Complex seating can be confronting, with no two consumers presenting the same. Therapist learn and become confident prescribers through experience (lived and shared), mentorship and through access to product knowledge. The story of Marty’s prescription will hopefully help one your clients in the future…

 Marty is a consumer who presented with flexion high tone patterns which cause him to collapse into a fixed convex scoliosis impacting on lateral forward flexion of the head and neck. This presentation in his previous wheelchair lead to the following occupational performance issues:

  • Severe lateral collapse to the left – Unaffected by normal tilt
  • Difficulties swallowing
  • Poor respiration
  • Skin chaffing/irritation under and around the left armpit
  • Pressure injuries present on the left trunk

 

Seating goals were developed to improve the symmetry of the head, neck and trunk in order the protect the “life box”. Distributing areas of pressure and forces on the body were also identified as important for maintaining skin integrity. The decision was made to trial dynamic lateral tilt as a custom power add on to the trial wheelchair to counter act the affect gravity’s pull was lateralling having on Marty. Utilizing dynamic lateral tilt instead of fixing a seating system on a lateral angle, allows weight shifting coming out of lateral tilt to ensure skin integrity is maintained.

 

 

The results from trail and prescription are evident in Marty’s outcome photos. Measurable results include:

  • Improved respiration
  • Decreased skin irritation
  • Decreased pressure on the left trunk
  • Functional gains including improved eating, improved interaction with peers and enhanced participation.

 

Marty now uses a combination of anterior/posterior tilt and lateral tilt daily for:

  • Pressure management
  • Improved sitting tolerance
  • Management of posture
  • Safe swallowing
  • Safe eating

 

Marty’s musculoskeletal postural challenges are not uncommon, and his results using lateral tilt have been remarkable. Contact Linds today if you have a client you would like to trial with dynamic lateral tilt.