Sunrise Medical SMA, Comprehensive Manual

Page 1: ... and other features will define your selection There are several major areas you need to consider when selecting the appropriate powered mobility device bases seat functions seating systems and access control methods Today s technology allows you to mix and match a variety of features This mobility equipment will be used for many years to come so careful selection and consideration is of utmost im...

Page 2: ...ter II FAQ on early provision of independent mobility 5 Chapter III Power wheelchair bases 8 Chapter IV Seat functions 12 Chapter V Seating systems 17 Chapter VI Controls Electronic interfaces Access methods 20 Chapter VII Funding 23 List of Resources 26 ...

Page 3: ...trols transportation etc Talk to other users and their families hear their experiences Browse some user groups for feedback Browse manufacturer s sites to get a better understanding of the available products Visit local trade shows to see and try a variety of products Get recommendations for a good supplier and a knowledgeable therapist from other FSMA members in your area Don t be shy to contact ...

Page 4: ...e wheelchair in your vehicle home etc to ensure everything will fit with your surroundings Be sure to discuss and agree to all details of the equipment After the appointment Your therapist doctor and supplier will assemble the paperwork and submit it to your insurance It usually takes minimum 3 months from assessment evaluation to delivery of the equipment Keep in touch with the professionals and ...

Page 5: ... around and move a few feet does not qualify for efficient mobility Always opt for a lesser alternative that provides efficiency however most children with SMA will not have sufficient strength to be efficient with a manual wheelchair In addition most pediatric manual wheelchairs are equal to or heavier in weight than the child occupying it and due to growth concerns their access to the drive whee...

Page 6: ...working on mobility Is it safe for a small child to drive a power wheelchair Is it ever safe for a small child to be left alone The answer is obviously no any small child requires constant supervision and that is no different with a child driving a motorized wheelchair Supervision however is not to be confused with the lack of independence we will always watch over small children but allow and enc...

Page 7: ...a safe environment while your child learns to drive level surfaces few obstacles and possibly a harder surface it requires more torque to move on carpet It is advisable to use low speed and torque settings for a beginner driver Keep your child motivated through use of their favorite toys etc so they develop an understanding that movement will be purposeful ...

Page 8: ...ing a lower seat to floor height Disadvantage of the front wheel drive system is the potential for fishtailing If you go higher speeds the rear of the chair may wiggle around This issue has been resolved on some models but not all The client also needs to get used to having a lot of the wheelchair behind her so she needs to be cautious when turning in tight spaces Mid wheel drive Mid wheel drive w...

Page 9: ...hat move to the floor however there may be funding difficulties During the evaluation carefully assess how high the seat is from the ground and what your child needs during her typical daily activities Transportability Some wheelchairs come standard with tie town attachment points while some offer it as an option It is likely that you child will need those when taking the school bus As for private...

Page 10: ...n grass etc Suspension Suspension is not available in all chairs nor is it always needed however it has many benefits especially at higher speeds It enables a smoother ride which improves comfort and helps maintain position which can be important for users with limited trunk control and strength A smooth ride can help maintain head position for users with weak neck musculature and can also reduce ...

Page 11: ...s cleaning and tightening of nuts and bolts and maybe some upholstery change Power wheelchairs require some of the following maintenance Regular charging of battery depending on use daily or a few times a week Replacement of battery typically they last 1 2 years Maintaining tire pressure Replacing tires Occasional check up ensure connections are good etc As with any electro mechanical device there...

Page 12: ...you might currently think Manual or power Some functions are available both in manual and powered version such as tilt and recline A manual seat function is usually operated by an attendant while the powered seat function is operated by the user of the wheelchair Whenever possible allow the occupant to operate these functions they know their bodies best and it is often intimidating to constantly a...

Page 13: ...to be utilized to help prevent contractures Recline Recline refers to opening or closing the backrest angle relative to the seat Various angles provide different benefits and they may be available with shear reduction Shearing is an unfavorable force that develops due to the body and the seat moving relative to each other and friction arising between the two Some shearing is good to maintain posit...

