Editor's Note

Taking Creative License

It’s time to get creative.

In our February issue, we devoted our cover story to the topic of tilt. I thought 5,000 words on the topic were plenty. I was wrong. In Vancouver the following month for the International Seating Symposium, I was greeted multiple times with “Nice story on tilt. But where’s the other half?”

What other half?

“Recline! Where’s recline?”

So by popular demand, here it is: Our cover story this month is on recline and elevating legrests. In much the same way that the tilt story examined the mechanics behind the positioning, and also discussed which seating & mobility clients could benefit, so this story looks at recline — its physics, its indications and contraindications for clients, and how it can work with tilt.

In researching and conducting interviews for our cover story, I developed a new appreciation for recline and new respect for its distinct identity and offerings apart from tilt. In many ways, recline is a much more naturally occurring position for humans, while the average human’s familiarity with tilt may come largely from amusement park rides. It’s not surprising, then, that for some complex rehab clients, recline is more comfortable, physically and psychologically. Start reading all about it.

You’ll also notice in this issue, our first-ever Pediatrics Handbook. Its cover story is about one of the toughest challenges that face providers who work with children: Predicting how infants, toddlers, kids and teens will grow, and creating seating & mobility systems that will keep pace and keep them properly positioned. Jay Doherty’s column on successful single-switch driving — by a little boy who was 3 years old when he learned — offers one more possibility for kids to achieve independent mobility. And Liz Stevens’ column examines what obstacles can stand in the way of more successful pediatric outcomes — challenges that range from communications breakdowns to lack of familiarity with pediatric technology. (And yes, we round out the Handbook with a collection of pediactric seating & mobility products.)

In putting together this issue, a common theme emerged. Success in the seating & mobility field requires not just depth of knowledge, but great breadth as well. And truckloads of creativity. It’s clear, for instance, from Jay’s description of single-switch driving that this is option is never going to be at the top of a clinician’s or provider’s list of independent mobility choices. It’s never going to be the best answer for a huge number of your clients. It’s not the “go-to” choice, the option you’re going to try first.

But it is one more possibility. For certain clients in certain situations, with certain abilities — and certain limitations — single-switch driving could be the tool that propels them (no pun intended) from dependent to independent mobility. And therefore, though it will never be a solution for most of your clients, it’s worth knowing about, worth keeping in your back pocket, in case the right client ever comes along.

Recline might be looked at in the same way. When tilt’s possibilities began to emerge and evolve — not that long ago, really — recline was pushed somewhat into the background. It’s gotten to the point where some payors question whether recline is needed at all. For some clients, it isn’t. But for others — those who feel not quite safe in a tilted position, or those who need more nuanced positioning, or those who simply need to move almost constantly to keep pain and discomfort at bay — recline is a good option to have. Used creatively by the right clinicians and providers in the right circumstances, recline can enhance a seating & mobility system in a way that tilt or tilt alone cannot.

A lot of the business world would point to this industry and say it makes no sense — and no dollars — to dream up and build solutions to help only a handful of people at a time. They would wonder why you’d bother to keep, in the back of your mind, the knowledge of how to set up a power chair to drive with a single switch, when you might not come across a suitable client for years.

Then again, those folks will never watch a 3-year-old drive across the room all by himself for the first time and be able to say to themselves, “I helped make that happen.”

This article originally appeared in the August 2010 issue of Mobility Management.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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