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August 2013 • Vol. 12 No. 8 Serving the Seating & Mobility

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1. mobilitymgmt com mm beat BL Meyer A New amp Energizing Future this really what retirement looks like After working in the medical S devices industry for decades starting in orthotics and prosthetics then moving over to seating and founding ExoMotion now known as Thomashilfen in 2004 BL Meyer retired and promptly moved to Ghana Her husband Dutch is already there working with their foundation named Yeko Anim a 501 c 3 organization The name roughly trans lates to progress in the Twi language of Ghana s native Akan people according to the organization It s another major transition for Meyer but hardly the first in her career In an interview with Mobility Management Meyer recalled coming to rehab from the orthotics amp prosthetics business The changing over from that into rehab was somewhat startling because everything was funded and done so differently she says The biggest adjustment for me was that everybody in the loop needed to be included in the discussion We sold our products at Seattle Foot made by prosthetics manufacturer M IND directly to the orthotist prosthe tist and that was that We weren t really interacting with any of their customers But in the case of rehab if your product is interesting to end users then we very much are getting calls directly from them A New Way to Do Business Meyer came to the complex rehab industry via positioning
2. When clinicians have more options clients have more say in what types of devices they want and ultimately more control of the chair Rotelli says today s electronics are more adjustable and change able than ever before which is especially important for clients with progressive diseases such as amyotrophic lateral sclerosis For example Rotelli says a system might have three switches in a head array backpad right and left When the client becomes weaker a Power Chair But when it comes to the future and practicality of eye gaze tech nology Morgan is hesitant Eye gaze is great for computer access for a communication device things like that think we ve really developed the eye gaze technology for those uses she says But as for driving the chair we re not there yet and I m not sure that we re going to get there The reason Morgan doesn t think the technology is safe The fact is when you re using it eye gaze for communication or he mouse doesn t move anymore she says When you re driving it s a whole other story It would go where your eyes go So if the cursor runs off the screen that s not hurting anybody But if the chair runs off the road because their eyes went in a different direction for computer access and you look away you just look away and For Morgan the cool thing about this particular eye gaze system is not so much the eye gaze technology itself but the integratio
3. mm beat sessions were created to address the unique needs of SMA types 1 2 and 3 as well as the unique considerations for adults with SMA An exhibit hall featured seating amp mobility respiratory and augmentative communications equipment The more than 1 300 attendees including more than 200 researchers from 15 countries also came together such as at the opening reception and at the general session titled It s a Wonderful Life where adults with SMA offered advice to parents of children with SMA see Editor s Note August is SMA Awareness Month For more information on the condition visit fsma org Laurie Watanabe Mobility has a n name ATG rehab 4 Our new site is coming soon visit numotion com 800 500 9150 Mobility starts here Moblitymanagement august 2013 1 1 3 United United Seating amp Mobility and ATG Rehab have come together to form one dynamic company Numotion With a strong local focus we aim to be the most responsive and innovative company to do business with for all our customers and a loyal and helpful partner that will move lives forward for years to come It s a nu day in mobility for registration and travel expenses for an adult with SMA to attend the conference The scholarship is named after FSMA board member Amy Marquez who had type 1 SMA Marquez died in September at the age of 41 Her husband Steve and their daughters Harley and Danielle attended the
4. 0 28 Milite sepeser 27 Permobil Wenzelite Re hab 28 27 6 0 Quantum product revue Company Name Page Company Name Page Comfort COMPANY seem 30 Freedom DesigNs ssss ss 30 GOMVAIG sis 510 5 rore a nite a 30 OODOCK 30 0 6 6 ieids 30 MM Editorial Josh Anderson TiLite eje mobility Pat Boardman Consultant management 5 Lois Brown National Seating amp Mobility Group Publisher Karen Cavallo 760 610 0800 Nat l Sales Manager Caroline Stover Ryani N 323 605 4398 yan Hagy Numotion Rita Hostak Sunrise Medical Jay Doherty Quantum Rehab Rick Graver Medtech Services Sales Assistant Lynda Brown 972 687 6710 Julie Jackson Invacare Corp Advertising Fax 866 779 9095 Karen Lundquist Ottobock mobilitymgmt com Complete Feet Footboxes The products really love and use all the time are the Complete Feet pictured and Single Foot foot boxes from Comfort Company They have thick comfortable foam padding which makes them ideal for clients who cannot wear shoes due to foot deformities And the angle of the back pad can be changed to accommodate dorsi or plantar flexion because it is attached to the bot
5. Oh wow That s perfect That s how they can drive a chair So it s kind of those aha moments that you realize you re really onto something that you can really help a lot of people drive that couldn t before The Future Is Wireless Smart homes are complex rehab s flying car We ve been talking about them for years but just how close are they to reality According to Rotelli some of the electronic capabilities to access the home environment are currently being used and there s no denying this is the wave of the future Computers are helping people activate lights and heating air remotely as well as open doors Tomorrow s power chair might just be the next control center In fact some of this is already being done ona small scale Our problem was getting access to the device and that s become a lot better Rotelli says The driver for this type of technology is the increased use of computers which is another area Rotelli sees improvements coming for power chair users What I see happening now are more and more clients wanting and should be having access to their computers access to their iPads and their tablets That technology is here today but I see that evolving completely Rotelli explains One of the biggest benefits for wireless technology is the transfer of information Rotelli says including the remote monitoring of prob lems with the chair and components such as batteries Technicians
6. said Larry Jackson Permobil North America s president CEO in a news announcement All of the other things from our marketing efforts to our customer service practices are continuously developed and improved to make things easier for our customer The site contains information on Permobil power chairs and seating systems including both major features and more detailed specifications Owners and service manual downloads are just a few clicks away For industry professionals the site includes information on training and education as well as funding resources Scroll to find HCPCS code lists Medicare fee schedules and documentation support such as whitepapers and samples of letters of medical neces sity for various Permobil products We want our customers to explore the site maybe even come up with new powered mobility solutions to their needs that they might not have known about previously said North American Marketing Manager Barry Steelman There is practically all the information you need to make informed decisions about the products that are right mobilitymgmt com Tomorrows Power Chairs Power Chair Components of Today and the Future Focus on One Thing Making Every Day Better The joystick The captain seat These two iconic images defined the first power chair decades ago By Elisha Bury Since then and especially in the last 10 years the industry has come a long way Today s power compone
7. REACHING THE STAFF Staff may be reached via e mail telephone fax or mail ist of editors and contact information is also available online at mobilitymgmt com E mail To e mail any member of the staff please use the following form FirstinitialLastname 1105media com Dallas Office weekdays 8 a m 5 p m CT elephone 972 687 6700 Fax 866 779 9095 14901 Quorum Drive Suite 425 Dallas TX 75254 Corporate Office weekdays 8 30 a m 5 30 p m PT elephone 818 814 5200 Fax 818 734 1522 gt aj 9201 Oakdale Avenue Suite 101 Chatsworth CA 91311 mobilitymgmt com american usiness mediagy A editor s note What I Learned from Families of SMA gt 7 15 on Saturday morning June 15 and I m at the Families of Spinal Muscular Atrophy FSMA It Sconference at the Disneyland Hotel in Anaheim Calif And I m pretty proud of myself Why First it s Saturday morning and l m not still in pajamas Second I m not in tears either Two evenings prior I d arrived for FSMA s welcome reception only to detour into a stall in the women s restroom As When You Wish Upon a Star played over hotel speakers saw dozens of children with SMA and thought about what had brought them together at this self proclaimed happiest place on earth t isn t supposed to be this way thought in my stall This isn t right As minutes went by hissed Stop being so pathetic until it worked Barely Today
8. one pointing toward and another facing away from the user so consumers can capture images of them selves and their world Environmentally Tobii can be used to control devices such as TVs and DVD players air conditioners lights doors and stereos While Tobii s eye gaze abilities get most of the buzz the devices can Research Stroke Patients May Benefit from Watching Others Perform Tasks But in the brains of stroke patients researchers said Activity was strongest in these regions of the damaged hemisphere and strongest when stroke patients viewed actions they would have had the most diffi culty performing Why Activating regions near the damaged portions of the brain is like exercising it building strength that can help it to recover to a degree the report said Kathleen Garrison the lead author of the research report explained Watching others perform physical tasks leads to activations in motor areas of the damaged hemisphere of the brain after stroke which is exactly what we re trying to do in therapy If we can help drive plasticity in these brain regions we may be able to help individuals with stroke recover more of the ability to move their arm and hand Researchers theorized that the results of the study could support the expansion of action observation as a therapeutic activity for stroke patients in the future mobilitymgmt com any people find that getting hands on with a new task great
9. particularly those with disabilities Movement some of us believe is life she says It gives information to the brain just like sound and just like all the other senses It brings sensory input through the body that can hopefully help in a case where 1 2 august 2013 Mobilitymaragement mm beat growth On behalf of the athletes families fans and volunteers we are grateful that an international company like MK Battery has become a huge advocate and active partner in the world of power soccer I cannot tell you how happy I am for the families and athletes for how this will affect their teams Athletes play with specially modified power chairs on indoor basketball courts The sport of power soccer enhances the lives of those with disabil ities says Wayne Merdinger MK VP of business development We are extremely proud to be taking such an active role in the program We have provided reliable power to wheelchair users for years and we were flattered to learn that our batteries have been in use by most of these athletes for some time Permobilus com s new scrolling navigation feature similar to the technology being used by tablets and smartphones makes it easy to move quickly from page to page on the redesigned site for you Plus the simplicity of the way we have categorized the site contents gets you where you want to be almost instantly Mobilitymanagement august 2013 1 3 MK Battery