Page 14: ...e to navigate thresholds ramps etc while the legs can be pulled in closer to the wheelchair for better maneuverability indoors Helps reduce edema BUT only if the legs are above heart i e with a combination of elevating legs plus tilt or tilt recline Seat elevator A seat elevator will raise and lower the user in their seated position through the use of an electro mechanical lift system without chan...

Page 15: ...floor height heavier wheelchair possibly slightly compromised sitting position Benefits Significantly increased environmental access basically increased vertical access equals the user s thigh length 10 20 Reach to shelves cooking sinks fire alarm light switches payphone vending machines water faucets grocery shelves etc More independence due to better access to surfaces Improved Bone Mineral Dens...

Page 16: ...al complications because there is less pressure on the internal GI organs May allow use of a public urinal for male users Increases self confidence by allowing to assume an equal standing position and eye to eye conversations ...

Page 17: ...that the body develops to balance those forces If your child requires posture correction a body jacket or other orthosis may be more effective and or more comfortable If your child uses a body jacket make sure the seating system works well with it Seating systems are modular and vary from a simple seat and back to a system supplied with many parts and accessories It is beyond the scope of this gui...

Page 18: ... the user s comfort position is Some are available with summer winter hardware which means you can easily vary the width depending on how thick clothing your child wears They also come in swing away or removable hardware to ease transfers Belts and harnesses Seat belts chest belts footstraps and anterior chest harnesses butterfly harnesses are available in a variety of materials and sizes These ac...

Page 19: ...de more upper extremity support They are usually easily removable and can be clear more aesthetic or solid color in case somebody has a visual deficit Custom molded seating Custom molds can be created as a cushion a backrest or both They are usually very restrictive for movement however they can accommodate significant postural deformities better than off the shelf seating systems Custom molds are...

Page 20: ...ut are not limited to speed power torque acceleration deceleration joystick throw etc Most manufacturer offer programmers on their order forms but they are typically not ordered with the wheelchair There are also non programmable wheelchairs on the market but these are rarely appropriate for users with SMA Programming capabilities vary by make and model Proportional control Proportional means that...

Page 21: ...a mid line mount and good arm support Other proportional controls There are other alternatives such as touch pads which looks and works like a mouse pad on a laptop and the Magitech which is a small tilt sensor making the chair move towards the direction of tilt With the appearance and popularity of the Mini especially among people with SMA their application has been reduced Digital control Digita...

Page 22: ...h a joystick in case the occupant is fatigued Power wheelchairs are very heavy often in the 200 300lb range so pushing them via push handles is overly demanding for long distances Attendant controls can be useful for example when you have a very young child who is just beginning to drive and you want to help her navigate through busy areas in the mall or a restaurant Specifically for SMA children ...

Page 23: ...ewers do not have time to read details that aren t applicable to the device Most well written letters for mobility devices tend to be around three to four pages However an LMN can certainly be longer or shorter depending on the specific situation Photographs are an asset They speak volumes and are quick to review They re more descriptive than words can ever be and they help turn a claim number int...

Page 24: ...rnatives that were considered and why they were not adequate Denials like choose a less costly alternative are not acceptable as long as you can prove that there is no cost competitive alternative with the same or comparable features How the device will benefit the user refer back to the needs section What would happen to the user without this equipment Describe all the negative consequences of no...

Page 25: ...but not least keep in mind that reviewers never hear about the success stories They only see claims and complaints Let us help them understand the benefits of these devices by describing how they make a difference After approval write them a letter and describe how this equipment changed your child s and your family s life It will help your next claim as well as other people s claims and may event...

Page 26: ...nizations Resna www resna org Organization for all Assistive Technology providers clinicians researchers and suppliers Provides info on annual conference expo as well as a list of certified professionals NRRTS www nrrts org National Registry of Rehabilitation Technology Suppliers Professional and voluntary organization of suppliers dealers You can find registrants in your area through their websit...

Page 27: ...nufacturer of powered mobility products and related items ranging from pediatric to geriatric Invacare www invacare com Manufacturer of power and manual mobility hospital beds accessories etc Sunrise Medical www sunrisemedical com Manufacturer of power and manual mobility hospital beds accessories etc ASL www asl inc com Manufacturer of switched solutions adaptive controls for individuals requirin...