Notes
Slide Show
Outline
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Re/habilitation Technology: Introduction to Seating and
 Wheeled Mobility
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What’s in a name?
  • Does DME by any other name still smell the same?
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Re/hab Technology
  • ….is a totally different fragrance
  • “Re” - represents rehabilitation
  • “hab” - represents habilitation
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Re/hab Technology
  • a process -
    not just a product
  • specific skills,
    knowledge base and experience required
  • on-site/in-person evaluation required
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Re/hab Technology
  • almost always purchased,
    not rented
  • requires specialized
    technical service staff
  • requires commitment
    to long term follow-up
    and service
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Re/hab Technology
  • requires a different
    mind set and
    business model
  • credentialing of
    individuals
  • specific standards for Re/hab Technology Companies (RTCs)
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Credentialing of Individuals
  • NRRTS
    • NRRTS Membership
      • membership requirements assure skill and experience
  • RESNA
    • ATS  Assistive Technology Supplier
      • successful completion of credentialing exam demonstrates knowledge base


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"NRRTS Membership"
  • NRRTS Membership
  • (experience + skill)
  • plus
  • RESNA ATS credential
  • (knowledge base)
  • equals
  • CRTS®
  • Certified Rehabilitation
    Technology Supplier™
  • (awarded by NRRTS)


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Accreditation of Companies
  • CARF, CHAPS, JCAHO, ACHC, etc.
    • do not relate specifically
      to the provision of
      Re/habilitation
      Technology
  • RAP2001
    • assures quality, cost
      effective Re/hab Technology
      products and services
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Re/hab Technology
  • comfortable
  • effective
  • cost-efficient
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Re/hab Technology
  • People Helping People
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Common Seating Goals
  • reduce and/or prevent the progression of deformity or contracture
  • accommodate bony prominences


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Common Seating Goals (con’t.)
  • reduce the effect of unprofitable “tone” or non-functional muscular activity.
  • support current function
  • increase the potential for future function
  • enhance appearance
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Disease Process
  • Stable / Non-progressive
    • Spinal cord injury
    • Brain injury
    • Cerebral Palsy
    • Spina Bifida
    • Osteogenesis Imperfecta
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Disease Process
  • Variable/Progressive
    • Multiple Sclerosis
    • Tumors
    • Muscular Dystrophies
      • Amyotrophic Lateral Sclerosis (ALS)
      • Myotonic Dystrophy
      • Spinal Muscular Atrophy
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No “slings” attached!
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Seat Cushions
  • support
  • redistribute pressure
  • provide postural options for function
  • address climate issues; temperature, humidity, etc.



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Seat Cushions
  • address moisture problems
  • provide options for client’s size/weight
  • comfort
  • durability
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Backrests & Back Supports
  • support
  • distribute forces
  • provide postural options
    for function
  • assist trunk balance
  • assist in tone control


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Other Seating Components
  • support/positioning
    • pelvis and thigh
    • trunk
    • shoulder
    • head and neck
    • upper extremity
    • lower extremity
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Three-Point Force System
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Simulation
  • hands on
  • product trial
  • “rough fitting”
  • simulator


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Seating Systems
  • all are “client” specific
  • may include components that are:
    • custom fabricated
      • in-house
      • out-sourced
    • custom modified
    • pre-fabricated
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Features vs. Benefits
  • Seat width
    • accommodate client’s body size
    • positions client  to propel effectively
  • Seat depth
    • appropriate pressure distribution
    • comfort
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Features vs. Benefits
  • Back height
    • appropriate postural support
    • allow client  to propel effectively
  • Seat-to-floor height
    • transfers
    • foot propulsion
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Features vs. Benefits
  • Armrests
    • full length or desk length
    • adjustable height
    • armrest pad size/texture



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Features vs. Benefits
  • Front rigging
    • angle in relation to
      seat surface
    • appropriate  height
      adjustability
  • Foot plates
    • appropriate size
    • angle adjustability
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Features vs. Benefits
  • Axle adjustment
    • up and down
      • seat-to-floor height
      • rearward tilt
    • front and back
      • shoulder integrity
      • stability
      • maneuverability



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Power vs. Manual Wheelchair
  • “Should they because they can?”
  • Dependent on
    • motor skills
    • mobility requirements
    • ADL skills & requirements
    • visual, perceptual & cognitive skills
    • endurance & tolerance
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