to go until the London 2012 Paralympic Games

Billy

Billy

Improved posture and comfort for Billy in the KIT seat

Billy is a 24 year old young man with spastic quadriplegia Cerebral Palsy and moderate learning disability. Billy has been known to his regional wheelchair service for almost 20 years. He is fully dependent upon a wheelchair for all of his mobility but is not an independent wheelchair user. Billy's hypertonus affects all limbs and has been the single biggest problem in finding a suitable "off the shelf" seating solution. Billy recently had an Intrathecal Baclofen Pump fitted, but this has yet to reach optimum therapeutic levels.


Clinical Assessment

 

In Billy's exising seating system, he shows a moderate degree of left side flexion in the trunk combined with pelvic obliquity and rotation (up on left and forward on left). Billy is unable to achieve mid line position with his head. There is a high degree of pressure exerted onto the right hand side lateral which causes Billy pain and discomfort. The left hand side lateral does not achieve adequate support as it can not be set so high into the region of the left axilla that Billy develops pressure damage. The pressure damage normally occurs through out the day as the degree of left hand side flexion increases in relation to increased tone, noxious stimuli and fatigue.

  • A brief assessment of Billy in supine lying and supported sitting demonstrated that there is some correction in posture available - extension of the spine and reducing pelvic obliquity
  • Overcorrection of the pelvis demonstrated that the degree of left side flexion increased thus leading to poor head position

Approach

By accommodating Billy's obliquity using the castellated foam cushion, along with some correction from the Pelvic Cradle, a more neutral pelvic position was achieved. The leg guides accommodated Billy's windsweeping, helping to maintain the position of his pelvis. The complex laterals - the right one placed vertically, and the left one placed horizontally - helped Billy to sustain a more midline posture and better head position. Subjectively Billy was able to express that he felt safe and comfortable. There was also noticeable difference in the degree of extensor thrusting that is normally evident in the lower limbs.

Outcome - Formal Research

Billy and his family have agreed to take part in a research project looking at the effect of postural support in seating on:

  1. quality of movement
  2. effect of unintentional movements
  3. abnormal reflexes

The project is a joint study with the Universities of Dundee (Scotland, UK) and Shimane (Japan), and it is hoped that the resulting paper will be published and presented at relevant conferences.

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The Buying Process

Some products require an assessment to ensure they are clinically suitable for the individual. For further information and pricing please complete the enquiry form, call us on UK 0800 318 265 or ROI 1800 626 020 or contact your nearest dealer.

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