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The Case for Client Conversation

May 1, 2017 by Mobility Management

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.”

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