4 Simple Seating Modifications That Make a Significant Difference
Are you aware of the many custom modifications that you can make to a foam base in your clinic? All you need is a bit of practice and an electric knife. Here are four alterations that can be completed in a short amount of time to benefit the end user’s seating needs.
Refer to the diagram below and allow me to spend a few minutes of your time reviewing these modifications.
1. The first modification (A) is a notch out.
This is typically beneficial when your client has a leg length discrepancy or may have increased tone with limited knee extension range. Maybe your client has a condition where the left lower extremity (LE) requires more femoral support and the right LE is responsible for aiding with propulsion. By taking a notch out, this will help prevent skin abrasion and discomfort.
2. The second modification (B) is a notch out along the entire depth of the cushion or in specific areas of the side walls.
This modification is generally performed when an end user needs to sit lower in the chair to achieve proper foot placement on a footplate, promote a proper heel-to-toe strike during propulsion, or further assistance is needed to achieve proper hand placement on the rear wheel during propulsion (besides moving rear wheel).
This is commonly performed when the end user has a folding frame chair with cross brace where the seat rails sit on top of the side frames.
Another instance is when an end user has a drop seat pan in which the cushion needs to be lowered. Often, I will see just one side notched out to help promote better midline alignment of the pelvis if the end user sits with a slight lateral pelvic, or a flexible thoracic lean.
3. The third modification (C) allows the cushion to extend past the back posts of a wheelchair.
Today, there are several out-of-the-box cushions designed with these notches already in place. This modification allows for an inch or two to extend rearward beyond the seat upholstery. (Usually seen on chairs that have sling upholstery for the back support.)
Another common instance for the notch out is to assist building seat depth growth in the cushion to allow for an individual to grow. Typically, growth in seat depth occurs at a faster rate than seat width, therefore to maximize the lifespan of the cushion the notch out allows for us to prescribe a seat cushion with a greater depth, position the cushion correctly in the chair and then slide the cushion forward as necessary to maintain proper LE contact and support with the cushion. Use caution when using cushions that have a built-in pelvic well. We do not want anyone resting their ischial tuberosities on the anterior shelf. (Not good form there!)
4. Finally, look at modification (D).
This one is sure to always puzzle at least one attendee in my seminars. The femoral scoop is completed when we have an end user that has limited hip flexion, or may have a fixed hip angle. Without this scoop we will see decreased femoral contact with the cushion and, most likely, some form of deviated sitting posture as the client attempts to sit comfortably. Try to mimic this yourself and see how you compensate for that lack of proper support. You will most likely gain a deeper appreciation for your client’s needs.
There are several other modifications that can be performed on cushions to help maximize proper position and capture the optimal seating footprint. Take the information that you’ve learned today and a foam base and see what you can come up with. Go ahead! Don’t be hesitant or anxious. If you make an error, your Sunrise Medical Representative is available to help bail you out. Before you know it, your job title will include “Seating Wizardry with an Electric Knife!”
I can’t wait to hear about your seating modifications!
Disclaimer: The contents of this blog are intended to be utilized as a general resource for clinicians and suppliers to then use clinical reasoning skills to determine optimal seating and mobility solutions for individual clients. Steve and Angie are unable to answer questions from members of the general public including caregivers and end users. Members of the general public should direct specific questions to their own clinicians, medical, suppliers, or other health care professionals.
Posted by: Date: 6/3/2014 5:12:44 PM
Filed under: Education