Seating and Positioning for Low Incidence Populations in the School Setting June 30, 2009

Objectives Review optimal and functional seating positions Identify factors that influence posture and positioning Review types of mobility, positioning, and seating equipment

Objectives Explore purposes of positioning/seating equipment Review case study of child using seating/positioning equipment

Optimal Seating Position Head/Neck Trunk Lower Extremities –Knees –Ankles 90 Upper Extremities –Shoulder flex 30 –Elbow flex 60

Factors That Influence Posture Abnormal muscle tone Joint deformity Persistence of primitive reflexes Range of motion limitations

Mobility Equipment and Seating Systems Mobility Manual wheelchair Electric wheelchair Scooter Cane Crutches Walker Seating Systems Cushions Custom fitted systems Tilt or recline features Accessories like lateral supports, foot supports, trays

Example of Seating System

Example of Positioning System for Standing

How to Achieve Functional Position for Task Performance Provide a stable surface with adequate trunk support to allow upper extremity function Reduce extraneous movement Decrease influence of reflex patterns Decrease tonal influences Increase comfort Maintain alignment to prevent deformity

Case Study - Gianni 3 years old Normal Cognitive Development Congenital Muscular Dystrophy Decreased Muscle Tone Decreased Active Range of Motion Against Gravity Respiratory and Feeding Issues

Components of Seating System to Maximize Function High Back Lateral Trunk Supports Hip Guides Foot Plate Tray

Additional Support Needed for Stability

Improved Upper Extremity Function for Completion of Daily Living Tasks

In Conclusion Mobility aids can contribute to improved quality of life by enabling a student to move with greater independence and safety in the school environment. Seating and positioning equipment provide a student with stability, and allow a student to function at the highest level possible by facilitating improved control of head, arms, and hands.