Georgie is a 22 year old outgoing lady who enjoys socialising, shopping and boccia. She communicates competently using an AAC device and has a great sense of humour!
Georgie’s diagnosis is dystonic quadriplegic cerebral palsy and presents presents with complex postural needs, including involuntary movements and increased muscle tone that required specialist intervention.
Whilst at college Georgie participates in regular Physiotherapy sessions. She has been prescribed night-time positioning as part of her 24-hour postural management programme. She also wears a body brace during college hours and a ‘second skin’ dynamic splint to help encourage normal movement and function. Georgie uses her wheelchair for all seated activities, including watching television, eating and drinking. Her wheelchair is bespoke with a fully moulded seat that supports her complex posture. She uses a four-point pelvic belt to aid pelvic stability and safety; she also uses foot and ankle straps to offer further stability with the aim of reducing the impact of her dyskinetic movements.
Rebecca Dunstall, Clinical Specialist, and Les Jones, Careflex Business Development Manager visited Georgie with her key worker and Occupational Therapist. The aim was to see if CareFlex specialist seating could improve her quality of life. On assessment, it was clear that Georgie would benefit from an alternative seating system to encourage a change of position out of her wheelchair and, more importantly, the opportunity to relax at home. Specialist seating would enable her to feel comfortable whilst also continuing to manage her postural needs and encourage energy conservation.
- Flexible postural support throughout, with the ability to adjust both left and right sides of the chair uniquely to accommodate her asymmetries.
- A multi-segmental back that accommodated, and corrected where possible, her scoliosis and her rotation through the spine and pelvis.
- Tilt-in-space to encourage pressure redistribution whilst opening up the chest and shoulder girdle when utilised. Tilt-in-space would also allow for a period of rest and recuperation.
- A padded four-point pelvic strap and an adjustable footplate with the option to add foot and ankle straps, as replicated in her wheelchair, which provided the feedback she needed for stability to manage her dyskinetic movements.
- An adjustable seat depth that ensured she had maximum contact with the support surface, which enhanced her comfort levels and reduced her risk of pressure injuries due to prolonged sitting.
- The ability to continue with assisted transfers using the stand-aid, and the option to integrate her AAC device to maintain her independence.
- CareFlex’s tailored seating solutions service would also allow for the prescription of a bespoke head support to accommodate Georgie’s asymmetry whilst maintain her visual field and a comfortable upper limb support that enabled functional movement.
Georgie was very clear in displaying her like of the chair; she communicated that the headrest offered significant comfort and the tilt-in-space function helped her to relax.
For the Carelfex team, meeting Georgie and seeing her character shine even more when she was sat comfortably was the highlight of the visit. Feelings of safety and the ability to relax should never be undervalued. It is important that postural management addresses clinical objectives holistically – with the person at the centre, always.
This article is an edited version and published with the permission of the author, Rebecca Dunstall, Careflex Clinical Educator. Careflex always strive to balance posture and pressure management with the individual’s own goals, whilst promoting comfort, independence and a meaningful life.