Free Essay

Seating

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Submitted By DeepScience
Words 538
Pages 3
Chapter 4:
Seating devices: Are general purpose extrinsic enabler (used in self care, work, school, play and leisure).
Rehabilitation assistant: Job is to setup and adjust (functioning, technology and feedback) for client needs
3 Categories of seating intervention: 1) Postural control: Use physical skills or Mat assessment: (orthopedic measures, respiratory and circulatory).

SUPINE Evaluation: starting with lumbar spine and pelvis, ROM of hips, knees, ankles, Upper extremities and neck. Alignment of head, shoulders, and trunk with pelvis.

Sitting Evaluation: ROM and skeletal alignment (Important for TBI, ALS or motor control loss). Ask how much support needed to be comfortable. * Response to changes in posture. * Use MAT assessment for skin tissue integrity. * Avoid pressure behind knee * lateral aspects of knee, ankles and feet should not be in contact with the wheelchair.
Contexts
* Visual perception, Proprioception, tactile and vestibular contributes to balance and sitting posture. * Cognitive (safety, judgment) * Psychosocial ( behavior technology) * Environmental (social (family support) * Physical (outdoors indoors) * Institutional (funding, laws) consumer needs (match device, restraints) Review (Box 4-3) pg. 73.

Kinematics: Study of motion/body in space. * Trunk to midline. * Velocity: rate of change in displacement. * Linear: same direction and rotational (movement in an angle) * Properties of force on gravity (magnitude, direction, line of application and point of application. * Tension: same line but away from each other. * Compression: forces act towards each other’ * Shearing: parallel pressure force per unit area (larger in smaller area) . * Newton: Force = mass. * Postural control: stability and mobility. * In clinic you can only find center of pressure location on front and lateral plains. * Pressure mapping: monitor pressure individual and surface. * Stability zone limits for person sitting or standing.
Guidelines for positing for postural control: Proximal stabilization, sitting and dynamic seating should enable movement, pelvis is key. Lower extremities in neutral trunk upright and midline. Head at midline, shoulders down and forward. Elbows at 90 degrees. Neutral shoulders. 90 degrees hip flexion Pelvic obliquity Ones is higher than other in frontal pain. Pelvic rotation one side is more forward.
Windswept: hip one hip adducted.
Prehensile: block extensor tone.
Spinal deformities * Scoliosis (lateral curve) * lordosis (add lumbar support seat back) * kyphosis (don’t push forward) Head and neck. Most common problem hyperextension of neck CP.

Pressure ulcers: liaison from unrelieved pressure. (Variety of factors SPI, body type, nutrition, infection, age, posture,) movement helps.
Microclimea: interaction between body and surface. Temperature of skin, and moisture.

Seating and position management:
Planar: flat surface support body when in contact (Minimal support is best)
Prefabricated: standard sizes fit wide range of people.
Custom fabrication: customized to fit individual
Standard contour: moderate seating needs low risk pressure ulcers.
Custom contoured: most support shaped custom for individual body.
Prefab: adjusted backs

Properties of material for seating:
Density :weight to volume ration. Greater is more durable. Stiffness. How much give under load.
Sliding :resistance to friction.
Resistance recover: of shape after load.
Dampening: cushion to soften on impact.
Aging adults: ambulatory dependent. Pressure redistribution: for Spinal Cord Injury, MS, elderly, Muscular Dystrophy, amputations and Arthritis 2) Comfort:
Assessment: Needs of client, COPM, Wheel chair Outcome Measure, abilities using HAAT model.
Fixed deformity: permanent changes in bones, muscles that restrict ROM in joint.
Flexible deformity: joint stretched passively in opposite direction to reduce deformity.

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