DME

Blog posts of '2018' 'October'

Mecenzi’s story of herself and her new F5 VS

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“I go places and people look down at me, I would rather look them in the face.” – Mecenzi

If we have the ability to fully access and participate in our environment, we may forget that this human right is not possible for everyone. Think about your daily life. Can you reach the counter in your kitchen to make a sandwich, or reach inside the refrigerator to grab a drink? What about reaching up in your closet to get your clothes? That is just in your home. Now think about experiences in your community. Can you look face to face with your friends and family? Can you give your loved ones a hug without an awkward bend over shoulder in your face outcome? How about accessing counters at a restaurant to pay your bill? For many individuals with a mobility impairment their environmental access is greatly limited. It’s not just environmental access though. How would you feel if you had to sit down in a chair at a party while everyone around you was standing and talking? For some individuals with a mobility impairment, they find it difficult to fully interact with their peers when they are unable to look them in the face. For individuals with mobility impairments it might not just be accessibility and peer interaction but returning to or choosing a career path that typically requires standing throughout the day. While accommodations can typically be made, what if instead of adapting the environment we adapted the individual’s mobility device?


Today I want to share with you Mecenzi’s story of herself and her new F5 corpus VS.
Mecenzi’s story, as you will see in the video below, illustrates how with the assistance of the F5 Corpus VS, Mecenzi has greatly improved not only her independence, but how being able to stand up makes her feel.

 

 

 

Part 1 Power Wheelchairs:

Where is my Drive Wheel and Why Does it Matter?

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The drive wheel on a power wheelchair is the larger wheel if you are looking at your wheelchair or client’s wheelchair. The location of this drive wheel can have a large impact on how the power wheelchair drives and maneuvers in different environments.

There are three main types of drive wheel configurations on power wheelchairs: front-wheel drive, mid-wheel drive, and rear-wheel drive. In this blog today, we will focus on front-wheel drive.
 
Front-Wheel Drive
The front-wheel drive power wheelchair is typically going to be good for maneuverability indoors and optimal for outdoor use. This is because of the larger drive wheel being the first wheel to overcome the uneven terrain versus the smaller casters. Because the front wheels are connected to the drive motors, these pull the casters over obstacles and through various terrains versus if the casters were the front wheel. In the case of the casters being in front, the casters are being pushed, the force generated is forward and downward. This would be similar to a plowing effect and can increase the likelihood of becoming stuck in certain situations. For individuals looking to go over all terrains, the front-wheel drive wheelchair may offer the best solution.

Another benefit of front-wheel drive is the smoothness of the ride. Look at how many wheels are on the ground. In the case of front-wheel drive there are four wheels versus the six wheels with a mid-wheel drive chair. This means that as the end-user goes over a bump in a front-wheel drive chair, they would feel the force of that bump two times versus three in a mid-wheel drive. This can also be important for individuals that may easily lose their positioning when going over any uneven terrain.
We could talk about front-wheel for hours, but the final benefit to mention is the front-wheel drive chair’s smallest front turning aspect. In all the configuration options, the chair will turn on its drive wheel.
 
The photo below shows an example of a bathroom. In this bathroom the sink is positioned against the wall. Because the wheelchair turns on its drive wheel and the end-user can only pull themselves so close to the wall before turning, we can see the only chair to gain full access to the sink is the front-wheel drive. Does this mean that everyone should have a front-wheel drive wheelchair? No, but it does mean that it is important for clinicians, suppliers, and clients (end-users) to consider the environment that the client lives in.
 
 
Often, I hear that people stay clear of front-wheel drive because it doesn’t have as small of a turning radius as mid-wheel drive and it is harder to learn to drive. Both of those statements are true. The front-wheel drive will have a slightly larger 360 degree turning radius, but as you saw above it has the smaller front turning aspect which may be utilised more than someone turning in a full circle. Front-wheel drive may be less intuitive to learn how to drive versus mid-wheel drive, but with a little practice and a few key tips, many users find front-wheel drive to be just as easy to learn as mid-wheel. The two key points I like to teach someone when learning to drive a front-wheel drive wheelchair is:

1. Hug the corner. When going through a doorway the end-user will want to “hug” the corner or keep a tight turn.
2. Turn towards the problem. For example, when positioned adjacent to a wall/barrier, turn toward the wall/barrier, then slightly reverse to allow the rear casters clearance for turning in the desired direction. This might sound complicated, but if you remember to turn into the problem you will easily maneuver away from the problem.

Keep in mind that not everyone will benefit from the same drive wheel configuration and it is important to ask the questions and complete an evaluation to determine which drive wheel would be best for you or your client.
 
 

What is Dry Floatation?

