Posts Tagged ‘power positioning system’

A Balanced Look at Seating and Positioning

Wednesday, October 19th, 2011

Pride Mobility’s Julie Polin and Mike McCarthy discuss the needs of wheelchair users, emphasizing the need for a clear understanding of the need. Their article, reprinted here, first appeared in Mobility Magazine.

Providers and clinicians share the same ultimate goal of ensuring that a client’s needs are fully met in the most complete and efficient means possible.

When it comes to a client’s seating and positioning needs, it is necessary that all parties involved have a clear understanding of how this is best accomplished.

Understanding the Need

A complete wheelchair evaluation is necessary to address what an individual requires from his or her seating system, which may include cushions, backrests, headrests and trunk, arm and leg supports.

Only through a thorough seating evaluation can the client’s needs be understood. While the evaluation is the clinician’s key area of focus, providers, as product experts, should take an active role on the evaluation team.

A stable and comfortable position in an appropriate wheelchair is critical to the patient’s comfort, health, productivity and independence. Individualized seating and positioning systems can enhance breathing capacities, prevent skin breakdown, minimize pain and greatly improve overall functional abilities of an individual.

The factors that determine what seating components are going to work best for the client are numerous, but on a general level, are similar to those of other rehab equipment.

The patient’s level of injury, his or her capability, body type and activities of daily living must all be factored in, so this information should be gathered during the initial evaluation process

Know What Is Available

Seating requirements vary from a simple out-of-the-box solution to a highly complex, custom-built power positioning system.

Staying up to date on the latest equipment available and the reimbursement rules that govern its provision is a full-time job in itself. Providers must work diligently to educate themselves and their referral sources on the ever-growing number of seating solutions available.

Numerous educational opportunities can be found within the industry. By investing in education, providers can serve as a valuable resource to the clinician. Clinicians should therefore make time to meet with providers by scheduling in-services.

Providers are an excellent source of information on the options available to meet the client’s needs. Listen to what they have to say regarding the products they carry and why they are best suited to meeting your patient’s needs.

Providers should engage clinicians for feedback when reviewing the benefits of a product they would like to provide. Chances are the clinician has experience working with the product or a similar item and can offer an informed opinion.

Clinicians will also be able to estimate how many of their patients use the product, giving providers an idea of its demand and potential applications. Clinicians should remain realistic in their expectations. Understand the reimbursement and economic reality for each client. If you are recommending equipment that cannot be funded, then the patients’ needs are not going to be met.

Providers should create a system that takes the guesswork out of the reimbursement process. Develop an easy tool for your staff and referral sources to match International Statistical Classification of Diseases, Ninth Revision codes (ICD-9 codes) with the local coverage determinations (LCD) and match the demo equipment available to this tool.

When providers and clinicians work together to stay up to date, they are capable of giving the client access to the broadest range of equipment available.

Efficiency Is Essential

Patients and clinicians depend on providers to deliver seating solutions accurately and quickly. To stay competitive, providers must take steps to ensure that efficiency is a paramount part of their business operations.

To ensure efficiency, providers should evaluate their purchasing history and identify trends regarding the seating products they provide. A clear picture of the most commonly supplied products should emerge. Efficiency can be improved by purchasing your most popular products in quantity.

Providers should partner with a high-quality manufacturer that can provide many solutions to diminish the need to order from multiple vendors. Again, this can dramatically reduce overhead, reduce product lead time and shrink the margin of error.

Product reliability is an essential ingredient to ensuring the satisfaction of the patient, clinician and provider. Replacing or repairing a seating system leads to downtime for the patient, frustration for the clinician and quickly drives up provider costs.

If you select a manufacturer who produces and stands behind high-quality products, there will be fewer service calls.

Think Long-Term

Providers must work with clinicians to keep the patient’s future needs in mind. Will the back you provided easily integrate with the positioning components they may need in the future? A commitment should be made to carry products and parts your customers may eventually need or that will serve their changing needs.

Choose products that can be easily modified to prevent having to purchase additional items. Identify which products work best with the other equipment you are providing.

Compatibility is key. Offer cushions and other seating products that work with all of the chairs you provide. This keeps both patient and provider costs and down and makes future adjustment fast and easy. Ensure customizations are provided in a timely and cost-effective manner. It is important to consumers that their customizations are performed accurately and as quickly as possible.

Partner with a manufacturer that can quickly and reliably deliver custom seating sizes, and if necessary, can help fabricate unique components to reduce time and cost. Clinicians should educate providers on the progression of a client’s need. If a patient’s ability is likely to improve or decline, a plan that encompasses these changes should be discussed with the provider.

