Tiarnan
Providing Tiarnan with a permanent seating solution
Tiarnan is a young man who has good static and some dynamic sitting ability. However the previous seating did not accommodate his acute windsweeping. With his femurs pointing forward Tiarnan’s head and shoulders rotate to the right, and there was a large gap behind the left side of his pelvis as he was very far forward in the seat. Tiarnan also had pressure areas on his knees from his kneeblocks.
Clinical Assessment
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Tiarnan has high tone and an extremely strong extensor spasm.
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His hamstrings are very tight, particularly on the right.
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He has a natural shaped spine with no scoliosis, however with his hips flexed and foot supports set at 70° knee flexion, his pelvis is pulled into posterior tilt resulting in a kyphotic posture.
Approach
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Tiarnan’s therapist used the femoral supports to accomodate his windsweeping, thereby allowing his head to face the direction of travel.
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It was also possible to position Tiarnan’s feet slightly behind his knees, using the adjustable foot support (below right), to accomodate his short hamstrings. This also prevented his pelvis from being pulled forward into posterior tilt.
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Using the large femoral gables on the medial side of the right femur and the lateral side of the left femur (below left), it was possible to control Tiarnan’s femur position and reduce the pressure areas on his knees.
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Using the Pelvic Cradle to contour around Tiarnan’s dislocated femur helped to support his pelvis in neutral alignment.
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Outcome
The KIT Seating System has encouraged Tiarnan’s head and shoulder girdle into neutral alignment, facing the direction of travel. There is no stress on already tight hamstring muscles and his back makes full contact with the backrest from shoulder to pelvis. A padded tray prevents elbows becoming jammed between the tray and his chest. Tiarnan’s therapist notes that finding a seating system that accommodates his windsweeping whist meeting his other postural needs ‘is a real bonus.’
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