Seating: Matching Client Needs to Product

Seating: Matching Client Needs to Product
Michelle Lange, OTR, ABDA, ATP/SMS
October 21, 2015

To earn CEUs for this article, become a member.

unlimited ceu access $99/year

Join Now
Share:

Seating Systems

Seating systems can be comprised of off-the-shelf components, things like a standard cushion that we order by dimension, a certain width and certain depth, or an off-the-shelf back.  We can also have a custom made linear, contoured, or even a molded seating system.  Each part of the seating system, the seat, back, and any secondary supports, can be either linear, which means a flat surface, or contoured.  The list of the main positioning systems available in the market today are off-the-shelf cushions and backs, planar or linear systems where all the components are flat surfaces, generic contours, aggressively contoured where we are customizing a little more towards an individual, and finally molded, which is absolutely molded to the client's specific body shape. 

Off-The-Shelf Seating Systems

Cushions

When do we look at an off-the-shelf cushion versus other seating options?  Some of the advantages of these off-the-shelf cushions is that they are removable.  It is easy to just pull this off of the sling upholstery or seat pan that it sits on.  That allows the chair then to be folded either side to side, as in a more traditional wheelchair, or in some of our rigid wheelchairs, the back canes fold downward and we end up with kind of a box.  Sometimes, with those rigid ultralight chairs, the back canes fold-down, the rear wheels pop off, and that cushion might get in the way of the back canes folding down as much as necessary, and so again, the cushion can be removed. 

The cushion can also be used on more than one mobility base.  If the client has a manual chair and a power wheelchair, then the cushion could go back and forth.  You can also take that cushion out and use it on other surfaces.  A great example of this is on an airplane.  If we have a client who has pressure concerns, or they are at risk of developing pressure ulcers, we need to make sure their skin is protected on other surfaces as well.  During the long trip, sitting on something like an airplane seat puts them at a pressure risk. These cushions are generally easy to maintain.  We can unzip covers, wash them, etc.  

As with everything that we recommend, there are always contraindicators.  It is very important to be aware of those, because there is certainly no one product that can meet everyone's needs. Postural control may be inadequate for some clients.  These cushions are designed to provide a limited amount of postural control.  Pressure distribution may be inadequate; it depends on the cushion.  There are some that are designed to prevent pressure ulcers and do so very well.  Linear seats, as they have a flat surface, tend to accommodate growth better, because you can simply pull that cushion out further. Often part of a linear seat is tucked underneath the back so we have some available growth for future needs, particularly in pediatrics.  With a contoured seat, it is not as simple as pulling the seat forward, because the contours now are in the wrong spot.  We have to have a different way of accommodating growth.

To earn CEUs for this article, become a member.

unlimited ceu access $99/year

Join Now

michelle lange

Michelle Lange, OTR, ABDA, ATP/SMS

Michelle is an occupational therapist with 25 years of experience and former Clinical Director of The Assistive Technology Clinics of The Children’s Hospital of Denver. She is a well-respected lecturer, both nationally and internationally and has authored 7 book chapters and over 175 articles. She is the editor of Fundamentals in Assistive Technology, 4th ed. Michelle is on the teaching faculty of RESNA and the University of Pittsburgh. She is on the RERC on Wheeled Mobility Advisory Board. Michelle is a credentialed ATP, credentialed SMS and is a Senior Disability Analyst of the ABDA.



Related Courses

Dependent Mobility
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #22861 Hour
Dependent mobility devices are not designed for self-propulsion. These include adaptive strollers, transport chairs, tilt in space manual wheelchairs, reclining manual wheelchairs and standard manual wheelchairs. For very small children, adaptive strollers are often required to meet positional and dependent mobility needs. Other dependent mobility bases, such as transport chairs and standard wheelchairs, are used for quick trips or for temporary use. Clients may also use a dependent mobility base as a back-up to a power wheelchair.

Manual Mobility for Self-Propulsion
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #22911 Hour
Most manual wheelchairs are designed for self-propulsion. A number of categories are available, however, including Standard, Standard Hemi, Lightweight, Ultra Lightweight, Pediatric, Bariatric and specialty frames. This course will systematically explore each category with clinical indicators, as well as optimal frame configuration to increase propulsion efficiency and reduce risk of repetitive stress injury.

Power Mobility
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #26781 Hour
This course will present power mobility options for those unable to self-propel a manual wheelchair. Mobility options include scooters and power wheelchairs. When recommending a power wheelchair, the clinician must determine readiness, seating, driving method, power seating and other features. This course will present various options with clinical indicators.

Overview of Computer and Tablet Access
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #26831 Hour
This course will present a hierarchy of computer and tablet access options for clients unable to use a standard access. Access assessment requires analysis of physical access, vision, cognition and functional applications. Alternative keyboards and mice will be presented, as well as other alternative access options.

Wheelchair Seating Assessment
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #26631 Hour
This course was part of our Wheelchair Seating- Back to the Basics Virtual Conference. Occupational and physical therapists are often key members of the wheelchair seating evaluation team. Seating assessment includes evaluation of current posture and equipment, a mat examination and equipment recommendations. This course will review this assessment process.

This course is part of the "Wheelchair Seating Back To The Basics Virtual Conference".