10. published papers amp seating c exoskeletons 3 amp mobility u emerging technologies 2 Ro gaze i fone prosthetics w trial robotics amp testimony participation g ra genetic news clinical trials new discoveries Tobii Communicates a Gaze ata Time also be used via touchscreen and Tobii is built with tough Gorilla Glass to stand up to heavy duty taps and touches The Eyes Have It Prep time for using the I Series eye gaze func tion was minimal just a few quick exercises so Tobii could see and sync with my eyes Tobii says its eye gaze works in most lighting conditions and has no trouble with users who wear contacts or glasses It took a few more minutes to learn how to work keyboard keys and the mouse via my eyes to hold my gaze long enough for Tobii to register it but not so long that my eyes inadvertently clicked the mouse repeatedly Dani Mohn the Tobii rep who trained me reported interest in the system was strong at the FSMA event and that the children who d stopped by for a demo had learned to operate the system quickly in that intu itive way that today s kids seem to have with technology Tobii suggests its devices could benefit clients with cerebral palsy Rett syndrome ALS or stroke aphasia as examples Kids with SMA known for being very quick on the uptake would seem to be prime candidates as well In fact Mohn said a father had brought his teenage
11. Named Title Sponsor for USA Power Soccer Gen Thanks to a new sponsorship from MK Battery power soccer players and fans may be hearing a lot more of that cheer in years to come The United States Power Soccer Association USPSA and MK Battery jointly announced that the manufacturer has signed a multi year agreement that gives it exclusive title sponsorship rights and offi cial battery designation for all U S Power Soccer Conference Cup tournaments and Team USA international competitions including the 2015 World Cup Team USA is the defending World Cup champion Power soccer is the fastest growing team sport for power wheel chair users in the world said USPSA President Taavasa Mamea MK Battery s financial support will significantly help accelerate the sport s Permobil North America Introduces New Web Site H aving recently launched a new corporate site Permobil now has turned its attention specifically to North America with a rede signed site that boasts not just updated graphics and layout but also a new way to navigate The North American site can be accessed through the corporate permobil com site use Select Country to get to the American or Canadian pages or directly by going to permobilus com Navigation is accomplished through scrolling tablet smartphone style which could make the site easier to use for visitors with finger or hand dexterity issues Our innovation is not limited to our products
12. Watanabe Editor lwatanabe 1105media com From 6 august 2013 Mobilitymanagement al RISE 1981 Manufactured in the U S A Freedom LEAF and MAPS patent pending Another Freedom First The NXT Specialized Tilt in Space Wheelchair Freedom s LEAF is an option on NXT folding and rigid frame models LEAF is a robust hinged front seat frame that adjusts 22 from midline Once adjusted LEAF bolts into position so NXT frames can help accommodate abduction adduction or wind swept leg positioning challenges LEAF adds NO width to frame and NO significant weight so NXT frames remain lightweight compact and easy to lift and stow into small spaces V MAPS Multi Axis Positioning System SAW Freedom s MAPS is optional footrest 9 Plate attachment hardware that ae _ connects Freedom aluminum footrest 4 plates to Freedom pop up or swing away footrest hangers With MAPS footrest plates rotate to adjust horizontally laterally and vertically for plantar and dorsiflextion inversion eversion and rotational foot and ankle positioning needs Freedom Designs Inc Phone 800 331 8551 Fax 888 582 1509 ee 1 www freedomdesigns com SS kids are our passion 2012 Freedom Designs Incorporated mm beat Numotion Offers Service to Alliance Seating Clients offer to help is an ind
13. are much simpler to use easier to maintain Technician support center and more affordable We are pleased to partner P us and Sunparts Online with Ottobock in helping rehabilitation profes sionals meet the needs of their clients e Expanded order forms literature and resources page Matt Swiggum Ottobock VP of mobility solu e Mobile site for optimized website viewing on tions for U S healthcare said of the new part p 8 nership With its pioneering technology and mobile devices its efficiency in addressing the important qual e Proactive order communications advanced ship ity of life issue of skin breakdown the BodiTrak and back order e mail notifications Pe ree Spe Syste Seer a e Electronic invoice management and bill pay Ottobock brand We are pleased to bring the BodiTrak to market and look forward to the posi tive impact our new partnership with PatienTech 800 333 4000 www SunriseMedical com SUNRISE Vista Medical has on our customers and the entire MEDICAL rehab community mobilitymgmt com Moblitymanagement august 2013 9 mm beat Event Coverage Families of SMA Honoring the Past Working for a New Future ANAHEIM Calif The annual Families of Spinal Muscular Atrophy FSMA conference has its feet in multiple worlds FSMA is dedicated to finding treatments and a cure for spinal Honoring Their Memories muscular atrophy a genetic motor neuron disease affecting one in
14. chair All this is to say that Doherty predicts adjustability will continue to Funding Update Power Seat Elevation hen it comes to funding for power seat elevation Medicare s lack W response leaves most in the industry scratching their heads don t understand it says Brad Peterson of Motion Concepts Medicare said that they pay for functional ability in the home don t know about you but if came home tomorrow in a wheelchair couldn t access most things in my home without being able to raise my seat It s something that should be looked at should be more readily available Amy Morgan PT ATP at Permobil says that even though progress is not being made with Medicare there is some hope at the state level State Medicaid funding for seat elevation is improving obviously dependent upon the state she says The states that have been chal lenged as to why they re denying seat elevation have seen success and have seen policies changed and now cover seat elevation In some instances Morgan has seen this strategy work with Medicare on an individual basis after fighting through the appeals process There have been individuals who have been successful in getting seat elevation authorized through Medicare but it s an individual thing she emphasizes They re Medicare not changing their policy anytime soon Jay Doherty OTR ATP SMS at Quantum Rehab is hoping the passage of the separa
15. footplate angle to always be symmetrical If we have an angle adjustable knee position like you might have with the Seating Dynamics multi spline joint there s somebody who would be saying They re not the same I know that we tend to think of everything being symmetrical and that s what s right but it s not It has to really be more of what the range of motion is and what the body presents In other words achieving the right foot and leg positioning can sometimes require meeting a consumer where they are And overall lower extremity positioning needs to work well with the positioning needs of other parts of the body So how do you know when you ve got the right combinations dialed in Greg Peek owner of Seating Dynamics says My experience in adjusting footrests and legrests taught me that when they re prop erly adjusted there should be minimal weight on the footplate and the thighs should be supported at the edge of the cushion or along the entire surface contact between the thigh and the cushion That s where the weight should be supported primarily and the footplate is there as a support It s not the primary support weight bearing surface When the footplate bears too much weight Peek explains It is going to have an impact on what the seat cushion is doing If you ve got an improperly adjusted footrest that is too short it s going to bear more weight and it s going to lift the thigh off the
16. manufacturer Bodypoint located in Seattle There she was the sales and international business development manager for a decade At Bodypoint she says she learned the importance of communicating effectively with all members of the rehab team If you re going to try to grow the business on behalf of the manufac turer found you had to understand how to communicate well with all the groups involved Meyer explains Always know who you re talking to If it s a mother she s advocating for her child If it s a dealer you re hoping they re advocating for that child through the therapist If it s the therapist they re advocating for the child but they never want them to be in a situ ation to see something they can t have Every time you get up and do a presentation every time you speak to someone you have to really know deeply who it is you re speaking to and advocate for your product line appropriately And sometimes you realize you re not right for them and be able to say I really think this is not going to be the right thing for you and give up that potential sale in order to do the right thing That mindset Meyer says is a big change from normal business There s nothing normal retail make a fine product and sell it about anything you do in the rehab business With the founding of ExoMotion Meyer had the chance to emphasize her belief in Micro Stimulation and the valuable input it gives to children
17. will be able to tell what is happening to the chair before they go to the client s home to repair it In addition some repairs such as software and firmware upgrades can be done remotely That s something that s really big and it has only been in the last few years that companies are able to instead of buying a new controller for their wheelchair actually just update your firmware Rotelli says And that s huge and that s really beneficial for the client She says both of these improvements will cut down on the time that clients are without their power chairs and save providers time Mobilitymanagement august 2013 1 9 and loses rotation on the backpad she ll take the sensor out and plug it in somewhere where the person might still have functional move ment such as near the finger or the thigh Then she ll add a switch there So we can really with the technology match their ability for a very long period of time Rotelli says For Morgan the excitement of today s technology really comes down to one thing integration She says today s chairs no longer have separate external controls for everything from communication devices to PCUs Environment controls turning on the TV changing channels talking on the communication device all of this can be done inher ently through the chairs now instead of needing to plan a whole sepa rate switch and system for the operation of those devices she say
18. 60 E1028 and K0108 Therafin Corp 800 843 7234 therafin com Kanga TS Frame This folding tilt in space wheelchair has a built in growth frame that configures to 10 12 and 14 widths adult sizes are also available The Kanga TS includes curb assist levers 20 rear quick release semi pneumatic wheels height angle adjustable armrests and push handles The Kanga is bus transit compatible and the frame adapts to most custom rehab seating systems Wenzelite Re hab 877 224 0946 drivemedical com mobilitymgmt com Stimulite Contoured Cushion Designed for positioning and comfort the Stim ulite Contoured pediatric cushion has a soft top layer fused to a firmer bottom layer of flexible Stimulite honeycomb Adductors abductors and an ischial dish comfortably position the child while the soft honeycomb cells hold the child in place In sizes starting at 10x10 with non standard sizes available on request At 2 5 thick and weighing just 1 2 Ibs the cushion is suitable for all the activities of today s busy kid Supracor 800 787 7226 supracor com Twist Designed from the ground up for the growing child the Twist encourages exploration It offers 2 of growth in seat width and 3 of growth in seat depth Because the Twist grows with the child there are no parts or growth kits to buy and the 1 aluminum frame design makes for easy installation of seating components TiLite
