Magazine article The Exceptional Parent

Positioning for Function: Wheelchairs and Other Assistive Technologies

Magazine article The Exceptional Parent

Positioning for Function: Wheelchairs and Other Assistive Technologies

Article excerpt

  by Adrienne Falk Bergen, P.T, Jessica Presperin, O.TR. & Travis Tallman, CCC-SLP, Valhalla Rehabilitation Publications, Ltd., P.O. Box 195, Valhalla, N.Y. 10595, (914) 948-1004. 387 pages, 1990. $49.95.   The following excerpt includes information from Cheryl Colangelo, O.T.R., from the book Positioning the Client With Central Nervous System Defects. 


... equipment is a prescriptive item and misuse can be destructive to the rehabilitation process, and the person's physical well-being, and self-image. Most commercially available equipment can be suitably adapted, with appropriate individualized fittings, for each client. Many clients, however, will require individually constructed equipment. Once the equipment has been supplied to a client, continual monitoring will be necessary to check the fit and suitability. Modifications are indicated when there are changes in functioning, growth, and so on.

When recommending static adapted equipment one should consider the impact on individuals and their caregivers in motor, cognitive/perceptual, and psychosocial areas. Since the prescription and design of equipment to meet motoric needs is in itself a challenge, it may be easy to lose sight of equally essential aspects of the client's life. The impact of a piece of equipment on cognitive/perceptual and psychosocial development must be taken into account. The final decision as to what pieces of equipment will be provided and when and where it will be used, should be made by weighing the pros and cons for not only motor but also cognitive and psychosocial needs. This is where the team process can lend perspective...


Good specialized equipment can serve all the purposes already mentioned - normalize tone, decrease the influence of pathological reflexes, increase ROM (range of motion passive and active), decrease the tendency towards deformities, increase stability, and facilitate components of normal movement in a developmental sequence. All of these will help provide the sensation of good body alignment while contributing to increased function.

On the other hand, static positioning devices do not respond to the client's self-initiated movements. Equipment cannot withdraw as the client begins to show a postural response. Thus, the equipment, when used without proper judgement and continuous supervision, can block function if the client's status changes. …

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