#ThursdayThanks to RESNA
[caption id="attachment_2418" align="alignleft" width="150"] Woman cheering in wheelchair[/caption]
The Rehabilitation Engineering and Assistive Technology Society of North America has great free resources with position papers, guides and best practices for wheelchairs, power mobility, is a great place for occupational therapists to learn.
One of the most compelling resources is the RESNA position on the application of wheelchairs, seating systems and secondary supports for positioning vs. restraint.
The clinical guidelines for the use of secondary postural support devices like seat belts, as well as the use of tilt and recline features in a wheelchair are incredibly helpful to occupational therapists in decision making around when secondary supports, and features like tilt and recline are best used.
Recognizing when secondary supports have the effect of restraining a person for reasons other than postural support is critical. Is it a seat belt or a restraint? Does it help position the pelvis and thus allow the person sitting in a wheelchair more function or is it a safety risk? These are important questions that occupational therapists who work in the field of seating and wheeled mobility, helping people choose wheelchairs must ask and answer every day. One of my first lessons in seating someone in a wheelchair is that sometimes you do have to restrict and stabilize movement in one place (like the pelvis) in order to enable and facilitate the person to move in another place (like push themselves with their hands on the wheels). Finding the balance between the two is paramount.