Motivation Workshop
Workshop 1. Introduction 2. Motivation Australia Approach to Wheelchair Provision 3. Managing Posture and Taking Measurements 4. History of Motivation Products 5. Motivation Direct Products 6. Group Sessions 7. Mobility Skills 8. Prescription & Ordering
Motivation Australia Approach to Wheelchair Provision
Managing Posture & Taking Measurements
Neutral Posture/Upright Sitting Theoretical reference point: • upright/level pelvis • upright trunk • head and neck upright and balanced over trunk • hips flexed to 90° • knees and ankles flexed to 90° • feet flat on the floor/footplate
Benefits of Neutral Posture Maximised: • visual function, eye contact and cognition • upper limb function • respiratory function • Digestion • Organ function • prevention of contractures/poor posture • prevention of pressure ulcers • comfort
Seating Methodology • A wheelchair is mobility and postural support • The pelvis is the foundation of good posture • A stable pelvis often enables less peripheral support • Stabilise the pelvis first, accommodate if necessary • Look to support the trunk and limbs next • Neutral spinal curves should be promoted • The spine is a support column for the neck and head – balanced over the pelvis • The feet are an essential weight bearer and point of stability (particularly if pressure under the IT’s is high) • “Less is More”
Generic Wheelchairs Aspects of generic wheelchairs that effect posture: • Slung backrest • Standard, flat foam cushion • Slung seat • Limited rear wheel adjustment • Open knee angle (notadjustable) • Fixed height/length arm rests
Seat Width Too Narrow: • pelvic rotation • increased pressure risk (thighs) • decreased comfort • low propelling efficiency Too Wide: • pelvic obliquity • increased pressure risk (loaded IT’s) • decreased comfort • low propelling efficiency
Seat Depth Too Long: • Posterior pelvic tilt • Increased pressure risk (C-Shape posture, shear forces) • Decreased comfort • Low propelling efficiency Too Short: • Decreased weight distribution • Increased pressure risk • Decreased comfort • Poor knee/ankle positioning
Backrest too High • Reduced propelling efficiency • Decreased comfort • Exacerbated lumbar lordosis, or • Exacerbated kyphosis
C-Shaped Posture • Common adult presentation Potential impacts: • decreased comfort • reduced upper limb function • reduced respiratory function • poor swallowing, digestion • development of contractures, poor postural habits • pressure ulcers
• Pre-ischial shelf • Rear PSIS pad • Tension adjustable backrest
• Lap strap
• Low back to accommodate the truck
• Contoured high back to accommodate the trunk • Tension adjustable backrest
History of Motivation Products
Product range Product
Fixed
Collapsible
ü ü ü
Tricycle (fixed)
ü ü ü ü ü
Children's 3 wheel wheelchair
ü
3 wheel wheelchair 4 wheel wheelchair Supportive seating Tricycle attachment
Folding
ü
Local
Imported
ü ü ü ü ü
ü ü ü ü ü
ü
• Motivation for it’s product design; developed over 25 different products since 1991
4 wheel wheelchairs • Bangladesh 1991 • Poland 1992 • Romania 1993 • Nicaragua 1995 • Sri Lanka 1997 • Worldmade 2008
3 wheel wheelchairs • Cambodia 1993 • Afghanistan 1996 • Sri Lanka 1997 • Bangladesh 2000 • Africa 2004 • Worldmade 2005
Supportive Seating • Russia 1994 • Lithuania 1995 • Bangladesh 2000 • Sri Lanka 2001
Tricycles • Cambodia 1993 • Afghanistan 1996 • Sri Lanka 2004 • Zambia 2004
Motivation Products
Rough Terrain Manual Wheelchair
Standard Adjustments Standard adjustments: 1. Seat width 2. Seat depth 3. Balance position 4. Backrest angle 5. Backrest height 6. Footrest position 7. Footrest height 8. Footrest angle 9. Sacral pad height
4 5
9
1
2
6
7
8
3
Improved Sitting Posture Backrest cushion with height-adjustable sacral pad gives improved posture
Solid backrest easily adaptable for increased postural support. Height and angle adjustable
Removable armrests For ease of transport and transfers
Folding backrest for ease of transport
Contoured cushion on solid seat base gives pressure relief and improved posture
Wheelchair geometry seat height & axle position gives ergonomic pushing position. Uses less energy to propel particularly over rough ground
Removable cushion for ease of transport and use when sitting on other surfaces Front castor wheel 220mm diameter durable rubber castor wheel travels easily over rough ground. Long wheelbase and 3 wheels are more stable on rough ground. One standard size bearing used throughout wheelchair
Removable wheels for ease of transport 26” Bicycle wheels 3o camber each wheel for stability and turning. One standard size bearing used throughout wheelchair. Standard bicycle spares. Anti-corrosion Stainless fasteners Galvanised & powder coated frame Anodized aluminium parts
Adjustable footrest Height, position & angle adjustment as well as strap options improve posture
