DME

Blog posts of '2018' 'December'

VSC |  An App Designed for You

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Can you imagine a world where the end-user would know the exact angles of their power wheelchair?

 

Where they would no longer have to guess if they were positioned correctly for pressure management? Or where they could easily go to an angle of tilt to access smaller entryways without the question of, “Did I tilt far enough back?”. All of this is now possible with Virtual Seating Coach by Permobil. You can now download a free app and pair with your power wheelchair to view your seat angles in real time.

To further discuss Virtual Seating Coach, this week we are going to hear from a guest blogger Stacey Mullis. Stacey is the director of Clinical Marketing for Permobil in the US and has over 20 years of experience as an occupational therapist.

Let’s face it: it can be overwhelming to learn every function that a power wheelchair has, every aspect of medical management, and manage daily ADL routines. Certainly, it’s helpful to be trained by a seating therapist on how often to change positions and the specific angles of changes. But to say that it becomes a habit right away? Not going to happen!

The University of Pittsburgh conducted a study on two groups of end users. Both groups received training on the frequency of position change as well as the angles/positions to go into. One of the groups was then provided with the Virtual Seating Coach app in addition to that training, and their use of power seat functions increased by 40%! It’s all about building habits, and the more automatic a behaviour becomes the less overwhelming it is.

How does VSC work?

Your seating therapist should have already done an extensive, thorough evaluation to get you into your current seating system. As a  result, he or she will know your clinical needs based on your medical and physical condition, your prognosis, and risk factors, and he or she can individualise a plan just for you! Although there are clinical practice guidelines, your therapist may find that you, for example, will benefit from four small changes in tilt/recline in an hour, then one longer more aggressive tilt and recline the next hour. In this case they will go into their clinic’s portal and assign you a specific regimen accessible through your app. It will literally coach and cue you on the following:

• Frequency of each tilt, recline, and power legs adjustment
• How long to stay in a position before coming out of it
• The angles you should be reaching in tilt, recline, and power legs with indicators that let you know you’ve reached them

 

Your therapist can set daily goals, and you can start noticing the benefit of this healthy habit of movement. The VSC app will automatically capture data as you utilise the power seat functions daily. This data will allow you and your therapist to monitor progress toward your repositioning goals.


The Virtual Seating Coach is one way you can be empowered to manage your care and decrease the health risks of immobility.

 

 

 

Did you know your Power Wheelchair could have Bluetooth?

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We live in a connected world. A world full of phones, tablets, and computers. Most of us use technology every single day. For many of us, it is difficult to even be without technology for a few hours. We are constantly looking at our phones whether it is to see the time, make a call/text, or use one of the thousands of apps available to us. For individuals with impaired hand/upper extremity weakness, being able to fully use a phone or computer is not always possible.
 
For many years now, most power wheelchair manufacturers have integrated Bluetooth into their chairs. What does this mean? It means that the wheelchair user can have their phone, tablet or computer connected to their wheelchair. The power wheelchair can control their phone, tablet, or computer with their driving device. Bluetooth can be utilised with any driver control: joystick, head array, chin drive, etc…

The type of connection will depend on the type of device. For iPhones this connection will be through switches where a blue box will appear on the phone allowing for selection of items. For Android and Microsoft phones and computers this connection will be through mouse emulation where a mouse pointer will appear on the screen.

The video below is an example of a Bluetooth iPhone connection with switches. A big Thank You to Todd Stabelfeldt for posting this great video.
 
 
 
The best part about Bluetooth on the wheelchair? As a therapist you can set this up on your client’s wheelchair. The set up will vary slightly based on each manufacturer and the age of the wheelchair and also the type of joystick or speciality input device is being used.
 
Included below are two quick start guides for getting started with Bluetooth on both iDevices and Android/computers on Permobil power wheelchairs with the Permobil Joystick Module.
 
 
 
 
 

Independent Repositioning Mode:  Getting the Most Out of Your Power Seat Functions

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We have been discussing the importance of power seat functions for the past couple blogs and what those power seat functions can do for the user. Often because of the limited mobility of the individual utilising the power wheelchair, power seat functions are used for pressure management. Pressure management or shifting weight off the user’s bottom is crucial to help to decrease the risk of skin breakdown. There are numerous research studies that discuss which combination of power seat functions are best for pressure management. The research shows that superior pressure relief may be achieved by utilising both posterior tilt and recline. Based on research by David Kreutz in 1997, the individual is recommended to initially move to a fully tilted position to stabilise the pelvis, and then follow with activation of the recline system so as to minimise loss of postural stability. Then reverse this order for coming back up to a driving or functional position: Recline and then tilt. This order is important because if the user starts for example with power recline they may lose their stable seated position or increase shearing to their sacrum. Commonly, users will have access to power posterior tilt, power recline, and power elevating legrests. In this case, the user should complete the following sequence for pressure management: posterior tilt, elevating legrests, recline. Then, reversing this order for coming back out to an upright driving position. When the user is fully tilted and reclined, this position is also helpful to reposition the user. Many users may be able to unweight their pelvis and shift their own hips in this unweighted position.

So, what is the challenge with utilising the sequence of posterior tilt, elevating legrests, and recline to maintain postural stability during pressure management? This sequence can be difficult for the user to remember, or maybe the user does not know the difference between recline and posterior tilt if they were not educated by their therapist or other seating specialist. This can create a fear for therapists and many will prescribe just posterior tilt in order to prevent the potentially negative effects of the 3 power seat functions when not used in the right sequence. Or, maybe the user is given all 3 power seat functions, but instructed to only use tilt for their pressure management. This is where it is important for manufacturers to see this limitation and develop a solution.

This solution for Permobil is called Independent Repositioning Mode or IRM. IRM comes standard on every F series, M3 and M5 power wheelchair.  This mode can be turned on to where the user can press a button on the controller, hit a switch, or use the actual joystick to enter the independent repositioning mode. Because the chair has smart actuators, when the switch for example is hit, the chair will take the client into a pre-set or therapist set amount of tilt, legrest elevation, and recline in the proper sequence one after the other. The user only has to know in this case to hit one button.  Users no longer have to worry about going all the way into posterior tilt before elevating their legs and then reclining. This feature is designed to take the stress and difficulty away from the user, but also empower the user to be able to be independent with their own pressure management.  Independent repositioning mode can also help with exactly what it says – repositioning. For some users, they are able to hit a button and go into this position so that they can independently repositioning their seated posture.  While the user can be set up for the standard IRM position, the therapist can also choose the final position of IRM so that this feature can be utilised for every users’ needs.

Click here for more information on power chairs.

Rachel 

 

References:

Kreutz, D. 1997. Power tilt, recline or both. Team Rehab Report, March: 29–32.