary to MVA • One year post, lost 100 pounds • Pear shaped • Leg length discrepancy