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Last week, we heard from Mal on the impact that Mr. Graebe and ROHO had on his life and he used the words “DRY FLOATATION™ Technology”. This week we are going to dive a little deeper into the design of a ROHO cushion and explain what Dry Floatation is. In designing the ROHO cushions, Mr. Graebe realised the best way to protect the skin would be if the client could be placed in water because of the benefits of floating. He knew that it would be impractical to achieve true floatation in a cushion, so Mr. Graebe concentrated on achieving the same type of floatation but used air instead of water. This idea developed into what is known as DRY FLOATATION™ Technology, and it’s a ROHO exclusive. Mr. Graebe spent many years in his garage working on his idea of Dry Floatation and in 1971 he released the first ever ROHO cushion – a high profile ROHO cushion.

 

  

The adjustable air-filled cushions and mattresses mimic the pressure relieving properties of water, removing friction and delivering stability and comfort no matter where you go or what you do. DRY FLOATATION™ Technology is based on 4 principles characteristics of water that causes floatation.

Here are the 4 principles:

1.          Low Surface Tension – Fluids have very low surface tensions, which allow an object to penetrate its surface with little force. The ROHO design of many small interconnected air cells made of a soft, pliable neoprene rubber results in a very low surface tension. This limits the amount of skin deformation.

2.           Constant Restoring Forces – both air and water have very small molecular forces of attraction that can be displaced. This displacement provides hydrostatic forces, or floatation, that are nearly constant no matter how deeply immersed the object is. What this means is that the ROHO cushion allows a person to sit immersed in the cushion for long periods without an increase in pressure over time.

3.           Six Degrees of Freedom – Each cell within a ROHO cushion can move in any direction, allowing the cushion to move with the body, in the same way water moves. The result is that instead of the skin and underlying tissue deforming, the cushion itself deforms. This minimises both friction and shear forces.

4.          Low Friction and Shear – Friction occurs when two surfaces rub together. The courser the surface, the more friction exists, increasing the likelihood of tissue breakdown. ROHO cushions and mattresses are made of a neoprene rubber that has been treated to reduce friction to minimal levels. Shear is a lateral force that occurs at a deep tissue level. This is the result of friction holding the skin in one place while gravity pulls the skeleton and attached tissues down. Shear can be a major issue when someone is lying in bed with the bed head elevated, or for someone seated with kyphosis and a posterior tilt of the pelvis. By minimising friction with the coating of the neoprene, as well as the size Degrees of Freedom, DRY FLOATATION™ Technology reduces shear forces.

Whether you are sitting on a ROHO cushion, you have a friend or family member that uses a ROHO, or maybe you have gotten a ROHO cushion for your client, hopefully you see just how much thought went into the design behind ROHO. We want to thank Mr. Graebe again for his contribution and positive impact on the lives of so many.

For more information on pressure injuries check out the Pan Pacific Prevention and Treatment of Pressure Ulcers: Quick Reference guide.   http://www.woundsaustralia.com.au/ptpu/index.php

 

Rachel and Mal

 

The man behind ROHO DRY FLOATATION™ Technology

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In 1978 a young electrical engineer, Robert H. Graebe, was introduced to a patient with a pressure injury. He witnessed a doctor excise tissue from the site. The doctor’s comment “we do not know how to prevent these sores” left such an impression on Mr Graebe that it inspired him to find a way to prevent pressure injuries. As a result, he invented a new technology, DRY FLOATATION™ Technology, and a range of products named ROHO. Since then ROHO products have changed the lives of millions of people in 65 nations, enabling them to pursue productive, independent lifestyles.

On Saturday 15th September the Starkloff Disability Institute in St Louis honoured Mr Graebe with a Lifetime Achievement Award.  The Starkloff Disability Institute is a non-profit organization dedicated to helping people with disabilities participate fully and equally in all aspects of society.

The award caused me to reflect on the impact Mr Graebe has had on my life. In 1980, at the age of 19, I was a passenger in a motor vehicle accident which resulted in a spinal cord injury at T5, complete. In 1982 I started to develop skin problems due to pressure, and in my research found the ROHO cushion. Ever since my first single valve cushion in 1982 I have been sitting on ROHO cushions. I have been using a ROHO Quadtro Select Mid Profile for several years now.

 

 

Thanks to Mr Graebe I have remained free of sitting acquired pressure injuries for 38 years! Mr Graebe’s invention has had a profound and life changing impact on me. It has allowed me to remain active, to successfully run a business, to play wheelchair basketball both here in Australia and internationally, to travel extensively, to meet fantastic people from all walks of life, to be a productive member of society, to be financially independent and so much more.

I have also been fortunate to work with the ROHO product line for 20 odd years. In that time, I have seen countless lives of end users, their families, and their therapists, improved by ROHO products.

One of the highlights of my career was the opportunity to meet and dine with Mr Graebe. I often share that on that occasion I got to thank him personally for saving my arse for all these years. I am so delighted that Mr Graebe has been honoured for his incredible work. What an amazing thing that he was moved to invent a product that would, and does, help prevent pressure injuries. He has truly changed the world of millions of people for the better. What an amazing legacy!

Mal

We would love to hear your stories on how Mr Graebe’s invention has had a positive impact on your life!