The Case for Client Conversation

Josh Anderson

Josh Anderson

Josh Anderson, Permobil’s VP of marketing, splits his time between Pasco, Wash. (where TiLite has been headquartered) and Lebanon, Tenn., Permobil’s North American home. That’s what a brief biography might say.

But dig deeper, and Anderson will add that he spends a lot of time in St. Louis, where ROHO has been based, because he oversees marketing for Permobil’s power mobility, manual mobility and seating brands. He spends a lot of time on airplanes and regularly travels to Sweden, where Permobil is based.

His medical record would show that Anderson has a C5/C6 incomplete spinal cord injury, and that he’s 6'9" tall. But that’s just a small part of his story.

“Overachieving” in an Ultralight

Anderson has used custom-built TiLite ultralightweight chairs for years (he was VP of marketing at TiLite when Permobil acquired the company). Given his level of injury, is it fair to say he exceeds clinical expectations by self-propelling rather than using a power chair? And that the precision fit of his chair makes a difference?

“Absolutely,” he said. “I think that’s a large part of it. I equate it to scuba diving. Some people are just naturally good swimmers, so they do well at scuba because they just possess great swimming skills. Others possess expert knowledge of their equipment and are better divers because they know how to use their equipment to their advantage.

“I see myself as the latter. [Paraplegics] are like the expert swimmers: They have all the muscle, they move really well, they can push any [chair] and do well — that doesn’t mean I want them to push just anything, because there are still advantages to a para having a better chair. It keeps their musculature and physique intact a lot longer. But it really matters to somebody with a higher level of injury, because it’s the ability to push or not to push at all.”

Anderson’s height is a second challenge. Despite his stature, he needs a reasonably low seat-to-floor height to move efficiently through a not-always-accessible world. As a result, his knees take an unusual position while he’s seated. Anderson knows his positioning doesn’t fit textbook definitions.

Understanding All the Parameters

“It’s understanding all the parameters,” Anderson said. “With somebody who has an injury at my level, with my height — you take those two factors, you put them into a funnel, and in a year there are maybe a couple of people like that who are seen by therapists. How do you deal with those extreme cases? How do you combine these things?

“My [wheelchair] frame, if we went by typical dimensions, would be enormous. How practical is that? We made a chair that fit to a textbook standard, 90-90-90, yet I can barely turn around in a wheelchair-accessible restroom. Combine that with the fact that I travel to places that even in the U.S. may not be completely up to [accessibility] standards, and it is certainly a different level of accessibility in Europe, and then in Asia.”

Anderson said he discusses finer points like those when he talks to new therapists.

“As a clinician, you know the textbook standard, you know the anatomy, you know how to do a mat assessment. But you need a line of questioning with everyone, even if they’re 5'8" and 160 lbs., which is the standard size for an average male. Still, ask what they do and want to do.”

As an example of how much wheelchair users can vary, and how important it is to know those differences, Anderson recalled a friend who is a wheelchair user — and a welder. As a result of flying sparks and metal shavings, he frequently got flat tires. So his seating team fitted his chair with solid tires.

“I’ve never used solid tires,” Anderson said. “But because of his environment, we did something a little different for him.”

This article originally appeared in the May 2017 issue of Mobility Management.

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