Seating & Mobility – Adult and Geriatric Populations

Register for one or both days!

Therapy Assistants can attend for 50% off the registration fee when attending with their OT!

Day 1 – February 23, 2019

It IS More Than 4 Wheels!: How The Mat Assessment Influences the Prescription of Seating and Mobility Devices in the Adult Population

Session Level: Beginner – Intermediate

Learning objectives:
• Describe surfaces on which to complete a hands on Mat Assessment
• List three components of three-point positioning
• List three components of the Mat Assessment
• List two postural tendencies
• Describe how centre of mass influences centre of gravity set up of the seating and mobility base.

Description:
Completing a thorough yet concise assessment has always been a challenge in seating mobility and is even more of a challenge when carried out in the community setting. It is imperative to gather appropriate assessment data. But with time constraints as well as environmental challenges inherent in community settings, this can prove to be a daunting task for the community therapist. This workshop will review what information is critical and how to access it in the community setting.

A good seating and mobility evaluation involves not only the assessment, but the consideration of many client factors including physical, functional and lifestyle. These factors play a large role in determining the prescription of seating components and wheelchair frames/design to enhance functionality and overall performance for daily quality of life issues. It is imperative that we recognize that seating is not exclusive of mobility or the other way around. One enhances the other and therefore must be considered together when completing an initial MAT assessment to achieve a final assistive technology prescription.

Assessment of postural tendencies and simulation of a support system with appropriate forces is imperative before a product prescription can be completed. This must be completed in order to determine if there are deformity tendencies in more than one anatomical plane as well as to determine balance and dependent sitting concerns.

This workshop will review critical points for wheelchair/seating prescription and set-up based on hands-on assessment and simulation. We will be reviewing complex seating involving three-point positioning to reduce postural tendencies. Consideration will be given to lines and angles of force based on client centre of mass and positioning. We will also explore seating and mobility base set-up to address pressure issues along with postural concerns. Our goal will be to provide our clients with postural control, and functionality while considering pressure and physiological functions.

Content references:
Buck, S. More than 4 Wheels: Applying clinical practice to seating, mobility and assistive technology . 2009, revised 2017.
Geyer, M., Kusturiss, M., & Holm, M. (2010). A Randomized Clinical Trial on Preventing Pressure Ulcers with Wheelchair Seat Cushions. Journal of the American Geriatrics Society, 58(12), 2308–2314. https://doi. org/10.1111/j.1532-5415.2010.03168.x 3.
Kirby R. L., Smith C., Parker K., McAllister M., Boyce J., Rushton P. W., Routhier F., Best K. L., MacKenzie D., Mortenson B., Brandt A. (2016). The Wheelchair Skills Program Manual Version 4.3. Halifax, Nova Scotia: Dalhousie University. Retrieved from http://www.wheelchairskillsprogram.ca/eng/documents/version4.3.3/ The_Wheelchair_Skills_Program_Manual.77_w_ comments_and_highlights.pdf 4. Lin, F., Parthasarathy, S., Taylor, S. J., Pucci, D., Hendrix, R. W., & Makhsous, M. (2006).

DAY 2 – February 24, 2019

The Impact of Wheelchair Set-up and Seating on Eating, Breathing and General Well-Being of the Elderly Client

Session level: Beginner – Intermediate

Learning objectives:
• Describe two postural tendencies in the geriatric population
• Describe three physiological functions that are adversely affected by poor seated posture in the elderly
• Identify three points of positioning that will assist to reduce sliding and restraint use

Description:
Occupational therapy along with the provision of seating and mobility is the art and science of enabling engagement in everyday living and enabling people to perform daily activities that foster health and well-being. The provision of seating to provide postural control and maximum mobility to all ages enables a just and inclusive society where all people may participate to their potential in the daily occupations of life.

As clients with medical, physical and often mental conditions age, we must deal with their inherent orthopedic and muscular changes as well as difficulties they begin to experience as their internal systems begin to fail. Often the trunk becomes severely curved with the force of gravity on weak muscles. Sliding out of chairs or falling becomes a common complaint with protective fetal positioning occurring. Fragile bones from osteoporosis complicate the mobility of stiff joints. Heart conditions, decreased lung capacity and arthritic changes decrease mobility and strength for moving and manipulating assistive technology. The challenge then is to respect the client’s need for comfort while at the same time supporting them against gravity for function and interactions with others within their environment and cognitive functional capacity.

In providing assistive technology for this population, we must assess the need proactively for change. Adaptability in equipment design, prescription and timeliness of reassessment is necessary to accommodate to the aging process changes.

This session will review the need to prescribe seating and mobility systems that provide the elderly with comfort and the ability to maintain autonomy while maintaining their safety and independence in functioning at the same time. It is intended for individuals involved in recommending seating and positioning equipment to “geriatric” clients. Discussion will review client needs, environmental and lifestyle barriers along with methods to prioritize these needs in order to make optimal product choices and reduce restraint concerns in long-term care facilities.

Content references:
Buck, S. More than 4 Wheels: Applying clinical practice to seating, mobility and assistive technology . 2009, revised 2017.
Geyer, M., Kusturiss, M., & Holm, M. (2010). A Randomized Clinical Trial on Preventing Pressure Ulcers with Wheelchair Seat Cushions. Journal of the American Geriatrics Society, 58(12), 2308–2314. https://doi. org/10.1111/j.1532-5415.2010.03168.x 3. Sitting Postures on Lung Capacity, Expiratory Flow, and Lumbar Lordosis. Archives of Physical Medicine and Rehabilitation, 87(4), 504–509. https://doi.org/10.1016/j. apmr.2005.11.031
Hill, S.; Goldsmith, J. (2010) Biomechanics and Prevention of Body Shape Distortion. Tizard Learning Disability Review, 15 pp15-30 7.

About the presenter:
Sheila Buck B.Sc.(OT), Reg. (Ont.), ATP

Sheila Buck is the owner of Therapy NOW! Inc., in Southern Ontario, CANADA. Therapy NOW! Is an Occupational Therapy company providing private consultation and education on seating and mobility assessments and prescription. Sheila is an Occupational Therapist who has been working in the Seating and Mobility field for over 30 years. Sheila has presented papers and workshops at National and International conferences on topics of basic and advanced positioning with emphasis on pressure management, cognitive functioning and maintaining independent living skills and restraint reduction. Sheila’s clinical skills have been developed from experience as an RTS as well as her current involvement as a clinician in long term care facilities, group homes, and client homes in the community. For five years, Sheila presented her own workshop series, Back To Basics…and Beyond. She has also volunteered in third world seating clinics in Haiti and Uganda. Most recently, Sheila has authored a clinical guide for seating and mobility with a current 2017 revision. It is titled, More Than 4 Wheels: Applying clinical practice to seating, mobility and assistive technology. Available at www.sheilabuck.ca.

The workshop includes morning and afternoon refreshments and snacks and certificate of completion. Please note that lunch is on your own.