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Prioritize Seating Challenges During a Wheelchair Evaluation

Michelle Lange, OTR, ABDA, ATP/SMS

November 10, 2015

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Question

These challenges that we see in seating often are not seen in isolation. We see combinations of them. How do we prioritize them during a wheelchair evaluation?

Answer

It really comes down to what is flexible and what is fixed. For example, if someone has a combination of posterior pelvic tilt and rotation, we are going to look at solutions that address both. An anti-thrust seat, whether it is part of a linear seat or built into a molded seat, has a curb to block the IT's. That can help prevent both posterior pelvic tilt and rotation. We also know that the position or the angle of the pelvic belt is important in limiting posterior pelvic tilt. We would choose probably a 60 degree angle to limit that posterior pelvic tilt but we would make sure it pulled down on the forward side if we were also dealing with rotation. It is keeping in mind all the challenges that we are seeing and trying to create solutions that address all of those. It is very important today to look at how we match individual seating challenges to strategies such as angles of pelvic belts, cushions that are anti-thrust shaped, etc. 


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 Seating: Considerations for the Hands-Free Sitter
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3585Level: Advanced1 Hour
  'It was very well organized'   Read Reviews
Wheelchair seating is designed to provide postural support and alignment, stability for function and mitigate pressure issues. This course will address assessment and intervention when working with a client who can sit without the support of their hands, referred to as the ‘hands-free’ sitter.

The Seating and Mobility Specialist (SMS) Certification: An Overview
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3586Level: Advanced1 Hour
  'Wow, good information in general'   Read Reviews
The Seating and Mobility Specialist (SMS) certification recognizes competence in assessment and intervention. This course will cover what this certification is, who the SMS is designed for, why it was developed, why the SMS may be beneficial to a clinician and how to acquire this certification.

Wheelchair Seating: The Mat Assessment
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3590Level: Advanced1 Hour
  'details of mat assessment were very helpful; good case studies'   Read Reviews
A key component of wheelchair seating evaluation is the mat assessment. This course will present the mat assessment, including supine and sitting, and will include case studies and videos.

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

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3595Level: Advanced1 Hour
  'Liked the refresher for pressure injury staging as well as the different type of seat cushions'   Read Reviews
A main goal of wheelchair seating is pressure management, specifically to prevent development of pressure injuries. This course will present pressure injury definitions, staging, etiology and specific seating interventions.

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

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3596Level: Advanced1 Hour
  'Well laid out course with examples to follow and think through'   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.

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