While Complex Rehab Technology wheelchairs
can be fine tuned to their users’ needs, there
are still groups of underserved consumers…
and as a result, underserved families as well.

Sunrise Medical’s new ZIPPIE Sphynx was designed to
address the clinical needs, goals, and activities of both.

Transportability in the Real World

The Sphynx has seat widths of 10″, 12″, 14″, 16″, and 18″.
Seat depths go from 10″ to 19″ standard, including 5″ of
built-in growth. A 14×14″ chair grows to a 19″ seat depth
without replacement parts, said Kelsey DiGiacomo,
Sunrise Medical’s Pediatric Product Manager.

But here’s where the Sphynx gets really interesting: Its
weight capacity is 250 lbs., thus accommodating older
kids and even adults while maintaining true portability.

In fact, that population of teens and young adults,
DiGiacomo said, “was really what drove a lot of the engineering
aspects. We’d been hearing from our clinical
advisory board, as well as parents who utilize the [ZIPPIE]
Voyage and some of our other products, that realistically,
transportability is hard to achieve with this type of adaptive
stroller or even our pediatric wheelchairs.

“Parents or caregivers of children with disabilities have
a lot on their hands, literally. They’re dealing with children
who have complex medical support accessories, or
they’ve got additional children who need attention. So
being able to have something that folds into a standard
size, even a compact car-sized trunk, without dissembling
all of the seating system really improves not only
functionality for the child, but for their family as a whole.”

The Sphynx folds clamshell style in seconds (watch
it on the sunrisemedical.com Web site). Seating and
accessories stay on the frame, so folding the Sphynx is
“something that [a caregiver] can do even with a child
in their arms, in a quick, one-step motion,” DiGiacomo
said. “That was something our clinical advisory board
drove home to us: We don’t want to compromise seating
and positioning, but what parents and caregivers want is
something they can fold on the fly to get out the door.”

The Sphynx’s transport weight is 30 lbs. “We did want
to prioritize the overall weight of the system,” DiGiacomo
said. “We’ve heard, It’s great if the frame itself is transportable
when you remove the rear wheels or the legrest or
the upholstery, but it ends up still being heavy when you
think about it as a complete system. So we wanted to
make it compact folding, but also as lightweight as we
possibly could without compromising strength.”

Dialing in the Best Positioning

The Sphynx offers static tilt settings of 10°, 20°, and 30°
“that could be adjusted as the child’s needs change over
time,” DiGiacomo noted. “So a child could utilize a 30°
seat tilt, but say they undergo scoliosis surgery and have
much better trunk support. Being able to have that 10°
option — just a quick, almost two-minute adjustment —
to upgrade their seat tilt to that 10° position really
improves functional access to participation.”

While the tilt isn’t meant to be frequently adjusted —
“It’s more to accommodate the child’s needs over time,”
DiGiacomo said — caregivers can use recline (85-100°)
to reposition as needed. “If they’re in a classroom and
they get fatigued, the teacher or clinician could adjust
that recline on the fly,” DiGiacomo said. “It provides
quick-adjust accommodation for a child who might
need the benefit of opening that seat-to-back angle.”

The Sphynx accommodates a wide range of positioning
components, DiGiacomo added: “The voice
of the clinician was asking us to have that transportable,
almost adaptive stroller-looking frame, but they
didn’t want to compromise with just soft, lightweight
positioning options. They wanted more complex anterior
trunk supports and lower-body supports. So we’ve
got trunk supports, pelvic support options, hip guides, upper-extremity support trays with all of our standard
upholstery. We have the opportunity to bundle with
more individually configured systems, like a JAY back
and cushion. That provides a hybrid between something
that’s basic, soft and comfortable for kiddos who don’t
need as much support. But for kiddos who are more
complex, we can completely configure their seating to
meet their needs.”

Just What They Want (& Nothing They Don’t)

Angie Kiger, M.Ed., CTRS, ATP/SMS, Sunrise Medical’s
Clinical Strategy & Education Manager, said of the
Sphynx’s development, “When we started talking to
clinicians a few years ago, the conversation was ‘We
have a large portfolio; what are we missing? Who’s being
underserved?” Teens were mentioned as among the
most difficult-to-support populations.

“They’re big,” Kiger explained. “It’s more difficult for
Mom and Dad to place them where they need to go.
Examples that were brought up were kids on the autism
disorder spectrum who have behavioral difficulties, but
also have cerebral palsy. They may be lower on the
GMFCS [Gross Motor Function Classification System]
scale, so they can ambulate short distances. But they
can’t go for a long period of time.

“If you get them a tilt-in-space wheelchair, are you
limiting their ability to go places with Mom and Dad? Are
you limiting people’s perceptions of them? That’s one
of the most difficult things for families: You don’t want to
look more disabled than you actually are.”

The Sphynx became a great fit for the real-life family in
the new chair’s marketing campaign. The family’s eldest
two children — Ariana (pictured) and Fernando —
are teens who have been diagnosed with Congenital
Disorder of Glycosylation, Type Iq; CDG1Q; Coloboma,
Ocular, with Ichthyosis, brain
malformations, and endocrine
abnormalities.

Ariana has intellectual
disabilities, but Kiger, on hand
for the photo shoot, described
her as “very active, smiley
and happy,” adding Ariana’s
feet “are always marching.”
Ariana’s previous mobility
device was an adaptive stroller,
but “because of Ariana’s significant movement and her
constant marching, she broke the lower-extremity pieces
multiple times,” Kiger said.

Ariana’s therapist decided to try an ultralightweight
chair next, reasoning that Ariana was capable of some
self propulsion and that the therapist could achieve
some positioning via the adjustable axle plate. So they
tried a QUICKIE 2.

“Mom and Dad were a little disappointed because
the QUICKIE 2 is created for someone with independent
mobility,” Kiger said. “We can set it up to be dependent,
but it’s intended to be [self] propelled. So it’s not nearly
as ergonomically correct for families to be pushing.”

Upon hearing about the Sphynx, Ariana’s therapist
recommended the family for a test, saying, “Mom and
Dad are at a loss; there’s nothing out there for them.”

Then Ariana tried the Sphynx. “Now Mom and Dad
can change her position while they’re in the community,”
Kiger said. “If they’re out for longer days and she needs
to rest a bit, they can recline her. She only sits at 10°
static tilt; that’s a good position for her.”

The minimalist Sphynx largely disappears when Ariana
is in it. “That’s one of the things Mom says,” Kiger said.

She added that Sunrise intentionally refrains from
calling the Sphynx a stroller: “If you look at the definition
of stroller, it talks about young children. A lot of times, if
people have an intellectual disability, they’re just considered
a child. And that’s not okay. If someone is 20 years
old, we should not be saying, ‘Let’s go get your stroller.’”

Indeed, the Sphynx has two HCPCS codes: E1161 (adult
manual tilt in space) and E1232/1234 (pediatric folding
tilt in space, with/without seating).

“The chair that Ariana was using didn’t offer as many
positioning options,” Kiger said. “[Therapists] get into
battles with families: They all agree they don’t need a full
tilt-in-space wheelchair. But then families say, ‘We like this
chair because there’s not a lot of stuff on it.’ And the therapist
says, ‘But I can’t get her positioned appropriately.’”

The Sphynx gives Ariana exactly what she needs…
without adding more tilt that she doesn’t need and that
would make her chair larger and harder to transport and
maneuver. “The family loved it,” Kiger said.