19. 800 545 2266 tilite com JAY Zip This lightweight adjustable back is designed especially for active kids and teens The Zip s contour shapes vary to fit the unique shapes of clients using each width One step release hardware offers 3 of depth 1 of width adjustability and 40 of angle adjustability The dual cover system is anti microbial water resistant and machine washable Positioning components such as Whitmyer headrests and lateral thoracic supports are available Sunrise Medical 800 333 4000 sunrisemedical com Recaro Monza Reha Booster Seat With adjustable lateral supports and a full range positioning harness the Recaro Monza Reha booster seat is built to provide superb positioning for children with special needs The swivel base is designed to provide safe convenient transport and gives parents a back saving way to transfer the child to and from he seat The seat is for children from 33 1 to 110 2 Ibs with a back height from 23 6 to 30 3 Thomashilfen 866 870 2122 homashilfen us 28 august 2013 Mobilitymanagement ad index Swing Door Opener www otodor com 4 800 304 1187 Aero Mobility Permobil Pride Mobility Products Quantum Rehab St Joseph s Children Hospital of Tampa Comfort Company Wheelchairjunkie com Motion Concepts Numotion Opener with remote control 3 models for different applications Other optiona
20. In some cases the fundraising and awareness efforts have gained every 6 000 babies born The organization invests heavily more momentum even after the person with SMA passed away One notable than 50 million so far in research into drug therapies while example is the Jacob Isaac Rappoport Foundation created by Adi and working toward a future that no longer includes as FSMA notes this Shaina Rapport in memory of their son who died of type 1 SMA at number one genetic killer of children under 2 years of age 9 months In the 11 years since the foundation has raised more than Those investments are due largely to the community s extraor 1 million for SMA research and support and the Rappoport family dinary fundraising efforts many of them grassroots activities by presented FSMA with a check for 100 000 during the conference families and friends on behalf of children and adults with SMA Another example is the Amy Marquez Scholarship which pays j 5 FSMA President Kenneth Hobby left was part of the The welcome reception was definitely a family affair In the exhibit hall Tobii ATI demonstrated welcoming committee during the opening reception eye gaze communications systems or A researcher left checks out his pint sized competition Minnie Mouse was in the house Guess who loves Minnie Mouse during the Researcher Relay Race 10 august 2013 Mobilitymanagement mobilitymgmt com
21. Positioning tne Tower Extremities Pa f i Do k k a e i i i F 9 i i SS 7 j a i p 1 j T gt i i j r a z gt 1 k 1 5 1 1 OIE I h oe 2 2 ottobock i New Kimba Neo Smoother Ride for Kids and Their Parents Parents work hard enough Make it easier for them with the new Kimba Neo A convenient folding mechanism makes collapsing the stroller for transport a snap We ve beefed up the weight limit by 10 percent so parents don t need to replace the stroller as often The sturdy frame boasts a unique adjustable rear suspension for a smoother ride across bumpy surfaces And with five seating systems to choose from you can address the full spectrum of needs making it the go to system for pediatric mobility Call your Sales Representative at 800 328 4058 and ask to learn more about the new Kimba Neo www OttobockUSMobility com OPTIMIZE SEATING Stealth Headrest Invacare Matrx Elite Deep Back Invacare Matrx Seating Series Body Point top Bok Single Invoicing Single Shipment Single Tracking Single Delivery Invacare Matrx Seating Products For more information visit www invacare com matrx or contact your local Territory Business Manager E Invacare Matrx Vi Cushion A eae www facebook com InvacareCorporation 2013 Invacare Corporation All rights reserved Trademarks are identified by the symb
22. a range of sizes including pediatric Invacare Corp 800 333 6900 invacare com Kids UP The Kids UP line offers a full range of attendant propelled pediatric solutions The Kids FAST and Kids ROCK products accept the Kids UP Reaction Dynamic Seating System that allows the child to move into flexion or extension in the chair while maintaining proper pelvic positioning and therapeutic support LifeForm positioning components allow products to be custom configured to the specific needs of each child Quantum Rehab 866 800 2002 quantumrehab com Moblitymanagement august 2013 27 Frontier V6 This super compact mid wheel drive power chair is made to grow with the child It shares the same frame as the Frontier s all terrain front wheel rear wheel drive versions so switching casters drive tires bogey and floater arms creates a new configuration The super small base is great indoors Innovation In Motion 800 327 0681 mobility usa com K450 MX With an all wheel smooth riding suspension the K450 MX gets kids where they need to go That includes getting down to floor level for time with peers as well as easier transferring Seat to floor heights range from 3 to 26 allowing kids to sit in the K450 MX at the dinner table Features R Net electronics and a range of power seat functions including seat elevator and optional power tilt Includes a free growth kit and ce
23. ally gives them a little bit more stability If they re going over uneven surfaces it s less likely that their foot might migrate out of the footplate drop off the front edge They can maintain that position without having to have something like a strap around their lower leg If somebody has the range I would rather set that orientation up with a little bit of dorsi flexion rather than having it too flat Reidmiller has seen a number of clients with tone so strong that they break footplates and similar accessories For these clients dynamic accessories that move and flex with them may be the answer The tone s got to go somewhere he explains And if something s solid or static the tone s going to go into that piece of equipment and it tends to break If we allow them to alleviate that tone hopefully there s less breakage Peek has a long history of developing dynamic components including dynamic rocker backrests and now dynamic footrests Being a mechanical designer when somebody tells me a footrest broke well why did the footrest break Peek asks When you hear that over and over again you know there s a pattern causing it And in a lot of cases what I hear of is extensor tone The rocker backrest and dynamic footrests were conceived for the same basic need to absorb energy and not transmit load into the wheelchair Their original purpose was from a mechanical perspec tive not a clinical per
24. am deter mined to do better and it starts with attending this morning s general session called It s a Wonderful Life The title has me feeling optimistic Kenneth Hobby president of FSMA explains the format of the session which he calls one of the most looked forward to events Six adults with SMA will field ask us anything questions from an audience largely composed of parents whose kids have SMA The panelists vary in age from young adulthood to middle age and have type 1 or type 2 SMA Some of the panelists had been expected to die as infants or young children But here they are describing their lives as spouses and parents as college graduates and grad students as profes sors disability advocates or in one case a policy staffer for a U S senator Hmmm My rolling out of bed this morning suddenly isn t so impressive a feat The first question is from the father of a 7 year old with type 2 SMA What is something your parents did right or wrong while you were growing up The answers fly My father fixated on the depressing aspect that I m not as able as other kids are even though have so many other great things going on My mother insisted do chores even though it took me an hour to dust the living room was expected to be respectful and polite Very early in life was empowered to take part in the medical decisions that affected me ext question from the father of a 12 year o
25. an be detached to offer walking support while the umbrella is also being used The Umbrella Cane is available in a plaid pattern with a gloss black cane handle ne Drive Medical 516 998 4600 drivemedical com Self Tensio Convaid s new self tensioning seating system is designed to provide therapeutic pelvic po sitioning similar to a solid seating system but in an umbrella style folding rehab chair It features an expanding frame design plus flexible self adjusting upholstery and underlying mesh support Self Tensio is standard on Convaid s EZ Rider Cruiser Scout and Metro chairs Convaid 888 CONVAID convaid com 30 august 2013 Mobilitymanagement iDrive is the most advanced head array ever built not only because of fhe wide range of positioning options offered by Stealth Products but by fhe technology engineered behind it LOGK for Gur mI in ihe Seating amp Positioning Socio The advanced progressing is nef required in epinio 8 drive control but is avaliable ba anaura customized ft and driving experience ha FOr ig aay imply cost a Windows PC lo or Tabip and use the application for sihr n System Voeg Low TE Ha Lice JO r RHA wl ba rears an rig n ne 10 r Whon that la ewi Gre arid hh adir haa good OT the application vill sian Fe sat up w
26. conference this year in her honor Support for Today But while FSMA seeks a world without SMA and remembers those who died from it the organization also strives to support families currently living with the condition At this conference that meant educational sessions for attendees of all ages There were separate Talk It Out sessions for kids with SMA their siblings and their grand parents Some classes discussed daily life experi ences from nutrition for G tube users to respira tory basics and physical therapy regimens Other Ai em AE jt WB Mick second from left talked to parents in the Permobil booth David Milligan left and Steve Fox of Sunrise Medical showed off the new Zippie Voyage mobilitymgmt com BL Meyer left with Darlene Hawthorne business development education manager for Thomashilfen postponed her retirement long enough to attend une s Families of Spinal Muscular Atrophy conference in Anaheim Calif so many of the issues we re dealing with that have physical results are rom damage to the brain not the physical part of the body that you re rying to help On to a New Challenge ow Meyer is trading the rehab community for one in Ghana We are moving into the village that we have been supporting she says Our main programs have always been education We ve supported that from the youngest child in the village who can t affor
27. cushion and put more pressure on ischials Tanguay says another problem occurs when the consumer is sitting more forward than they should be or when they ve slid down or forward on the seat cushion causing some posterior pelvic rotation Once the pelvis rotates posterior it s very easy to lose alignment of our femurs she says A lot of time how it manifests is our patient sits abducted and at the lower extremities the outside aspect of the calf just below the knee can be sitting up against the hanger of the lower extremity support Tanguay says in those cases consumers or family members will report seeing on the skin an indentation there s always a little curved tubular mark If it s somebody who has mild edema if you re touching that hanger of the lower extremity support the soft tissue and the fluid will kind of move around it so we have that indentation Tanguay says manufacturers offer padded hanger wraps or offset receivers so hangers can be set offboard and the hope is out of the way Or If we can do something a little better with their posture to mobilitymgmt com ATP Series Getting Under Foot In some cases it s sensory seeking he says Consumers bang on the backrest to make sure they re grounded with Mother Earth Tve heard numerous people comment that when they meet with firm resistance and I think this can apply to the back foot whatever that will trigger thi
