Back to accessibility links
State Spinal Cord Injury Service

Spinal Seating Modules

Case Study: Katherine

Case study questions

  1. Why would posture be important to Katherine?
  2. Can you identify the indications that Katherine will require postural assessment and intervention in her new wheelchair?
  3. What other questions and investigations would you consider to identify postural issues?
    You are conducting a seating assessment on Katharine and have completed all assessments including MAT, body measurement, seating and wheelchair evaluation. So far you have noted that:
    • Katherine sat with a 50mm right pelvic obliquity, left pelvis rotation, posterior pelvic tilt, left scoliosis apex at lower thoracic, lateral flexion of the neck toward left.
    • She had good flexibility for neutral alignment in the pelvic tilt, lower extremities and trunk in supine
    • Katherine had significant weight loss over the last 2 years
    • Her seat and cushion width were too wide for her in comparison to body measurement, and
    • She had utilised a single valve low profile air filled cushion.
  4. What are the postural goals of postural intervention when selecting trial products?
  5. What should the trial be covering?
  6. Who would you consider consulting about Katherine’s goals and postural interventions?
  7. Why would posture be important to Katherine?

Case study answers

  1. Why would posture be important to Katherine?

    Impact on comfort, bladder management, home responsibilities, computer work, school attendance and access to community activities
  2. What are the indicators that Katherine will require postural intervention in her new wheelchair?

    Pressure injury, increased pain, replacement of seating and wheeled mobility system
  3. What other questions and investigations would you consider to identify postural issues?
    • Medical, surgical and history of pressure injuries
    • Pain and spasm occurrences and management
    • Weight lost and reasons – likelihood of change
    • Katharine’s priority on functional tasks
    • Katherine’s perceptions on what worked and didn’t work in her current wheelchair and seating
    • Katherine’s aesthetics and cosmetic preference towards seating and wheeled mobility
    • MAT evaluation, skin checks, body measurement in supine, seating and wheelchair evaluation, and
    • Environmental and access and transport considerations
  4. What are the postural goals of postural intervention when selecting trial products?
    • To provide a stable base of support at the pelvis
    • To provide a seating system that matches the client’s body size
    • To provide adequate postural support to match the client’s body shape for optimal skeletal alignment. This includes correction of right pelvic obliquity, left pelvis rotation, posterior pelvic tilt, left scoliosis apex at lower thoracic, lateral flexion of the neck, and
    • To facilitate optimal functional abilities and environmental access
  5. What should the trial be covering?
    • Time duration
    • Daily / regular functional task conducted: e.g. bladder management
    • Activities as listed in initial interview
    • Access to  usual environment: school, shops, Taxi, and
    • Transfers
  6. Who would you consider consulting about Katherine’s goals and postural interventions?
    • Katherine
    • Katherine’s husband
    • Homecare coordinators and key workers
    • Spinal Seating Services
    • Spinal Outpatient Clinics
    • Spinal Pressure or Plastics Clinics
    • Dietician
    • Physiotherapist
    • Occupational therapist, and
    • Suppliers