Ease of Transport Backrest cushion with height-adjustable sacral pad gives improved posture
Solid backrest easily adaptable for increased postural support. Height and angle adjustable
Removable armrests For ease of transport and transfers
Folding backrest for ease of transport
Contoured cushion on solid seat base gives pressure relief and improved posture
Wheelchair geometry seat height & axle position gives ergonomic pushing position. Uses less energy to propel particularly over rough ground
Removable cushion for ease of transport and use when sitting on other surfaces Front castor wheel 220mm diameter durable rubber castor wheel travels easily over rough ground. Long wheelbase and 3 wheels are more stable on rough ground. One standard size bearing used throughout wheelchair
Removable wheels for ease of transport 26” Bicycle wheels 3o camber each wheel for stability and turning. One standard size bearing used throughout wheelchair. Standard bicycle spares. Anti-corrosion Stainless fasteners Galvanised & powder coated frame Anodized aluminium parts
Adjustable footrest Height, position & angle adjustment as well as strap options improve posture
Appropriate to Remote Australia Backrest cushion with height-adjustable sacral pad gives improved posture
Solid backrest easily adaptable for increased postural support. Height and angle adjustable
Removable armrests For ease of transport and transfers
Folding backrest for ease of transport
Contoured cushion on solid seat base gives pressure relief and improved posture
Wheelchair geometry seat height & axle position gives ergonomic pushing position. Uses less energy to propel particularly over rough ground
Removable cushion for ease of transport and use when sitting on other surfaces Front castor wheel 220mm diameter durable rubber castor wheel travels easily over rough ground. Long wheelbase and 3 wheels are more stable on rough ground. One standard size bearing used throughout wheelchair
Removable wheels for ease of transport 26” Bicycle wheels 3o camber each wheel for stability and turning. One standard size bearing used throughout wheelchair. Standard bicycle spares. Anti-corrosion Stainless fasteners Galvanised & powder coated frame Anodized aluminium parts
Adjustable footrest Height, position & angle adjustment as well as strap options improve posture
Anti-corrosion Backrest cushion with height-adjustable sacral pad gives improved posture
Solid backrest easily adaptable for increased postural support. Height and angle adjustable
Removable armrests For ease of transport and transfers
Folding backrest for ease of transport
Contoured cushion on solid seat base gives pressure relief and improved posture
Wheelchair geometry seat height & axle position gives ergonomic pushing position. Uses less energy to propel particularly over rough ground
Removable cushion for ease of transport and use when sitting on other surfaces Front castor wheel 220mm diameter durable rubber castor wheel travels easily over rough ground. Long wheelbase and 3 wheels are more stable on rough ground. One standard size bearing used throughout wheelchair
Removable wheels for ease of transport 26” Bicycle wheels 3o camber each wheel for stability and turning. One standard size bearing used throughout wheelchair. Standard bicycle spares. Anti-corrosion Stainless fasteners Galvanised & powder coated frame Anodized aluminium parts
Adjustable footrest Height, position & angle adjustment as well as strap options improve posture
Active Folding Wheelchair
Standard Adjustments Standard adjustments: 1. Seat width 2. Seat depth 3. Balance position 4. Backrest height 5. Footrest height 6. Footrest angle
4
1 2
3
6
5
Improved Sitting Posture Contoured cushion with bevel base gives improved posture on sling seat upholstery. Pressure relieving cushion. Removable cushion for ease of transport and use when sitting on other surfaces
Double Cross Brace for increased rigidity, strength, durability Cross Folding Frame for ease of storage and transport
Tension Adjustable Backrest easily adjusted for increased postural support. Height adjustable Wheelchair geometry seat height & axle position gives ergonomic pushing position. Uses less energy to propel particularly over rough ground 26” Bicycle wheels 3o camber each wheel for stability and turning. One standard size bearing used throughout wheelchair. Standard bicycle spares. Puncture-proof Inner Tubes
Adjustable footrest Height & angle adjustment improve posture
Anti-corrosion Stainless fasteners Galvanised & powder coated frame Anodized aluminium parts
Front castor wheel 150mm diameter, durable rubber castor wheel travels easily over rough ground. One standard size bearing used throughout wheelchair
Ease of Transport Contoured cushion with bevel base gives improved posture on sling seat upholstery. Pressure relieving cushion. Removable cushion for ease of transport and use when sitting on other surfaces