28. d school fees all the way up to last year when 37 kids were in college The Meyers Yeko Anim foundation also supports a disability action fund It s a micro lending program where people in town can come and get a small loan to start their own business in the town she says It s a 3 a day market economy We have guys who have gotten 60 as a loan and they ve paid that back and made some money because they were able to set up a little storefront instead of just squatting on the side of the street and doing whatever their work is And these are all disabled people Future plans could involve setting up a sustainable adventure tourism resort built and staffed by locals All of Yeko Anim s work Meyer adds is done in consultation with community leaders We didn t come with a program of our own that was going to be right for them she says We sat down and listened and thought Where could we best put our collective knowledge We ve been doing this remotely for a number of years and now we re going to go and do it hands on The best way to stay in touch with the Meyers will be through the Yeko Anim Web site which is being upgraded yekoanim org It s all very amazing that s it s just kind of rolling into the next chapter Meyer says It s going to be an incredible retirement from this working world to something much simpler and yet just as challenging in every way That s very energizing
29. e consumer is the key to improving funding Just as they ve demanded technological improve ments in equipment clients must also demand coverage think that consumer advocacy is now the best opportunity to get seat elevators funded he says As consumers continue to become more involved in the efforts to improve their access to this technology and complex rehab technology as a whole believe funding sources will follow To find out if your state covers power seat elevation visit medicaid gov click on the menu Medicaid and choose By State mobilitymgmt com Tomorrow s Power Chairs emPOWERed We don t want to sacrifice function for form but we need to make sure that we design our systems with a critical eye to how they look and how they function Brad Peterson Motion Concepts feet through all arcs of motion and the seat size can be adjusted inde pendent of the back size Doherty says In fact fine adjustments can be made while the client is in the chair saving time for everyone involved Adjustability is especially important for the provider Doherty explains He remembers when he worked as a clinician and provider Often he would take a client s measurements in the rehab center and by the time the chair came in the client had already gone home and gained weight from lack of activity The chair no longer fit With this new system however adjustments can be made without purchasing a new
30. e to have a durable system that can withstand that type of force but also give those people opportunity to for example get their feet above their heart mobilitymgmt com Rotelli for example says electronics have helped clinicians fine tune a chair to meet a client s needs In fact today s electronics can even make a switch feel more like a proportional drive control using sensors and lightning switches with fiber optics Some of these switches do not require pressure and can be initiated simply by covering the switch Rotelli says You can now with today s electronics program that so much better that it feels like a proportional joystick which gives people more control of their environment Rotelli says Specialized programming can adjust acceleration top speed and response when moving to a different switch all individualized to the user And that old joystick has given way to many other options Ligi describes Switch It s version of the mini joystick which requires little pressure and flexion for activation and reduces throw It takes even less movement or really no movement and you can adjust how much pressure or force you need in order to operate Ligi says So you have clients that have limited range of motion or no range of motion and are just extremely weak they could not operate any kind of control before And that s opened up the doors to let them use that to start driving chairs again
31. e who are going to say Oh I ve got to lower my footplate a notch today That doesn t happen Tanguay recalls working with a fashionista consumer who had a C4 spinal cord injury Sitting in her heels in her power chair all the time she had a lot of contractures of her ankles because of the shoeware she loved and insisted on wearing Because she lost a lot of stability she got in the habit of riding in her power chair with one leg crossed over the other at the knee because this flexed her up a little more and helped to hold her back in the chair But it caused her to sit with an obliquity and scoliosis eventually developed Because of potential side effects like these Tanguay suggests it could be helpful to educate consumers about how footwear or swapping out seat cushions for that matter can alter lower extremity posi tioning But she acknowledges there s no easy fix for the overall issue Part of it is human nature When illness or injury has limited some one s personal mobility and drastically changed his or her life The last thing they want to hear is And by the way you can t wear your favorite shoes Tanguay admits And no This isn t just a female issue Tanguay remembers working with male clients who were in chairs and were still buying the brand new Nikes regardless of whether they were walking on the bottoms It s about showing the tops mobilitymgmt com tance It actu
32. eelchairs but work with clients with wheelchairs Lisa Rotelli Adaptive Switch Laboratories But before the industry can embrace this change there are a few bugs to work out Once I unplug something from my general system it means I m going to have to have battery power to make it work Rotelli says So that s something else I need to charge something else I need to think about Ligi also says there are issues with seamless integration and who either manufacturers or third party electronics companies will provide the wireless technology I think it could be double work For example if we do Bluetooth and they do Bluetooth is that going to be a redundancy Or is one going to be better than the other Ligi questions There s a lot of things that we re going to have to figure out how they re going to play PAS I 20 august 2013 Mobilitymanagement nightmare Well it does and it doesn t because funding is there for people to have telephone access And if I can access my iPhone or my Android phone then that is an avenue that I can get funding for somebody because it is a safety issue Once I have access to that then my whole world opens up so I can get back into life she says Rotelli says the key to getting people access is that the industry must explore other avenues such as this one We have to make sure that we take a look at the whole funding realm she
33. ependent one and not part of any partnership with The SCOOTER Store The Numotion leadership team came together and decided this was the right thing to do Wilson told Mobility Management We saw the need with the Alliance customers who are complex rehab customers and we wanted to be able to provide this service Numotion was formed earlier this year when national rehab providers ATG Rehab and United Seating amp Mobility merged That timing as well as ongoing transitional work as a result of the merger puts Numotion in the right place at the right time Wilson explained We have a number of initiatives that we re working on to improve our efficiency and our capacity he noted We are making process changes and investing in new technology which give us the capacity to take on additional customers Given its complex rehab focus Numotion is offering to service Alliance Seating amp Mobility chairs and accessories We re able to help any customer who has a piece of complex rehab technology who is finding it s not functioning in the way that it should Wilson said Alliance customers are invited to call Numotion s National Customer Care Center 800 500 9150 or their local branch office Numotion intake personnel will work with consumers to discuss what s wrong with the equipment as well as to determine Medicare information such as what equipment is on file with the agency Wilson noted that all Numotion n
34. es And some of those choices involve tweaking a client s positioning rather than opting for accessories Tf we have a consumer that could actually sit in a chair with a tighter knee angle Tanguay says I m thinking of a manual chair with an 85 front or an 80 front orientation where somebody sits with their feet kind of tucked underneath them a little bit more that person hopefully has a little bit more of that range I actually angle footplates quite often in those types of chairs so they can have a little more of that stretch and be oriented in a little more dorsi flexion There are some people who might say they really like that because that dorsi flexed angle of the footplate when they position their feet back on it it has a little bit more contact and there s a little bit more resis Moblitymanagement august 2013 23 lot of the time saying They re not the same Positioning Goals to Aim For But ultimately optimal positioning for feet and legs might not include picture perfect symmetry We re not always guaranteed that both of our ankles have the same range of motion or the same leg length Tanguay points out There s a lot of things that can contribute to having asymmetrical leg length maybe rotation of the pelvis a dislocated hip a surgical revision of the head of the femur You could have a history of lower extremity frac ture that can shorten seat depth as well Consumers want the
35. es change But the truth is everybody changes The modular system increases clinicians confidence in prescribing because they know they can add a component down the road Morgan explains In addition Critchfield says integrating these power components enables the product itself to accomplish more tasks without taking up as much space I do think there is more opportunity for integration as technology improves Critchfield says Modularity can even come to the rescue with funding For example think about that power seat elevator which is hard to get funded Tve had this situation happen where the consumer decides that the seat elevator was denied so they re going to go with a tilt and recline system Doherty explains But then they find out a few months down the road that they have other funding for it but they weren t aware of it at the time Now they can get their seat elevator funded To retrofit it would be difficult That is it wouldve been difficult before the modular systems Adjusting the World Sure the new modular systems can adjust to changing needs for power positioning but the adjustability of the system covers much more than that For example the articulating foot platform on the TRU Balance 3 can be dialed into an individual s needs to properly support the legs and Mobilitymanagement august 2013 1 5 asking for the latest components They re also asking for components that don t
36. f tilt By setting the tilt to move into position automatically clinicians can be sure the client is getting the proper pressure relief Also when clinicians can set the system to remember angles it allows them to prescribe technologies to clients that might not otherwise get them For example Morgan says sometimes posi tioning components move out of place during recline but with Permobil s Intelligent Control System the clinician can simply limit the angles of certain functions to prevent the client from reclining past a certain point I have the ability to stop that where it is and also reevaluate it change it and improve it give them more in the future if that s indi cated Morgan says So you have a lot of programmability options within the seating systems themselves to make them work for people Improving Access What s more tomorrow s power positioning systems will likely be available to more people and help them do more in their environments Already the addition of a 430 10 weight capacity to power positioning systems is bringing power positioning to a whole new set of clients Previously power seat functions have been significantly limited for those larger individuals just because of the stress they put on the power Morgan says The Corpus HD has given people that are larger the ability to have full range of tilt recline leg elevation and even seat elevation That s pretty impressive to be abl
37. hat sort of thing so our body will try to pull in different directions to keep our head the way it needs to be So with the windswept position it usually means their spine is rotated also to allow their head to get into that visual plane Sometimes we re not trying to get the pelvis in a neutral position because the majority of those windswept positions are fixed types of positions where they have muscle shortenings they re really tight So what we ll do is give them the proper head position and to help support them and let the legs fall where they need to go to give us that and support the rest of the body Meanwhile Tanguay says the more time a consumer is in a seated position such as in a wheelchair there s a higher prevalence of them having shortened calf muscles A lot of our consumers end up losing some of the dorsi flexion of their ankle meaning that they re toe up and heel down When the calf muscles get tight that type of range of motion we see a lot of consumers who lose that very rapidly It gets tight and they have to do stretches Lower Extremity Interventions There are many ways to intervene when optimal lower extremity positioning isn t easily achievable In the past solutions have included essentially strapping feet to their footrests an intervention that could result Reidmiller says in consumers looking like Frankenstein But today s clinicians and ATPs have a wider array of choic
38. he future of wheeled mobility and home medical equipment While Miller s sells respiratory and DME it s best known in this 8 august 2013 Mobilitymanagement CONNECT with us on the NEW www SunriseMedical com Check out our new website designed Ottobock to ae to save you valuable a Distribute time when selecting ordering and BodiTrak geor Sunrise Medical for Vista i Medical New Sunrise Medical website Ottobock has signed an exclusive agree ment to distribute PatienTech Vista Medical s BodiTrak system in North America according to an announcement from Ottobock The announcement described the BodiTrak Smart Fabric system as a completely new approach to interface pressure mapping and data collection and noted the system uses advanced electronic sensors with built in smart USB elec h Compare up to three Online quote order entry tronics and the world s only three dimensional products side by side and product configurator stretchable breathable pressure sensing material This proprietary material means an interface pres sure mapping reading that closely represents what is actually happening at a load bearing surface in order to promote tissue protection and to help avoid the trauma of a pressure ulcer Andrew Frank VP of sales and marketing for PatienTech Vista Medical added that the BodiTrak system includes simplified electronics that
39. ired which will guido you E roca of eating your mey HO aie i I d Alor soting up your deco a corbis el be able to reconfigured device in case any of the setings ant not monouting as eapocted Sensitivity the chara con be independently bo cbant spora lena O Bluetooth Sas 9 Windows Eg Windows 8 1 800 965 9229 oe htto www stealthproducts com idrive permobil THE POWER OF MOBILITY The C500 Corpus 3G is designed for the collage of life busy streets meetings lunches entertainment and nightlife With its independent suspension the powerful 500 provides a smooth ride over a variety of terrains from sidewalks to grassy parks while the Corpus 36 seating system offers the ultimate in comfort for your exciting lifestyle am Permobil com
40. l accessories also available Easy to install with website video support Affordable price MSRP from 260 Dealers Wanted Advisory Board Orooor Skylink Group Please visit Toll Free Email sales skylinkhome com Joe McKnight Amy Morgan Julie Piriano Lauren Rosen Jean Sayre Mark Smith Stephanie Tanguay Cody Verrett Mobilitymenagement august 2013 29 advertisers index Company Name Page Company Name Page a 32 8 20 Adaptive Switch Laboratories reris 7 Pride Mobility Products Quantum Rehab 5 2 05 5 Freedom 29 Seeders 3 SKYLINK Groups 0 0 Invacare 31 ssn en 11 StealthiProducts csis cassis da 11 1 9 06 sesane 2 Sunrise 0 0 0066 pediatric mobility marketplace Company Name Page Company Name Page aces 27 Sunrise Medical 28 see eee deren GONVAIG aie 28 su 27 Innovation In Motion ennaii 7 cscs gasses 28 Invacare CORD 28 scissor 601 6 27
41. l s independence without the need for home modifications Critchfield says Morgan sees people having more access to independent living through improvements in components such as seat to floor height and transferring In the past we ve thought of power seat functions primarily for pressure relief Morgan says But now I think we re opening our eyes more to how power positioning can really improve someone s func tion and their activities and their participation in different things In the end manufacturers might not have the most power over what changes will come We take a lot of feedback from the physicians clinicians rehab technology providers and the end users Doherty explains We take that feedback and are constantly looking at what we can we do better based on the feedback they give us Is there something they are asking for that we can meet a need I don t necessarily know where it s going but it s always changing based on the feedback Mobilitymanagement august 2013 1 7 Motion Concepts new communication device mount is the result of client feedback Quantum Rehab s TRU Balance 3 system was launched last month and features a modular power positioning system that adds or subtracts functions as the client s needs change pressure relief when they re really not she says Sometimes tilting 20 or 30 feels like a lot but really pressure relief comes more at 45 or more degrees o
42. ld As my son gets older he wants to hang out with his friends How do we teach them to help with his care so he can spend time with them Answers Kids naturally like helping and will be inclined to help their friends If your child is polite and a good friend other kids will jump in to help because they ll want to be around him The earlier that kids get comfortable with others doing some caregiving the earlier they can start directing their own care ext from a foster parent How do find good mentors for my son who has SMA he panelists There s a new Facebook group just for people with neuromuscular condi tions Contact your local FSMA chapter and ask if an adult member would like to be a mentor Ask yourself How would find a mentor for him if he didn t have SMA As the discussion continues that theme becomes more prevalent One panelist suggests parents ask themselves Would treat my kid without a disability the same way Another panelist explains to parents why kids with SMA need to learn to take charge of their medical decisions Because they may outlive you The panelists proved that SMA isn t the top priority in every conversation they have Nor does every SMA diagnosis have a foregone conclusion This isn t the journey that parents expected but there can be hope and happy moments despite the detour For that lesson I m grateful Kawi letavel gt Laurie
43. ly helps Mie to learn to perform it But a new study from the University of Southern California USC has found that merely watching someone else perform a difficult task can help patients who ve had a stroke In a June 11 news announcement USC researchers said they d moni tored the brains of 24 people half of whom had a stroke and half of whom had not but were the same age as the stroke patients Both groups watched other people perform activities using their hands and arms such as lifting pencils and flipping cards These activi ties researchers said would have been difficult for the stroke patients to perform because they d lost function in their hands and arms Researchers then checked to see how participants brains responded to the activities they were watching The brains of the people who had not had strokes responded normally Researchers reported activity in cortical motor regions that are generally activated when we watch others perform actions 26 august 2013 Mobllitymanagement pediatric mobility marketplace Matrx PS Cushion An exceptionally lightweight cushion the Matrx PS is designed to provide superior position ing stability and comfort for active users The anatomically contoured shape has a waffled ischial relief recess and a reversible outer cover use either the smooth or the fabric side out The inner cover is moisture resistant and easily wiped clean The Matrx PS is available in
44. n of features such as the system s ability to answer phones and func a personal computer in addition to being a wheelchair Now that level of integration is definitely a possibility for tomorrow s ion as power chair mobilitymgmt com Tomorrow s Power Chairs emPOWERed We feel like it s not just a black and white type of world Chris Ligi Switch It regarding switch vs proportional driving controls Electronics a recent industry consumer show a Permobil display showed Ale a museum of electronic drive controls Among the technol ogies on display were head arrays a cup navigator touch switches and a mini joystick with a finger cup control that require less throw and pressure When you see all of these technologies laid out before you it really shows how hard the industry is working to improve driveability for today s power consumers Permobil s Amy Morgan PT ATP national clinical education manager agrees that we ve come a long way in only a short time The past three to four years is when everybody upped their game in the electronics field and everyone updated their electronics even further she says Today s Exciting Electronics One thing the electronics industry understands is that there is always room for improvement So when Mobility Management ques tioned electronics experts Lisa Rotelli director of Adaptive Switch Laboratories and Chris Ligi director of global sales at Switch I
45. n the foot platform or footplate Do they tuck their feet back and drop their heel off the back side of it While shoes might seem a minor point in the midst of other conver sations on clinical efficacy and funding challenges Tanguay points out that the problems caused by differing sole and heel thicknesses can be significant A couple of years ago we had a resurgence of platform shoes she 24 august 2013 Mobilitymanagement clinically speaking By Angie Kiger Sunrise Medical Look Whos Driving Now Activity Ideas for Power Mobility Evals easy to implement in a time when music is digital and portable The concept of this strategy is simple When the client is moving in the wheelchair play the music but the moment the chair stops turn the music off Eventually the client will learn that if he keeps driving he will get to enjoy his favorite tunes Go Get It Take the client s favorite toy or item and place it a few feet in front of the client n his line of vision Inform the client that if he drives over to where the item s he can play with it for an established mount of time As time goes on your goal will be to increase the amp Angie Kiger M Ed CTRS ATP is a clinical education specialist at Sunrise Medical aw w istance that the client must drive to get the item and decrease he length of time he is allotted to play engage in the activity Red Light G
46. ndicates the legs are way out of proportion also Tanguay cites clients with knees being up higher than their pelvis and being unsupported or unweighted We tend to see somebody who has their femurs offloaded Their legs tend to swing in the breeze a little bit left and right Consumers themselves tend to speak up when legs and feet aren t positioned symmetri cally Tanguay adds I hear them mention symmetry I hear consumers and their caregivers a 22 august 2013 Mobilitymanagement mobilitymgmt com get them positioned back a little bit more or maybe have a cushion that has a slightly higher contour on the front corners on the edges of the product That s when we tend to use something that has an adductor it would help keep the legs a little bit better in alignment and hopefully keep them from touching the hangers Range of Motion amp Other Restrictions Loss of range of motion and similar mobility restrictions can be another lower extremity positioning challenge For instance windswept positions Reidmiller says can be difficult to accommodate They have fixed leg angles he says but consumers with windswept positioning may have other issues as well Tf you hold your head to the side long enough your body is going to try to correct itself he explains So when you have a spinal rota tion your body is trying to correct itself over time We all want our visual plane horizontal and t
47. ng needs you wonder how we ever got by without it Permobil launched its modular system the Corpus 3G and Corpus HD the version with a 450 Ib weight capacity more than a year ago Amy Morgan PT ATP Permobil s national clinical education manager says that what makes this system especially cutting edge is its low seat to floor height which is the same with or without power functions In the future the industry will see much more of these systems mobilitymgmt com be the wave of the future The adjustability and the ability to give the consumer the ability to independently change their position will continue to be present but the way the end user can change positions will continue to be explored he says Morgan agrees She says tomorrow s power positioning systems must have adjustability plus memory Morgan describes this function as taking the guessing game out of it for the client Already Permobil s Independent Repositioning Mode enables the rehab team to set an ideal position for the client s pressure relief or other clinical goal The chair automatically moves into the correct position This function is especially important when using tilt and recline Morgan explains as there s a specific sequence tilt and then recline to prevent shearing and other negative outcomes Sometimes it s hard for even the clinician to remember that sequence much less the user themselves Morgan sa
48. ngs and they will work harder at getting that sensory feedback But dynamic components Peek has created telescoping vari eties as well as those with dynamic plantar dorsi and angle adjustable features can help to de escalate those incidents of extensor tone instead of revving them up By absorbing the energy unless it reaches end of travel we re never going to see the load to the component or the wheelchair that we would if the component was not there he says It s absorbed the energy and the travel hopefully successfully but at least to some degree Doing the Most with the Least While perhaps not getting the same amount of attention in seating discussions as the pelvis properly positioned lower extremities can greatly enhance the mobility experience for consumers And greater understanding of the hows and whys of seating give clinicians and ATPs the opportunity to achieve positioning success while possibly using fewer static accessories We all want to live we all want to move Reidmiller says That s what our bodies are intended to So allow them to move but finda compromise says Thankfully it was rather short lived What happens to somebody who gets a thick shoe like that and goes into their kitchen or lunchroom or desk and pulls up to it and doesn t realize their knee is now 1 5 or 2 higher than it was They ram their knee into the table or the desk don t know a lot of peopl
49. nter mount adjustable legrests Permobil 800 736 5 permobil com EZ Rider The newly enhanced EZ Rider is available with Cordura upholstery and a one piece push handle that easily adjusts to the height of the caregiver The new Self Tensio a self tensioning seating system designed to increase seating tol erance comes standard with EZ Rider Available in sizes 10 12 14 16 and 18 EZ Rider with transit is custom built for each user Five years of growth are built into this lightweight compact folding chair Convaid 888 CONVAID convaid com Natural Fit LT amp Surge LT Handrims Helping a child to establish good propulsion techniques right from the start is important for efficiency and the future health of their arms and shoulders The Natural Fit LT is an ergo nomic handrim while the Surge LT is a light weight all in one oval handrim with Gription strip to provide traction on every push Both are available in smaller sizes to fit littler hands Out Front 480 833 1829 out front com mobilitymgmt com pediatric mobility marketplace Pediatric Seating Therafin s pediatric seating amp positioning components range from crash tested WC20 offerings pictured to tray options early inter vention small anterior supports ProFit Adjust headrests communication device mounts and FlexSure Feet Approved HCPCS codes include E2609 E2617 E09
50. nts for complex rehab conjure images of tilt recline seat elevation and standing as well as several out of this world proportional and switch driving controls including the tablet and head array systems These high tech improvements have made a marked difference on quality of life accessibility and independence for many people with complex rehab needs So what exactly are the industry s tech gurus dreaming up next Power Seating amp Positioning A Culture of Demand The laws of supply and demand sometimes lead to great improve ments for products and such is the case for power positioning No longer are power positioning components an afterthought says Brad Peterson VP of sales and education at Invacare Corp s Motion Concepts Power chairs out there from all the manufacturers are better designed to accept power positioning systems he says Now your power chairs are being made with power positioning in mind So it allows us to do a lot more as far as seat to floor heights and a more integrated functional system Because power positioning is top of mind clients and clinicians are mobilitymgmt com ithout question power positioning has greatly improved the lives of people who use complex rehab equipment For individuals with disabilities with complex medical needs a lot of these power positioning devices they re not a luxury item says Jay Doherty OTR ATP SMS clinical education manager for Qua
51. ntum Rehab They have functions that are critical to living safely and inde pendently in the home and community But the technology is more than just a medical necessity It s a confidence booster It gives users more control It helps people access their environment With outcomes like these it s no wonder consumers and clinicians are demanding more and it s a demand the industry welcomes 1 4 august 2013 Mobilitymanagement In the past we ve thought of power seat functions primarily for pressure relief But now think we re opening our eyes more to how power positioning can really improve someone s function and their activities and their participation in different things Amy Morgan Permobil Peterson predicts We think what we re seeing in the future is more modular systems he says We re seeing systems that more easily grow and adapt to the patient s changing needs Evidence of Peterson s prediction rings true with Quantum Rehab s release of the TRU Balance 3 modular seating system last month The company also plans to release a version with a 430 10 weight capacity in September The ability to add and remove power components is a revolu tionary way of building complex rehab chairs We already know that people with progressive conditions such as amyotrophic lateral scle rosis ALS and growing children can benefit from the ability to make adjustments as conditions sizes and shap
52. of Poor Positioning Asked the goal of proper lower extremity positioning Chris Reidmiller ATP national sales manager of Therafin Corp says A natural pelvic position Everything is a stepping stone everything has its place One spot out of position can cause the rest of everything to be out of position If the lower extremities are out of whack they can pull the pelvis out of whack which in turn can pull the spine head position and so on Stephanie Tanguay OT ATP clinical education specialist at Motion Concepts agrees As long as our legs are attached to our pelvis there is absolutely going to be an effect of not properly positioning the lower extremities she says Keeping our feet and legs in orientation in the proper alignment 1 1 will help with stabilizing and maintaining seated posture What then does poor lower extremity positioning look like What are some visual cues that indicate there might be a problem Lalways think of one where the knees are up in the air essen tially Reidmiller says The lower extremities aren t posi tioned properly or aren t at the right length Or they could have a poor angle of the lower extremities which is causing the pelvis to tilt which is going to ultimately result in their Wey head leaning forward maybe more of a C curve of their i lle spine allowing their head to lean forward You usually see that because the pelvis is being pulled out which i
53. ols 5 and All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted 13 354 130506 Yes you can august volume contents 14 cover feature em Powered As funding sources and consumers demand more from their complex rehab power chairs the industry answers with new features new adaptability and new possibilities Getting Under Foot 22 Identifying lower extremity positioning challenges and solutions can give wheelchair 29 Classifieds Ad Index 3 0 Product Revue Tobii ATI s system is much more than the next generation of augmentative users the best mobility experiences possible 6 Editor s Note OO MMBeat Marketplace Pediatric Mobility 26 New Discoveries communications device What s New Online MobilityMgmt com stories involving all modes of personal mobility accessibility freedom and independence See what topics have your clients cheering ranting and raving 24 7 and join in the conversation yourself Corporate Headquarters 1105 Media 9201 Oakdale Ave Ste 101 Chatsworth CA 91311 www 1105media com Media Kits Direct your Media Kit requests to Lynda Brown 972 687 6781 phone 972 687 6769 fax lbrown 1105media com Reprints For single article reprints in minimum quantities of 250 500 e prints plaques and posters contact PARS International Phone 212 221 9595 E mail 1105reprints parsintl com www magreprints c
54. om QuickQuote asp This publication s subscriber list as well as other lists from 1105 Media Inc is available for rental For more information please contact our list manager Merit Direct Phone 914 368 1000 E mail 1105media meritdirect com Web www meritdirect com 1105 mobilitymgmt com Be part of ever expanding social media conversations on MobilityMgmt com and facebook com themobilityproject Tune in to keep up with industry and consumer caregiver discussions of breaking news events and human interest Mobility Management ISSN 1558 6731 is published monthly by 1105 Media Inc 9201 Oakdale Avenue Ste 101 Chatsworth CA 91311 Periodicals postage paid at Chatsworth CA 91311 9998 and at additional mailing offices Complimentary subscriptions are sent to qualifying subscribers Annual subscription rates payable in U S funds for non qualified subscribers are U S 119 00 International 189 00 Subscription inquiries back issue requests and address changes Mail to Mobility Management P 0 Box 2166 Skokie IL 60076 7866 email MOBmaqg 1105service com or call 847 763 9688 POSTMASTER Send address changes to Mobility Management P 0 Box 2166 Skokie IL 60076 7866 Canada Publications Mail Agreement No 40612608 Return Undeliverable Canadian Addresses to Circulation Dept or XPO Returns P O Box 201 Richmond Hill ON L4B 45 Canada Copyright 2013 by 1105 Media Inc All rights reserved Printed in the U S A Re
55. orizon you d think our power pros would have their creativity tapped Unfortunately funding is making our industry think outside more than just one box and their creativity is making these advances possible for all clients not just the ones capable of paying out of pocket Rotelli cites access to iPhone and Android technologies as one example A lot of times people say Well this becomes a huge funding Take 2 momentto FIXED Just go online to com ep Use Priority Code MHR Mobility Management is the industry magazine focused specifically on the mobility and rehab technology segment on the HME market Let MM be your source for DME information that ec your plea Moblitymanagement august 2013 21 mobilitymgmt com ATP Series How Lower Extremity Positioning Can Impact More Than Just Legs amp Feet By Laurie Watanabe discussions of seating amp mobility there is no shortage of talk about the N pelvis the head Proper position optimizes field of vision and oppor tunities for socializing and the upper extremities We re aiming for efficient self propulsion or ease of reaching driving controls In all the conversations of clinical efficacies and medical justifications lower extremity positioning may get short changed But there are multiple reasons to get feet and legs properly positioned and a number of obstacles that can keep it from happening Visual Signs
56. productions in whole or part prohibited except by written permission Mail requests to Permissions Editor c o Mobility Management 14901 Quorum Dr Ste 425 Dallas TX 75254 The information in this magazine has not undergone any formal testing by 1105 Media Inc and is distributed without any warranty expressed or implied Implementation or use of any information contained herein is the reader s sole responsibility While the information has been reviewed for accuracy there is no guarantee that the same or similar results may be achieved in all environments Technical inaccuracies may result from printing errors and or new developments in the industry On the Cover The correct combination of power mobility posi tioning and electronics can empower consumers to new heights Cover by Dudley Wakamatsu Cover concept by Elisha Bury 4 august 2013 Mobillitymanagement ViZUBALANCE OWER POSITIONING SYSTEMS ONLY US 866 800 2002 Canada 888 570 1113 quantumrehab com herapist_ Approved iu Quick adjustments throughout entire system allowing for multiple client seating evaluations H Quickly make fine adjustments while client is in chair via Loosen amp Slide Technology center of gravity seat depth leg length accessory adjustment H Internally or externally rotate articulating cantilever armrests QUA TUM 4 Sleek and innovative look and design W Tool kit included for quick adj
57. reen Light Some clients find it difficult to stop once they get moving while others have difficulty moving once they have stopped The classic game Red Light Green Light is a fantastic activity to teach stop and go Involve the client s friends or siblings if it is appropriate Scavenger Hunts Through the use of clues and prizes you can create a fun activity that requires the client to drive to specific locations and include a variety of skills in the adventure Obstacle Course As the client advances with his skills create an obstacle course through which the client has to complete fun activities while timing the event Push the client to see if he can improve his time each training session Create a Game Tape If the client and caregiver agree video tape portions of the very first session a few in between and the final session Just as a professional football team would do review the tapes with the client and caregivers to identify strengths and areas that need to be improved Because of the objective limitations that arise during a power mobility evaluation it is critically important to tailor device suggestions based on a client s potential abilities instead of present abilities Use of the above strategies in making your professional recommendations can be the key to seeing your client drive on to success in their power mobility device Mobilitymanagement august 2013 25 ecommending the best power mobility sys
58. s A Step in the Right Direction Ligi says advancements in electronics are really made in one of two ways baby steps or giant leaps He describes the process of fine tuning the programming as baby steps It s always been good and it s definitely a step in the right direc tion But it s expected it s a natural evolvement he says The giant leaps on the other hand don t happen often Ligi says but when they do it s like Oh wow this is not just one more program ming parameter this is a whole new way of driving A lot of times Ligi says those steps are made by integrating some thing familiar from another industry into the mobility system such as a PlayStation control that someone already knows how to use or Switch It s new capacitive touchscreen that mimics the way people use a cell phone or iPad Ligi says he knows he s onto something good when he see a light bulb go on for a clinician as it did for a provider whose client had an old RIM control joystick on the headrest that was breaking down He s sitting there thinking should he repair that or should he get anew one or should he get something else and the client was just going to town on their iPad just surfing the Internet with their knuckle And it really didn t exist a tablet type control Ligi says mobilitymgmt com out and what s going to be the most seamless Morgan also says that even though clients ask for the abili
59. says Vocational rehab pays a lot for computer access because that s a vocational opportunity for somebody So we re going to have to get more creative as time goes on The bottom line is technology will have to keep up with today s changing client Our age groups are a lot more computer savvy and that s really going to change how we not only view people with wheelchairs but work with clients with wheelchairs because we can all have the same access Rotelli says And that s what the goal is Elisha Bury is a freelance writer and editor who has worked in the mobility sector since 2005 She previously served as the editor of The Mobility Project and associate editor of Mobility Management E F1E W your FREE subscription to be able to move their arm forward or backward They can only move it laterally Ligi says So you may just start with switches on a tray and let them go left and right for all their directions But once the client settles into a daily routine as long as he or she has the capability to move the hand or arm forward and back ward Ligi says the clinician can convert the switch to a proportional control By reprogramming the same device or enabling a provider to hit a provider accessible panel the device could become proportional without needing a new device or more importantly new funding Ligi explains Obstacles Ahead With all of these advances on the h
60. son with SMA to the booth and was inquiring about his son s potential ability to use Tobii devices By the time that conversation was done the kid was using a design program to paint a picture on one of the devices Take a look for yourself at tobii com Laurie Watanabe Tobii ATI s eye gaze systems enable consumers to communicate with loved ones near and far But no it can t drive a power wheelchair A June s Families of Spinal Muscular Atrophy FSMA event one of the more popular exhibit hall booths belonged to Tobii ATI a company specializing in eye gaze communications technology With their sleek good looks almost indiscernible from a laptop or large tablet Tobii products are clearly not yesterday s eye gaze systems By comparison Tobii s Series is remarkably self contained free of mazes of cables and blessed with a nine hour battery life so it doesn t need to be frequently tethered to a power cord either Series products stand on their own via a picture frame like wedge design but they can also be mounted in other positions if necessary The Social Network The bar is much higher today than it was for augmentative communications systems in the past so Tobii s products enable consumers to stay in touch with family and friends not just verbally and face to face but also via e mail texting phone calls and Skype Users can also access the Internet Tobii systems even have cameras
61. spective But in working to create more durable positioning components Peek also has tapped into the cause of at least some tone incidents A Mile in Their Shoes Marilyn Monroe famously said Give a girl the right shoes and she can conquer the world For wheelchair users it s certainly true that different pairs of shoes can significantly change their lower extremity positioning Stephanie Tanguay OTR ATP clinical education specialist for Motion Concepts has seen first hand how differences in sole thicknesses and heel heights can impact a seating system s effectiveness Your sandals vs your dress shoes vs a pump Every time you change your shoe and that thickness changes it s going to change the orientation of your foot platform or foot support she says While the wheelchair s seat to footplate length remains the same shoes can alter the lengths of the client s legs With women you can change 1 5 to 2 easily by changing your foot wear Tanguay says So we can have more weight bearing on the thigh and less contact of the heel If you go to a shoe that s thicker or has a heel now we ve got that change in orientation Your knee is up higher than your pelvis You ve offloaded a little bit underneath your thighs ATPs and clinicians may notice that consumers position their feet differently depending on the shoes they re wearing Tanguay adds If somebody wears heels what happens Is the heel o
62. t the word that kept popping up was fine tuning Is Eye Gaze Coming to Near You ye gaze is nearly an urban legend in the industry we ve been hearing about it for years but no one s quite sure if it s powering wheelchairs as of yet According to Amy Morgan PT ATP at Permobil the simple answer is no A company out of Norway has developed an eye gaze driving is essentially a single switch 0 choose direction Users simply focus on the direction they want to go next and then depress a switch when they re ready to go that way In an indoor situation when someone doesn t have glasses it works pretty well wear glasses So when tried to use it it kept messing up because it wasn t able to see my eyes because of my glasses That was a problem for me Morgan says control Morgan explains that the contro scanner that uses the person s eye gaze That same issue arises in outdoor lighting especially bright sunlight and any other situation that might prevent the system from seeing a person s eye gaze Fortunately the driving control has a backup plan In those situa tions the system reverts to a single switch scanner 1 8 august 2013 Mobilitymanagement Photos by Laurie Watanabe Permobil s 2013 Power Trip display features an array of electronic drive controls including a mini joystick head array and finger cup control joystick When he saw our Touch Drive he thought
63. t parts for yes If not we do see if we can point them in a different direction Numotion has announced it s willing to help Alliance customers if they re looking for a place to turn Merger Creates Greater Service Capacities Michael Wilson director of national repair for Numotion says the John P Miller Takes Over as Miller s President sector for its complex rehab technology expertise and engineering Johnny Miller current president of the Ohio Association of Medical Equipment Services is an active member of Three Trackers of Ohio a non profit organization focused on adaptive sports Miller is a certified bi ski teacher Tm extremely proud of the organization built up over the past 64 years and I m excited about our opportunities in the years to come Miller said Miller s has an outstanding group of committed staff members united in our goal of Advancing Care Enhancing Mobility for the clients we serve mobilitymgmt com Miller s has announced its newest president John P Miller whose father John J Miller served as president for 30 years The provider with four locations in Ohio is now in its third genera tion of leadership The business was founded in 1949 by John F Miller the new president s grandfather John P Johnny Miller most recently served as the company s executive VP and a news announcement said he would oversee all company operations and lead Miller s into t
