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In 2002, in one of our very first issues, we featured a story on “early” intervention.
An absolutely adorable 5-year-old had just received his first power
chair — and his first opportunity for independent mobility — in time to
don a powder blue tux and roll down the aisle as ring bearer in a relative’s
wedding. Not surprisingly, he stole
That success story would now be
considered archaic. Waiting until
age 5 to introduce independent
mobility? Wasting all those precious
years of cognitive, physical, social
and emotional development?
I also remember hearing in our early days that the industry of Complex
Rehab Technology (CRT) — referred to as rehab or re/hab back then — was,
leaving childhood and entering its adolescence. If that’s true, then 20 years
later, CRT is a young adult.
This issue supports that metaphor. We set out to demystify seat cushion
standards (page 10): Kara Kopplin and Tom Hetzel explain what standards
mean, what they don’t mean, and why we can’t just say, “Cut to the end
and just tell me the best three cushions that I should prescribe/supply to all
my wheelchair clients.”
We also take a look at the importance of a thorough home assessment,
thanks to Cindi Petito, who explains why it’s just as important to accurately
measure the wheelchair environment as it is to measure clients for their
wheelchairs (a truth that could be the tagline for home assessments).
We wouldn’t have written about either subject 20 years ago, and it’s
telling that both topics are what I (as an unscientific English major) consider
science or evidence based. Cushion standards seek to bring a common
language and understanding to the field, so seating teams can use
measurements and testing results to narrow their product choices. Accurate
home assessments provide additional data that can also be used in the
equipment selection process to improve the chances of ultimate success.
Cushion standards and home assessments both work to support the
clinical expertise and experience of the seating team. And developing these
methodologies are examples of how CRT has evolved and continues to
establish itself within healthcare.
On the flip side, Medicare’s “in the home” policy of covering only CRT and
DME used in the client’s home was short-sighted in 2002, but still lives on. So
does (at press time) Medicare’s non-coverage for seat elevation on power
wheelchairs — although the CRT industry has formally requested coverage
from the Centers for Medicare & Medicaid Services.
It can be frustrating to see antiquated thinking still be the rule decades
later. But it’s also good to occasionally look back over our shoulders to see
how far we’ve come… before turning back to face the road ahead.