Change can be Hard, not being able to help is even harder........

I met a women the other day, where I was asked by their therapist to see if we could make some suggestions to improve the way she sits. This patient suffered from Quadriplegia and was currently in a new powered wheelchair. The therapist was concerned that the company who recently provided this new powered wheelchair did a poor job due to the appearance of her posture.

This patient was sitting slid forward in a posterior pelvic tilt, with a significant rounded back posture (khyphosis). This is a typical position for anyone post SCI who was not initially provided structured seating.   She was being held in the chair by her seat belt.  She had to hook her arms around the back canes (push handles) to stabilize her posture.

On inspection, it was concluded her ROHO cushion was over inflated, and her back support provided only support to her scapula with a huge gap between her pelvis and lower back support. Patient complains about sitting pain, and the therapist is deeply concerned that her posture will only progress and that it is destructive and will lead to significant health complications.  She also stated the company who provided the chair had to provide more foam to the back support since it was provided.

I asked the woman, who has been using a powered wheelchair for over thirty years, what her concerns were. She said discomfort, and in-stability.

When discussing the cushion, she said she had inflated the cushion as when it was delivered the cushion was too unstable and she added air to make it more stable. We discussed that the cushion for its therapeutic value needed to be less inflated she said that was not a possibility. We discussed that a different cushion may have been more appropriate, but she had always used a ROHO, and nobody asked her those questions. her insurance only covers a one cushion every five years.  When we discussed the back support, I offered that a back that was more contoured, possibly even molded would improve her stability and posture. She said that if she had a back that was more confining it would affect her ability to move and she was not willing at this time to compromise.

After several minutes of listening and learning what her needs were, and more importantly what she was unwilling to compromise over; it was obvious that there was little we could do to improve the situation.  She is an adult and can make her own informed decisions. At this time her function outweighs any physical complications that will result in the future from sitting in a destructive manor.

I offered her some information, and suggested she watch her postural progression and remember that there are other options if and when she is open to trying them. As a Seating and Mobility Specialist, I was disappointed that I could not help; however understand that I am not in her body, and understand that it is ultimately her decision.

Carey Britton, is the seating and mobility specialist forActive Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .