Invacare PATRIOT Manuel De L'utilisateur Et D'entretien page 22

PROCEDURE 5
THE ADJUSTABLE TENSION STRAPS.
The straps can be adjusted at various levels of tension to
accommodate individual end-users. In a typical scenario,
the bottom two (2) straps can be adjusted tightly to sup-
port and/or assist the extensor muscles.
S
The top two (2) straps would be left looser to allow the
E
upper body to lean back over the upholstery to fight grav-
A
ity. This configuration may enable the back canes to be
T
lowered for a quad. In another instance, you might loosen
/
all of the straps and allow the end-user to sink all the way
B
back into the wheelchair.
A
Every person will be different. Let the therapist experi-
C
ment with different positions and then decide. It is easy to
K
change.
THE BACK UPHOLSTERY COVER.
The back upholstery cover is designed for three (3) reasons:
1. It is as a modesty cover to prevent one's posterior
from protruding out of the wheelchair.
2. It reduces the chance of the cushion sliding out of the
back of the wheelchair.
3. It is a sacral support depending upon how far or tight
the flap is pulled under the seat cushion.
WHY USE ADJUSTABLE BACK UPHOLSTERY:
A CLINICAL DISCUSSION.
IMPORTANT INFORMATION
The best way to avoid problems related to pressure sores
is to understand their causes and your role in a skin man-
agement program.
Your therapist and physician should be consulted if you
have questions regarding individual limitations and needs.
All seats should be selected carefully. Working with your
therapist, and physician is the best way to assure that a
seat choice matches your individual needs.
As the needs of the individual become more complex, the
seat evaluation becomes more important.
The flexible sling upholstery commonly used on wheel-
chairs allows the wheelchair to fold without removing rigid
components. Sling upholstery will stretch with use. Unfor-
tunately, stretched upholstery does not support the back
well. Stretched upholstery often allows the pelvis to drift
into posterior tilt while the back assumes a kyphotic pos-
ture.
With the adjustable tension backrest, the sag can be taken
out of the sling restoring the original tightness. Adjustable
tension upholstery can also provide significant improve-
ment to the seated posture and function of the wheelchair.
By changing the tension of the strap, the backrest can be
adjusted to accommodate back postures such as kypho-
sis, lordosis, stabilize the pelvis and back, and provide lat-
eral stability.
In addition to restoring the sling to original tension, the
adjustable tension backrest can be adjusted to help main-
tain the pelvis and back position, which can improve pos-
ture balance and function.
The wheelchair backrest should be able to follow the natu-
ral anatomical contours of the back. When viewing a per-
son from the side, the thoracic portion of the back will
extend posteriorly to the pelvis and buttocks (FIGURE 4).
When using a nonadjustable flat backrest, the top portion
of the upholstery will usually push the trunk forward of the
center of gravity over the pelvis. To maintain the trunk in
the upright posture, the user must have and use the back
extesor musculature, or add tilt or recline to backrest (FIG-
URE 5).
When using adjustable upholstery, it is possible to tighten
the lower portion of the backrest which assists in main-
taining a neutral pelvis. The upper portion can then be
adjusted to follow the natural curvature of the spine bring-
ing the back over the pelvis in a position of balance rela-
tive to the center of gravity (FIGURE 6).
22
SEAT/BACK
FIGURE 4
FIGURE 5
FIGURE 6