DME

What Happens After the Mat Assessment?

What Happens After the Mat Assessment?

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What happens after the mat assessment? We have to use the results of the mat assessment and work as a team, utilising the skills of the therapist, the supplier, and the manufacturer to meet the clients’ seating needs. There are many roles and people involved in the seating evaluation process beyond the supplier and therapist including the client, family, teachers, nurses, etc… Today, we will focus on the role of the therapist. As a therapist becomes more experienced and comfortable with mat assessments they may start learning about specific products and the ways those products could work for their clients. Initially though, the role of the therapist is to be able to communicate to the supplier their findings from the mat assessment.

 

 
During the mat assessment the therapist should be assessing if their client is in a neutral posture, or if not, where the asymmetry is coming from. This doesn’t mean that you have to remember exactly how to name, for example, a pelvic rotation, but you want to be able to tell the supplier that the client’s pelvis sits further backward on the right side. Once we determine that there is a right hip rotation, then we need to assess if this hip rotation is reducible or non-reducible. You may have also heard this term referred to as fixed or flexible. If the asymmetry that we see can be reduced back towards neutral, it is flexible, or if it is “stuck” and non-reducible, then it is fixed. Knowing if the client has reducible or non-reducible asymmetries is important in determining the best products for the client. If someone has a reducible asymmetry, then we want to make sure products are selected to correct the asymmetry towards neutral. If the asymmetry is non-reducible, then we will have products to accommodate to this asymmetry and assist with prevention of furthering the asymmetry.

The other key questions we need to think about would include: What are the goals of the client? Let’s take for example a client that has scoliosis and is leaning to the right. We determine, based on our mat assessment, that this is a reducible asymmetry and that we can use positioning products to achieve an almost neutral seated posture. However, during our goal setting, the client explains the importance of being able to reach objects off the ground for maintaining his functional independence. How does this goal guide our practice? In this instance, with correcting his posture we may prevent him from leaning side to side to reach the ground. We need to be sure when we are choosing seating and positioning products that we remember MOBILITY is our ULTIMATE GOAL. The goals as the therapist may not match the same goals as the client. For this example, the therapist would need to consider both their positioning goals and the client’s functional goals.

We also need to remember that our clients change over time. Their goals change, their posture changes, and their needs will change. We want to remember that this equipment whether it is the wheelchair, or the seating on the wheelchair, will need to last a reasonable amount of time. Therefore, we need to keep in mind the long-term goals and anticipate any long-term changes that might occur.

Finally, before you choose your solution remember that you need to determine the cause before determining the solution. There will likely be problems that require more than one intervention, or different problems that may utilise the same intervention. Remember to keep the client’s goals and the ultimate goal of mobility in your mind as you work towards finding their seating solution.

Next week we will take a look at specifics behind the design of seating products and how we know what type of product to choose for our client when we are looking at all the options.
 
Rachel
 
 

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