Picking Out Children's Wheelchairs

 Picking Out Children's Wheelchairs

Gather Your Colleagues Before Making a Purchase
Chair shopping for a child should never be a parent's alone affair, according to Chris Seiberlich. Not because they lack the qualifications to make decisions, but because no one person can handle all of them. You need to consider a wide range of topics.

The Tucson, Arizona-based Children's Clinics for Rehabilitative Services employs Seiberlich as a physical therapist. She is having a conversation with her occupational therapist partner, Kimberly Becerril, about selecting and fitting a wheelchair.
When it comes to selecting a chair, "transportation is one of the most fundamental issues," Becerril explains. I need to know how to get this chair from my house to my school. A motorized chair isn't going to cut it if the solution is stashed in a station wagon. Because of its weight, a power chair still requires a ramp for transportation, even in a van. We need to find a solution to the transportation problem before we can consider getting our children power chairs, even if many of them would benefit from them.
Many of the children Becerril knows who use power chairs at school also use manual chairs when they are at home.
"During the process of choosing a chair, we do a lot of transfer analysis," according to Seiberlich. We need to know who will be handling the transfers, and we want to see examples of the parents' work. If necessary, we might recommend aids like a Hoyer lift or transfer board to make the process easier.In her opinion, the majority of parents are pleasantly surprised by the impact they can have when they see a board for the first time. Still, they put themselves at significant danger for back problems if they lift the child and the chair multiple times a day. One mom had bruising all over her legs from carrying the chair around all the time. It might make a significant impact to choose a chair that is lightweight and has detachable hardware.
Neither Seiberlich nor Becerril can decide on every chair, as they both point out.
"We want the involvement of those people who see the child on a regular basis," explains Becerril.
Naturally, that refers to the parents, as they have the most intimate knowledge of their child. However, we would also like the school to be involved, particularly the educator or therapist who observes the child in their everyday life away from home. School problems aren't always the same as domestic ones.
The chair provider should also be involved, according to Becerril, so they can inform them of the options. The supplier can explain their capabilities in relation to the requirements we outline. When we work as a team, we can ensure that every detail is covered, unlike when we do it alone, where mistakes are more likely to occur.
Way of Life and Natural Setting
Can you recommend a good chair style? Although this is highly subjective and dependent on personal taste, Becerril does provide some useful pointers.
The sports frame style is popular among young people: It appears fantastic and maintains a low profile. The problem is that these frameworks aren't flexible at all; neither can the youngster. That being said, we wouldn't suggest getting one of these till they've fully grown. The transportation problem still persists, though.
We also would never suggest a chair without detachable armrests or footrests," Seiberlich continues. An individual who received a chair with inflexible footrests went from being able to transfer himself independently to now need the assistance of two individuals. The good news is that we were able to find a new home for the chair's recyclable parts.
Lifestyle, terrain, and surroundings are important considerations for Seiberlich and Becerril when choosing specific components.
"We can choose the wheels based on how rough the ground is around the home," according to Seiberlich. "Airless inserts are what we advise for this desert environment. A flat can be made from a single healthy cactus spine! On the East Coast, we must take into account the slush, snow, and rain.
We are also interested in learning more about the home's interior: Would a well suited chair have problems fitting through small doors? We need to reevaluate our approach, Becerril argues, if this is the case and renovating the house is out of the question financially.
In this context, social and educational variables also have a role. "Is the chair appropriate for the school setting?" „Seiberlich“ stated. Is the youngster positioned higher or lower than their peers, for example, depending on the chair's height? Is it possible to make some minor adjustments so that it appears less complicated, if that is the child's desire? It would be far more efficient and cost-effective if we could consider these details beforehand.
Child-Centered Development
The front frame portions (blue) and the X-shaped cross bracing (black) can be swapped out as the child develops.
Furthermore, cost is a major concern: The price of a power chair can be four times higher than that of a manual wheelchair with specialized seats, which can reach $5,000. On its alone, a high-quality cushion could cost $300 or $400. Many families have insurance that takes care of most of this, as Becerril points out. The correct chair, one that can adapt to the child's changing needs, can be an investment that pays off for a decade or more. The child's movement and freedom are demonstrated here. Getting things correctly is crucial.
How can a chair adapt to a child's changing needs? To individuals who believe the bulky "one-size-fits-all" sling back chairs are the sole option, the concept may be novel. These days, it's common practice to swap out the underside cross brace supports for wider chairs and the front frame portions that support the legs for longer ones.