Double Cross Brace for increased rigidity, strength, durability Cross Folding Frame for ease of storage and transport
Tension Adjustable Backrest easily adjusted for increased postural support. Height adjustable Wheelchair geometry seat height & axle position gives ergonomic pushing position. Uses less energy to propel particularly over rough ground 26” Bicycle wheels 3o camber each wheel for stability and turning. One standard size bearing used throughout wheelchair. Standard bicycle spares. Puncture-proof Inner Tubes
Adjustable footrest Height & angle adjustment improve posture
Anti-corrosion Stainless fasteners Galvanised & powder coated frame Anodized aluminium parts
Front castor wheel 150mm diameter, durable rubber castor wheel travels easily over rough ground. One standard size bearing used throughout wheelchair
Appropriate to Remote Australia Contoured cushion with bevel base gives improved posture on sling seat upholstery. Pressure relieving cushion. Removable cushion for ease of transport and use when sitting on other surfaces
Double Cross Brace for increased rigidity, strength, durability Cross Folding Frame for ease of storage and transport Adjustable footrest Height & angle adjustment improve posture
Anti-corrosion Stainless fasteners Galvanised & powder coated frame Anodized aluminium parts
Tension Adjustable Backrest easily adjusted for increased postural support. Height adjustable Wheelchair geometry seat height & axle position gives ergonomic pushing position. Uses less energy to propel particularly over rough ground 26” Bicycle wheels 3o camber each wheel for stability and turning. One standard size bearing used throughout wheelchair. Standard bicycle spares. Puncture-proof Inner Tubes Front castor wheel 150mm diameter, durable rubber castor wheel travels easily over rough ground. One standard size bearing used throughout wheelchair
Anti-corrosion Contoured cushion with bevel base gives improved posture on sling seat upholstery. Pressure relieving cushion. Removable cushion for ease of transport and use when sitting on other surfaces
Double Cross Brace for increased rigidity, strength, durability Cross Folding Frame for ease of storage and transport Adjustable footrest Height & angle adjustment improve posture
Anti-corrosion Stainless fasteners Galvanised & powder coated frame Anodized aluminium parts
Tension Adjustable Backrest easily adjusted for increased postural support. Height adjustable Wheelchair geometry seat height & axle position gives ergonomic pushing position. Uses less energy to propel particularly over rough ground 26” Bicycle wheels 3o camber each wheel for stability and turning. One standard size bearing used throughout wheelchair. Standard bicycle spares. Puncture-proof Inner Tubes Front castor wheel 150mm diameter, durable rubber castor wheel travels easily over rough ground. One standard size bearing used throughout wheelchair
Overview •
Pressure Relieving Cushion (Solid) The cushion has sculpted top and bottom surfaces to help provide the following features
Pressure relief for high risk areas: Moisture drainage channel Coccyx relief
Ischial relief
Cutting grooves Perenial relief
Firmer foam insert (in underside of cushion)
Abductor
Positioning: Pre-ischial bar
Proximal thigh relief
Product Summary Worldmade hard seat pressure relief cushion
motivation
1
Pressure Mapping
Solid Cushion Pressure Map • Without cushion cover after 5 minutes
• With cushion cover after 5 minutes • Slight increase in pressure around the trochanteric shelf not IT’s
Pressure Relieving Cushion (Sling)
Sling Cushion Pressure Map • Without cushion cover after 5 minutes
• With cushion cover after 5 minutes • No appreciable increase in pressure
Sports Wheelchair
Light Weight Frame 12kg, steel frame (1.2mm)
Height Adjustable Backrest low, medium and high
Rear Sport Castor Height adjustable Adjustable Footrest low, medium and high
Defensive Wing Basketball version only
Quick Release Wheels Aluminium, 26” adult & 24” junior
Moti-Start & Moti-Go • Paediatric Portable Supportive Seat • Backrest – height and lumbo-sacral pad adjustment • Trunk supports – width and height adjustment • Abductor (removable) • Contoured headrest • Contoured cushion • WM3 Wheelbase
Tension Adjustable Backrest Benefits: • promote neutral posture • trunk alignment • accommodate non-neutral posture • ‘roomy area’ for gluteal mass
• manage slack/sag in backrest
Measurement • Accurate measurement is essential for accurate prescription Where should we measure to and from? • Hip Width • Upper Leg Length • Lower Leg Length • Client Weight
Hands on Products
Mobility Skills
Prescription & Ordering
Prescription & Ordering 1. Assess 2. Prescribe 3. Order
Fault Reporting • Telephone or email Motivation Australia • Complete Fault Report form* • Motivation UK Reporting
• Suggestions welcome too!
