By “Coach” Scott Chesney
Since I began writing this column late last year, I have received several e-mails inquiring about wheelchairs and seating. The e-mails are coming not only from newly spinal cord injured (SCI) individuals, but also from people who have had an SCI for over 35 years. Considering that our wheelchairs are basically an extension of our bodies, it is imperative that we devote the necessary time to choosing one that not only appeals to our eyes, but more importantly, fits us like a glove.
To that end, I invited Mary Shea, MA, OTR, ATP, clinical manager of Wheelchair and Seating Services at Kessler Institute for Rehabilitation in West Orange, New Jersey, to share her expert advice on these subjects with you. Here is what she had to say:
“How is your wheelchair? Do you have pain that you did not have before? Do you sit as upright as you would like? Do you have any pressure sore concerns or issues? Do you feel comfortable in your wheelchair? Do you feel you have sufficient stability for functioning? Can you get up and down a 3-inch curb by yourself?
“These are all questions that we address daily in the wheelchair clinic at Kessler. These are very important issues to us because it often affects your long-term health and your ability to be as independent as possible. There is a plethora of equipment out there and we can help you sift through the options to find the best combination to meet your specific needs.
“Where do you begin? You would need to see your physician, speak to him or her about your issues, and ask for a referral to a wheelchair clinic. It is important to work with an OT or PT clinician who has a specialty certification as a RESNA certified ATP. This insures that the therapist has a certain knowledge base of wheelchair and seating products.
“Once you schedule an appointment, the therapist would begin by interviewing you to understand your medical history, functional level and lifestyle. You would then be evaluated on the mat to assess your body for strength, flexibility, balance, and measurements to help determine your seated postural goals. This will help the therapist to determine how to narrow down the product options to best meet your needs.
“After that you would try several wheelchairs, cushions, and back supports to determine angles and the optimal combination to support your lifestyle. If you have pressure issues or concerns, a pressure mapping system will be utilized to objectively compare cushion pressure distribution. Once the products are decided upon, the wheelchair and/or seating system specifics are completed with a vendor. After funding is secured, the wheelchair and seating products are ordered.
“When everything is ready, each client is seen in the wheelchair clinic to ‘fit’ the products. All adjustments are made at this point to insure the wheelchair and seating system meet your original goals.
“If training is necessary for manual or power wheelchair skills, your therapist can help you learn the skills you need to be as safe and independent as possible.
“Due to normal life and body changes, it is important to have your wheelchair and seating system fit checked on a regular basis. For some people, it means every 2-3 years and for others, every 5-6 years. If you have any questions, please do not hesitate to contact your therapist or seating clinic.”
From my own perspective, I thought that I sat perfectly in my wheelchair up until about four years ago. I figured that I had been in a wheelchair for 18 years, I know what I am doing, I know what I need, and I don’t need any help. (Can anyone out there relate?) Well, after being reevaluated by Mary, I certainly recognized how little I actually knew and that no matter how long I have been in this wheelchair and how many experiences I have had, I still need to be open to learning. There is so much change that is evolving in the wheelchair and seating industry every year, and I certainly can’t afford not to be informed. And neither can you! Do yourself a favor, just as I am hopeful that you visit your SCI doctor and urologist regularly, add a visit to a seating clinic to your “to do” list.
Scott Chesney, paralyzed 22 years ago as the result of a rare stroke, is a popular international motivational speaker and life coach. You can reach him via e-mail at schesney@unitedspinal.org.
This column is intended for informational purposes only and should not be construed as offering medical advice. If you have a medical condition requiring attention, please seek the help of qualified medical professionals.