When providers and clinicians work closely together to meet seating and positioning needs, a great outcome is easily attainable. The needs and goals of each simply need to be understood and addressed.

Alternative Drive Control Case Study for Power Wheelchair: The MicroPilot

Wednesday, October 19th, 2011

by Robert Spitzmesser, ATP

Every once in a while we come across that one custom wheelchair application that is extremely difficult or almost impossible. I recently came upon one of those that the clinicians as well as I thought would just not work. But, having a “never say never” attitude I started looking for what I needed to make it happen. That’s when I was introduced to the new “MicroPilot” proportional joystick by one of my factory reps. Switch It has always been the “go to” company for really tough drive applications for PWC’s but they have really out done themselves this time! This device, I believe is the best thing to come along in several years as far as drive input devices go.
The MicroPilot is a extremely compact, very durable, proportional control that works off of pressure as opposed to movement. This is amazing in the fact that as little as 10 grams of pressure is all that is required. It is all metal construction and much more durable than the “mini joystick” which has a plastic housing and is prone to breakage.

The beauty with the MicroPilot is it can be mounted literally anywhere because of its size. It also only needs a minute amount of pressure to activate it. If an individual has simple control of a single digit on their hand but no fluid movement capability then this would be a perfect application for the MicroPilot. Here is an example of how I used it to allow an individual that was considered absolutely a non candidate for power. For privacy reasons we will call her Kim.
Kim is a 21 year old female that suffered a severe allergic reaction to a medication which left her with severe neurological deficits. She presents symptoms very similar to somebody with severe spastic cerebral palsy. Kim burns about 15k to 20k calories a day because of the severe spasticity and uncontrolled movements. She has to have injections and oral medications every hour to two hours to help control the spasms and severe hypertonic muscle tone. She is very bright and intelligent and communicates with eye movements to yes and no questions. She had actually used a PWC several years back with a head array but had trouble controlling it and injured a playmate and was reluctant to ever use it again.

Upon physical examination I noticed she was held in place in her manual wheelchair by several straps, supports, padding and positioning harnesses. But, even constricted as much as she was I noticed she had a very steady left hand even though it was in a severe fixed posterior wrist contracture which was rotated inward toward her midline torso area. I thought to myself “this is going to be impossible!”. A head array was out of the question due to limited movement only to the right and her reluctance to use it again. The only way this would work was if I could figure out a way to get a control mounted directly in front of her ring finger on her left hand, but her hand was so badly contratured and rotated that it would take something I had not ever seen. Walla, in comes the MicroPilot!

I began assembling a Quantum Q600 with the proper supports and straps to hold Kim in place to perform an evaluation with the MicroPilot. After 14 padded straps, laterals, and other numerous supports, we were ready. I originally mounted the MicroPilot in the Bullet Tray from Switch It on the left side flush with the arm pad trough. The Bullet Tray allows you to mount the MicroPilot flush with the half circular cut out so that it is not exposed for accidental input by a random spasm. At first we strapped down Kim’s arm very snug to keep it from moving but she could not reach the tray properly to make contact with the MicroPilot. So, to compensate for her severe rotation in her wrist, I used the “multi axis 360 degree” mount to position the Bullet Tray with MicroPilot perpendicular to the armrest and at a 45 degree angle to the arm tough in toward midline of her torso. Bingo! Kim did not have to struggle to reach it! It actually allowed her to rest her palm on the Bullet Tray and insert her ring finger into the cutout to make contact with the MicroPilot. That is all you need! Just contact and the ability to apply pressure not movement! The first thing that happened was she went in a circle, like all first time users of something new! But then she was able to follow commands such as forward, left, right reverse and stop. The only issue we had was she became so excited she couldn’t control her spasms! We worked a little more to find the optimum position for the MicroPilot and discovered she could actually use her palm as well! What was amazing is her dad could not believe she was driving because her hand nor finger were actually moving! I had to show how the system worked off pressure and not movement and he was totally amazed (as was I!) on how efficient it actually was!

I believe Switch It has hit a home run with this input device. I believe this will allow so many more applications for individuals that would otherwise not be considered for power wheelchair applications. Like any device it will take a lot of training but in the long run it has opened the door for us ATP’s to create mobility where it would have never been before.
For more information on this new and revolutionary device, please contact Switch It or visit their website at http://www.switchit-inc.com/ for more information.
You will not be disappointed!

For more information contact Active American Mobility at 888-734-2207

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