Case Study: Setting a Successful Boundary
Gabriel Romero, director of sales and marketing for Stealth
Products, was discussing laterals and headrests with a complex
rehab technology provider and a client, a woman who had ALS.
Romero said in the middle of the conversation, the woman told
them, “I’ve got to tilt back because I’m starting to get a little fatigued.”
As she tilted, Romero noticed the woman was holding her elbow up.
“I could see her elbow shaking,” he recalls. “She’s holding onto the
He asked her to return to her regular seated position, and the
woman complied. “She put her elbow on the armrest,” Romero said.
“And I asked her, ‘Did you realize you were holding up your elbow while
you were tilting back?’”
The woman responded that doing so must have been “a survival
“What she was basically telling me,” Romero says, “was ‘I’m holding
my elbow up because I’m holding onto the joystick, gripping it so I
don’t let go and lose my arm positioning because of gravity.”
Romero asked the woman to go into tilt again, but told her this time,
he would place his arm right behind her elbow. “So, she does that. She
keeps her elbow down, and she lets go of the joystick because she felt
support” — i.e., Romero’s arm against her elbow, which prevented it
from sliding out of place.
The equipment solution: taking a headrest that had a sub-occipital
and cutting it in half to create an elbow support for her.
“We shaped it to her, and I held it there so it was doing the same
thing my hand had done,” Romero says. “She said, ‘This is fantastic!’”
Romero added that unlike a traditional arm trough, the elbow
support provided a “physical barrier at the back of the elbow” to
ensure the woman’s arm stayed properly positioned throughout the
tilt process, and to ensure she could move in and out of tilt easily while
continuing to access her joystick.
Having the assurance that her arm would remain correctly positioned
could even make the woman more apt to use her tilt feature,
Romero proposed: “How many times do you think people don’t effectively
use tilt because of problems like this?
This article originally appeared in the October 2012 issue of Mobility Management.