64. te benefit category for complex rehab tech nology will lead to more funding for power seat elevation One of the problems we face right now is that durable medical equipment and complex rehab technology are still lumped into the same category in Medicare which really makes it difficult for coding coverage and payment policies to be written in a manner that accu rately meets the needs of the smaller groups within the larger group he says And the complex rehab technology really has its own niche It 1 6 august 2013 Mobilitymanagement Permobil s Corpus 3G provides a unique modular power positioning system with a low seat to floor height The Corpus 3G also has a function in which the footplates lower to the floor completely and then the seat elevator raises the seat so that someone can independently do a sit to stand transfer out of the chair kind of like a lift chair might do Morgan says In fact access to the environment is the next big thing for power positioning I believe that for the most part manufacturers have addressed mobility and positioning Now we need to focus on increased acces sibility and independence to improve the whole life experience Critchfield says He says the industry is moving in that direction For example the ability to reach high cabinets with a 12 seat elevator while maintaining a seat height of 16 makes an incredible impact on an individua
65. tem for a specific Roo needs typically involves navigating through count less equipment options A proper evaluation is crucial because obtaining funding for new devices often takes a substantial amount of time An improper yes or no recommendation for specific devices during a one or two hour evaluation can lead to lasting consequences Further difficulties arise in the evaluation process due to financial and space constraints It is virtually impos sible to have all of the options at one s fingertips during an evalu ation and technology is ever changing Moreover like everyone clients have good and bad days so if caught on a bad day the client may not exhibit all of their potential during the evaluation Out of the desire to best serve the clients worked with and see better outcomes from power mobility evaluations and recommendations established a powered mobility driver s education program This program includes not only an evalu ation but also protocols for what to do when a client exhibits potential for learning specific powered mobility options Training sessions provide the best framework for determining the potential for powered mobility These sessions provide clients the opportunity to trial more equipment and develop skills while a treatment team is able to dial in the ideal power mobility system have led training sessions that have resulted in a virtual standoff with clients who refuse to activate the inp
66. tom pad by Velcro This is a big advantage over the other footboxes that are fixed at 90 We have been using these for several years and they hold up very well even in institutional settings Dave Stoddard ATP United Disabilities Services Lancaster Pa Comfort Company 800 564 9248 comfortcompany com Custom Back Insert Now specify exactly where you want those ROHO air cell inserts thanks to a new custom back insert offer ing from Freedom Designs A new partnership between the two seating companies gives ATPs and clini cians the ability to order on a single purchase order a pre assembled and fitted product Via the order form indicate exactly which air cells you want and get an insert custom ized for your client s needs Freedom Designs 800 331 8551 freedomdesigns com Kimba Neo The newly upgraded Kimba Neo features adjustable rear suspension tension settings for a smooth stable ride to suit individual needs The folding mechanism has been improved to facilitate easy transportation and storage The tilt system is built to be easy to access and larger rear wheels help to maneuver confidently over rougher ter rain The frame is available in silver or black Ottobock 800 328 4058 ottobockusmobility com mobilitymgmt com product revue Umbrella Cane When rain is in the forecast the new Umbrella Cane can do double duty The umbrella contains a hidden cane that c
67. ty to use their phones and computers through their chairs all the time the quickly advancing technology has inhibited the integration into the chair The problem is phone technology is changing so rapidly As soon as you get it set for one type of system it s going to be obsolete for the next system she says The Future Is Not Black and White Ligi predicts that the future will soon bring drive controls that are not all proportional and not all switch One of the other things we re trying to do is even though our name is Switch It we re really trying to move more toward propor tional devices he says In the past it s been kind of like okay you can drive with a joystick kind ofa staple around here but you can drive proportional with a joystick or you can drive switch through a head array And we feel like it s not just a black and white type of world Ligi says Switch It is looking at more hybrid devices that combine the best of both worlds and can adjust with the client s needs In some cases a kid for example they may just go into extension the first time they drive because they re so excited and they may not Adaptive Switch Laboratories Inc www asl inc com ASL Power Tiger OS Head Arr mobilitymgmt com 1 800 626 8698 Tomorrow s Power Chairs emPOWERed Our age groups are a lot more computer savvy and that s really going to change how we not only view people with wh
68. umotion com locations are offering to help out Alliance customers Our locations have the size and capacity to handle additional influx he said In addition we have neighboring locations that can assist on a case by case basis Numotion hasa timely message for former clients of Alliance Seating amp Mobility We ll service your complex rehab seating amp mobility equipment The offer comes at a time when Alliance Seating amp Mobility s parent company The SCOOTER Store is undergoing a business revi talization according to its Web site and has limited ability to service the power mobility products it s sold Bankruptcy Filing The SCOOTER Store based in New Braunfels Texas filed for bankruptcy in April At press time its Web site homepage said the company was open for business and serving customer needs But another page warned that The SCOOTER Store s ability to service Medicare purchased equipment may be limited while we restructure our business As for consumers who paid cash the site says Our ability to service that equipment will be extremely limited A customer representative answering The SCOOTER Store s phone prior to press time was asked if the company was currently able to service purchases from Alliance Seating amp Mobility its rehab division We do some of them it depends what the issue could be she said If it s something fairly simple that we can ge
69. ustments on the fly ALS Association Fighting Lou Gehrig s Disease Muscular Association Fighting Muscle Disease 2013 SPONSOR Watch us on You Tube youtube com QuantumRehab Like us on facebook facebook com QuantumRehab QUANTUM REHAB mobility management mobilitymgmt com Volume 12 No 8 AUGUST 2013 Laurie Watanabe 949 265 1573 Cindy Horbrook 972 687 6573 Karen Cavallo 760 610 0800 Dudley Wakamatsu David Seymour Jenny Hernandez Asandas Charles Johnson Marlin Mowatt Caroline Stover 323 605 4398 Editor Associate Editor Group Publisher Group Art Director Director Print amp Online Production Director Print Production Production Coordinator Director of Online Product Development National Sales Manager SECURITY SAFETY amp HEALTH GROUP Kevin O Grady Karen Cavallo President amp Group Publisher Group Publisher Group Circulation Director Margaret Perry Group Marketing Manager Susan May wiv 1105 MEDIAS President amp Neal Vitale Chief Executive Officer Senior Vice President amp Richard Vitale Michael J Valenti Christopher M Coates Erik A Lindgren David F Myers Jeffrey S Klein Chief Financial Officer Executive Vice President Vice President Finance amp Administration Vice President Information Technology amp Application Development Vice President Event Operations Chairman of the Board
70. ut device to move the chair because refusing was the only bit of control they had And have worked with clients who refuse to stop or follow directions once they get the wheelchair moving Situations such as those can be frustrating for clinicians and caregivers because we know that the client has the potential to become independent in mobility if he would simply follow instructions and fully engage in training Through significant time and trial developed a set of strate gies to increase the rate of success for clients who demonstrate the potential for powered mobility What Makes Your Client Tick The client and or caregiver interview portion of the evaluation process is the perfect time to gather essential information such as what motivates the client and more importantly what the client does not like Knowing what the client does not like can help you establish purposeful movements and skills For example if you put three of the client s favorite toys or activities directly in front of him and ask him to drive to the activity he wants no matter where he goes it is a win But if you establish contrast in the options using only one option that he likes and others he does not like then there is a motivating force to see if the client will drive toward a desired option Rolling with Tunes Music can be a tremendous motivator and one that is relatively mobilitymgmt com outcome measures experimental technologies
71. yet exist which drives the growth of the technology For example Peterson notes that Motion Concepts latest develop ment a mount for communication devices such as a tablet or PC came by way of demand The mount enables someone to move the communication or electronic device farther away or closer and it flips down to improve the visual field for driving The device also swings away for caregiver access transferring or transportation If Apple s success is any indication clients won t be satisfied with the same old designs either and manufacturers such as Motion Concepts are taking note They want to be seen for who they are not for the chair that they re driving So we want to make sure the chairs are aesthetically pleasing and that they re highly functional Peterson says We don t want to sacrifice function for form but we need to make sure that we design our systems with a critical eye to how they look and how they function Dan Critchfield product manager for power Sunrise Medical agrees As we bring in more industrial design combined with more appealing aesthetics we may see a higher level of use he says A Word About Modularity But let s go back to that integrated functional system that Peterson mentions Cue the modular system It s one of those advancements that when you think about what it does enabling clinicians and providers to add and remove components to meet a client s changi
72. ys In addition recent studies have shown that people aren t tilting as far as needed for proper pressure relief according to Morgan Clients think that by tilting just a little bit that they re getting good really meets a need of a specific part of the population In the meantime Doherty encourages clinicians to continue prescribing power seat elevation In fact he says clinicians have an obligation to do so and to tell clients how they will benefit from the technology Without the continual recommendation of that type of system we can t document the benefit of the device itself he says The National Registry of Rehabilitation Technology Suppliers NRRTS and the University of Pittsburgh are currently working on a study that Doherty says is showing that many individuals cannot reach surface heights and carry out daily tasks using their current mobility devices without seat elevation He hopes this type of evidence will fuel the fight for coverage Meanwhile the industry laments the lack of funding that ultimately dampens the development and implementation of new technologies not only for seat elevation but also across the board There are still many many many things that we can do Peterson says We can give people access to different parts of their environ ment but also give them the ability to use their chair to do more But it all comes down to funding For Dan Critchfield at Sunrise Medical th

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