Using this method, we may provide a child with the same chair from the time they are very little all the way into their teenage years. From a 10 by 10 inch seat, we can expand it to an 18 by 18 inch chair. If you compare the whole cost to buying a new chair, you'll see that there are savings in the long run. According to Becerril, the frames come with a lifetime warranty. "Make sure you choose a color you're not going to be sick of in a few years!"
Chairs and Back Support
The selection of a seating cushion is among the most important chair alternatives and one that requires expert advice.
An individual's pelvis is the "foundation" for proper sitting posture, according to Seiberlich. "We're looking to distribute the weight over as big an area as possible, for support, for comfort and to prevent skin breakdown."
One major issue with sitting for lengthy periods of time, she says, is decubitis, or pressure sores. Someone who doesn't spend long periods of time in their wheelchair can benefit from a more flexible seat. When sitting for longer periods of time or when you start to feel unsteady, it's best to upgrade to a high-quality foam cushion. Cushions packed with gel or air are two other options.
"Children with scoliosis (curvature of the spine), whether or not it has been stabilized with spinal fusion, may have some left-right tilt in the pelvis," according to Seiberlich. To lessen the impact of the tilt, we might employ the sitting system in these instances. By elevating the lower side, we might be able to achieve pelvic alignment in some of the children who still have some flexibility. Alternatively, if the tilt is fixed, we can support the upper side, which will help distribute the weight. The secret is to divide up that load.
When deciding on a back, scoliosis is another factor to consider. A typical sling back or flat back isn't usually an option. To accommodate the curvature of the spine, a molded back can be necessary. The goal, according to Seiberlich, is to reduce pressure by increasing surface contact.
Additionally, lateral supports could play a significant role. Using laterals is necessary if the infant lacks the trunk strength to remain upright. They may still require them to assist with post-fusion spinal stabilization and avoid falling.
Someone with low trunk strength may benefit from a "tilt-in-space" chair, as pointed out by Becerril. The user remains in a sitting position as the chair tilts back, providing temporary relief from the effects of gravity and helping to prevent weariness. For individuals who find the typical angles of sitting uncomfortable, reclining chairs, which enable a prone position, are frequently utilized.
Last Adjustment
According to Becerril, there will be a two-month wait until the chair is delivered once it has been ordered. Time is of the essence when dealing with authorization, especially when working with multiple firms and a particular product. As far as wheelchairs are concerned, nothing ever occurs fast.
The time it takes to physically fit the chair could range from two to three hours, according to Becerril, after it has arrived. "Sometimes, unexpected things happen. One of our goals is to educate parents on how to recognize an inappropriate fit. Because children develop and change rapidly, it is essential to keep an eye on the fit at all times.
For Seiberlich, "redness indicates too much pressure," so it's important for parents to keep an eye out for it. It is imperative that they examine the rear end, feet, buttocks, and rear of the legs. There is a risk of excessive pressure anywhere the chair comes into touch.
As a general guideline, she recommends keeping no more than three fingers' width between the seat's front and back. If you sit on more than this, you risk having your legs squished by the chair because it won't support your thighs enough. Because there isn't as much surface area to support your weight, sitting becomes more of a chore. Be sure the footrests are at a low enough height to provide complete coverage of the thigh. Half an inch is the minimum recommended distance between a person's hips and a chair's side. Ensure that the laterals are not very snug or chafe the underarms. "Parents can make these adjustments, if they know what to look for," Seiberlich advises. At the very least once a year, particularly if the child is still a developing one, we like to see him or her in his chair. And we want people to come in anytime they think there's an issue they can't fix.
Maintenance
The chair should be washed routinely with a spray cleaner," Seiberlich says, emphasizing the significance of routine maintenance alongside checking the chair's fit. You can wash most cushions or at least their covers. Every week, give the chair a full once-over, making sure to inspect the brakes, loose hardware, tires, and seat.
Tire pressure and the amount of air or gel used to fill seats are also affected by temperature changes, as pointed out by Becerril. Home remedies are sufficient for minor issues. Even more complex ones can be handled by the vendor, who will typically provide maintenance at no cost to the customer.
As a last point, Seiberlich brings up the transportation issue again to emphasize a crucial safety regulation.
The pelvic strap that secures you to the chair isn't as sturdy as a seat belt, and chairs aren't typically crash-tested. Rest assured that a youngster must be securely fastened to the car seat using both the seatbelt and the seat itself. You can also utilize a chest harness if you need lateral assistance.

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