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Handling Tone in a Seating Evaluation

Michelle Lange, OTR, ABDA, ATP/SMS

November 17, 2015

Question

When tone is variable, how many times do you re-measure or what is your recommendation for how to handle during a seating evaluation?

Answer

These are really challenging clients. If you have enough hands on this client, you want to try to get the best measurements you can. As tone changes, the measurements might seem to change, at least in terms of available range, but body dimension should not change. We can look at the seating intervention that best meets this client's needs over the course of those fluctuations in tone. This might require seeing the client more than once.


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

Wheelchair Positioning: Postural Care
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

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Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3596Level: Advanced1 Hour
  'Knowledge imparted'   Read Reviews
The goals of wheelchair seating include managing posture and pressure as well as providing stability for function. Postural care addresses positioning outside of the wheelchair, particularly during sleep, and can be used to improve the quality and duration of sleep, promote health and maintain safety during sleep, as well as to minimize, prevent and even reverse orthopedic changes.

Dynamic Seating
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3093Level: Intermediate1 Hour
  'It taught me about a lot of the options that are available here in the US and the pros and cons of the different items'   Read Reviews
Dynamic seating has four primary functions – to allow movement, to diffuse force, to protect the client, and to protect the seating system and mounting hardware. This course will take a look at the product options, discuss clinical indicators and contra-indicators for dynamic components and present case studies to illustrate these points.

Positioning the Head
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3098Level: Intermediate2 Hours
  'Good info that covered a variety of topics'   Read Reviews
This course will discuss various strategies to optimize head position. First, we will explore strategies beyond the head support, including specific positioning interventions and addressing visual issues. Second, we will explore posterior head supports in depth, matching specific features to client needs. Third, we will explore other options which may be required if posterior support alone is inadequate, including anterior head support.

Wheelchair Mobility: Optimizing Driving in Power Wheelchairs
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3622Level: Advanced1 Hour
  'Clear explenanation of different types of power wheelchair configurations'   Read Reviews
Power wheelchair evaluation determines appropriateness for power wheelchair use and then determines the optimal power wheelchair base, power seating, driving method and other needed components. Optimizing power wheelchair driving is critical to improve outcomes and includes choosing the best drive wheel configuration, utilizing tracking technologies, and programming.

Positioning the Pelvis
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3157Level: Intermediate1 Hour
  'Easy to follow'   Read Reviews
The position of the pelvis very much determines the position of the trunk and lower extremities and so achieving and maintaining the optimal position is critical. This course will present common pelvic asymmetries with suggested strategies to address each challenge. Providing as neutral a pelvic position as possible improves overall posture, stability and function.