Editor's Note

Best-Laid Plans

Ultimate Seating GuideI’ve been a magazine editor for more than, you know, a few days, and I’ve seen more than a few editorial plans go awry. Most editorial emergencies on a monthly publication aren’t exactly DEFCON 1, so you work out a Plan B, and life goes on.

Every so often, though, one of my stories will, uh, completely jump the tracks. Go rogue. Turn right at Albuquerque.

When I create our editorial calendar each summer for the coming year, I develop feature story premises that serve as road maps for what the stories will be about. I make plans.

And then, complex rehab technology happens. Such is the case with this month’s issue, our annual Ultimate Seating Guide.

My clever plan was for the main feature story to discuss “accommodation vs. intervention” in seating. The idea was to explore when, why and how a seating team should elect to accommodate a client’s present posture, and when the team should instead seek to intervene to prevent a postural problem from progressing.

In my defense, I never meant this to be a showdown in Batman vs. Superman style. I didn’t think accommodation was superior to intervention, or vice versa, and I imagined that for many wheelchair users, the two strategies co-existed. Perhaps, for example, a seating team would decide to support a client’s current posture while hoping to stop or slow any postural progression.

It was a nice plan. Then complex rehab seating happened.

In talking with Stephanie Tanguay, clinical education specialist for Motion Concepts, I learned that complex seating is, yes, complex. In practical terms, there is always accommodation, and not just of the client’s postural situation. Where I’d been looking for a neat distinction between the two philosophies, Steph pointed out there’s a lot more gray than black and white. Read more in detail starting on page 10.

That general principle — There’s more here than meets the eye, or the editor’s first glance — is echoed in the column penned by Jay Doherty, Quantum Rehab senior clinical education manager, eastern United States. Jay discusses how thinking in the black-and-white terms of funding sources, who want to speak only of official “mobility-related activities of daily living (MRADLs),” is a disservice to clients. He reminds us of mobility for mobility’s sake, and how so many “non-MRADLs” are really the activities and capabilities that people ultimately live for. Read what Jay has to say on page 18.

I am happy to say that our ever-popular Wheelchair Cushion Comparo went according to plan: It’s our yearly pictorial and statistical comparison of many of today’s leading complex rehab cushions (page 19). But yes, our other Clinically Speaking columns, by clinicians Lee Ann Hoffman (page 24) and Steve Mitchell (page 26), also push boundaries. Lee Ann finishes her series on 24-hour posture management, an idea gaining ground in the U.S. And Steve brings us his latest installment on the “Open Complex Rehab Technology” concept, now drilling down into how this anticipatory thinking looks when applied to systems designed for ALS clients.

I don’t think seating & wheeled mobility professionals get nearly enough credit for their nimble, creative thinking. You certainly keep me on my toes.

This article originally appeared in the September 2016 issue of Mobility Management.

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