Components of the seating system to be evaluated
This section contains an overview of the various components of a seating system that should be considered as a part of the system evaluation.
Seat and pressure care cushion
- Check the seat base under the cushion, noting whether a drop seat base or seat wedge is used and the condition of the seat upholstery or solid seat insert.
- Check the cushion inside the cover and for any additional inserts or layers.
- Take details of:
- Manufacturer, model and product code of the cushion and cover if they are labelled
- Size: measure for width, depth and height - especially when there are no codes
- Features to be noted include: modifications/customisations/additional positioning aids/ material of the cushion components and the cover age: check for date of manufacture on previous prescriptions/orders/product labels/box
- Condition of both the cover and the cushion
Note the location of ischial tuberosities (ITs), greater trochanters (GTs), sacrum, coccyx and in some instances, posterior superior iliac spine (PSIS) against the support surfaces. Investigate if these bony prominences are at risk or positioned correctly according to the contour of the cushion.
There is a range of back support systems including:
- Non-adjustable, tension adjustable upholstery or sling back support
- Rigid or solid pre-contoured back support with (minimum, mid, or deep contour and a range of height options)
- Bi-angular and segmented back support systems, or
- Moulded or configurable back support systems.
Features and additional components of the back support system may include:
- Lateral trunk support and mounting hardware (record swing away or fixed, height and depth of lateral support padding and material of padding)
- Posterior trunk support / lumbar in the lower back region
- Lateral pelvic support attached to back support
- Customised back support padding and cover (lumbar spine channelling, multi-density foam insert, shear reduction cover)
- Power recline back support with shear reduction features in power wheelchairs
Identify and record back support details from the label if possible for clarifications, for example:
- The width of a solid back support may not always correlate to the width of the wheelchair seat frame.
- There may be various components from different manufacturers used within the back support system- back support components and thoracic lateral support. Check and describe every layer and component. Take photos for future references.
Identify issues related to the seating set up on the client:
- Note the location of the posterior superior iliac spine (PSIS) against the backrest support surface
- Note the apex of any scoliosis as detected in MAT evaluation in relation to the position of the thoracic support.
Other postural support devices
- Head support and mounting hardware (take a photo)
- Anterior shoulder and/or chest support: shoulder harness and chest belts
- Anterior pelvic support: pelvic positioning belt, rigid pelvic stabilizer
- Arm support: arm rest (desk or full length), arm trough, hand piece, posterior upper arm support (elbow block); assembly type (dual, single post, or flip-up)
- Thigh or knee support: lateral thigh support (thigh adductor, wedges), medial knee supports (abductor, pommel), lateral (adductor pads) knee supports and anterior knee support (knee block)
- Foot support and assembly type: 60/70/80/90 degrees, centre mount, elevation, fixed, flip-up or swing away
- Lower leg support: Calf pads, stump support for amputees
- Foot supports: angle adjustment footplates, ankle huggers, heel loops
Other assistive devices
There are a great number of assistive devices available that are often quite distinct, for example, ventilators, drinking aid, electric leg bag drain and mounting hardware for ECU/tablets, additional charger for electronic devices. Try to notice any particular details that allow these devices to be effective for meeting the client’s needs.
- Queensland Spinal Outreach Team and School of Health and Rehabilitation Sciences, 2013. Seating systems for people with spinal cord injury assessment, prescription and other consideration. University of Queensland. www.health.qld.gov.au/__data/assets/pdf_file/0019/423433/seating.pdf Accessed: 29/02/16.