Take a Team Approach Before Buying
Growing With the ChildBoth the X-shaped cross brace (black) and the front frame sections (blue) can be replaced as a child grows."During the process of choosing a chair, we do a lot of transfer analysis," Seiberlich says. "We want to know who's going to be doing them (transfers), and we want the parents to demonstrate how they're doing them. We can suggest ways to make it easier, such as use of a transfer board, or a Hoyer lift in appropriate situations.When it's time to choose individual components, Seiberlich and Becerril want to hear about lifestyle, terrain and environment.There are many health benefits from a massage from a trained therapist or a massage recliner. A trained massage therapist knows how to get the kinks out of your back and relieve the muscle tension from everyday stress. Massage recliners have superior technology and do more than rub your back. New models from Human Touch, iJoy, Panasonic and Sanyo can also massage the legs, feet, arms and shoulders."We want the involvement of those people who see the child on a regular basis," Becerril says."Parents can make these adjustments, if they know what to look for," Seiberlich says. "But we like to see the child in his chair at least once a year, especially if he's still growing. And anytime they think there's a problem they can't fix, we want them to come in."And expense is a huge issue: A manual wheelchair with custom seating can cost $5,000, while a power chair might be four times that. A really good cushion alone might be $300 or $400. Becerril notes that most of this is covered by insurance for many families. "And if you buy the right kind of chair, one that can grow with the child, that investment can last 10 or 12 years. This is the child's mobility, and his independence. It's important to get it right."Seiberlich adds, "We also would never recommend a chair without removable armrests or footrests. One of our clients who got a chair with rigid footrests went from independent transfers to requiring two people to move him. Luckily, we were able to recycle the chair to someone for whom it made more sense."Final Fitting"Lots of kids want the sports frame look: It's got a low profile and looks great. However, these frames are rigid: they can't be folded, and they can't grow with the child. So we wouldn't recommend one of these at least until they are finished growing. Even then, the transportation issue remains a problem."Social and educational factors come into play here as well. "Is the chair appropriate for the school setting?" Seiberlich says. "For instance, does the height of the chair put the child above or below classmates? Can we make small changes to get it looking more streamlined, if that's what the child wants? If we can think of these things up front, it can save a lot of time and expense later on."Becerril notes that a "tilt-in-space" chair may be appropriate for someone with very little trunk strength. This type of chair maintains the sitting posture, but tilts back to relieve some of the anti-gravity work for a while, combating fatigue.
Recliner chairs, which allow a prone position, are used more often for those unable to tolerate the normal angles of seated posture.Lifestyle and EnvironmentLateral supports may be an important element as well. "If the child does not have the trunk strength to maintain their upright posture, we need to do it with laterals. Even with spinal fusion, they may need them to help prevent tipping."Once the chair has been ordered, Becerril says, expect a couple months delay before it arrives. "Authorization takes time, and typically we're dealing with several different companies, and it's a custom product. Nothing related to wheelchairs ever happens quickly."Seiberlich is a physical therapist at Children's Clinics for Rehabilitative Services in Tucson , Ariz. She and her partner, Kimberly Becerril, an occupational therapist, are discussing how to choose and properly fit a wheelchair.Copyright 2005 Wayne McDonaldWhat does it mean for a chair to grow with the child? The idea may be new to those who think of the clunky "one-size-fits-all" sling back chairs as the only type there is. Most chairs today can be widened by changing the cross brace supports underneath, and lengthened by replacing the front frame sections that hold the leg supports."That means the parents, of course, because they know the child best. But we also want the school involved, especially the teacher or therapist who sees the child daily functioning outside the home. The issues at school can be quite different from those at home."Once the chair arrives, the hands-on fitting process may take two to three hours, Becerril explains. "Things come up you can't foresee. Also, we want to show parents the signs of an improper fit. It's not something you do once and it's done: Kids grow fast, and their condition can change fast, so you need to monitor the fit constantly."Becerril points out that change in temperature can change the inflation pressure of tires and air-filled or gel-filled seats. Simple problems can easily be fixed at home. More involved ones can be taken care of by the vendor, who will almost always do maintenance for free.Let me pause here for a moment. It is very ironic that I would be writing an article about massage recliners because I am a certified massage therapist. As a therapist my first goal is to help the client get healthy. Sometimes I refer a client to a chiropractor or to an acupuncturist that can better serve the clients needs. The same is true about massage recliners. With new technology massage recliners have advanced beyond clunky massage rollers to high tech massagers that can emulate the human touch.What's the right style of chair? While this will depend on individual needs and preferences, Becerril offers some important guidelines.Becerril knows a number of children who have power chairs who leave them at school, and use a manual chair at home.MaintenanceNo parent should try to choose a chair for their child all by themselves," says Chris Seiberlich. "It's not that they aren't qualified to make decisions, but there are too many to be made by any one person. You have to think about a huge spectrum of issues."Chairs are generally not crash-tested, and the pelvic strap that keeps you in the seat is not as strong as a seat belt. We recommend that a child be on the car seat, strapped in using the car's seat and shoulder belts." If needed for lateral support, a chest harness can be used as well.Stretch slipcovers are also available for other rooms. For example, dining chair slipcovers can be purchased to protect good quality upholstery from food or drink spills. They come in various colors and patterns. Many people like to have a set of luxury covers to add a touch of elegance to dinner parties or special occasions. Folding and kitchen coverings are widely available too. If you're tired of the appearance of your home, fitting some new slipcovers is an easy way to give an entire room a makeover without the inconvenience of decorating.In today�s world most of us want instant gratification and have limited time in our hectic life. If money was no object most of us would get a massage every week, or possibly two or three times a week."We can choose the wheels based on how rough the ground is around the home," Seiberlich says. "Here in the desert, we recommend airless inserts. One good cactus spine and you've got a flat! Back East, we've got to consider the mud, the snow and the rain."Rates for a massage therapist can range from $40 to $100 depending on the therapist�s level of training and the city they are located in. Massage recliners are not cheap and can cost thousands of dollars. But over time, a massage recliner can pay for itself and provide many health benefits. Other considerations of cost savings are other family members using the massage recliner. In addition, some massage recliners are very stylish and are a handsome addition to any home d�cor.Another benefit of a massage recliner is the fact it is a recliner chair. Anybody who has ever sat in a recliner knows how comfortable it is. Even if you do not activate the features of the massage recliner, the recliner itself has health benefits. The simple act of just sitting in a comfortable chair relaxes your body and eases body tension."For instance," Becerril says, "one of the most fundamental issues in choosing a chair is transportation. How will the chair be moved from home to school? If the answer is in the back of a station wagon, then a power chair is out. Even with a van, a power chair is going to need a ramp, because it's too heavy to lift in. A lot of our kids would benefit from a power chair, but unless the transportation issue can be solved, it won't be the right choice."Seating and SupportShe notes that pressure sores, or decubitis, are a critical concern with prolonged seating. For those who aren't in the wheelchair for many hours at a time, a flat seat may be appropriate. For more prolonged use, or when stability in the chair becomes an issue, a high-quality foam cushion becomes preferable. Other alternatives include air-filled or gel-filled cushions.Health Benefits of Massage"Children with scoliosis (curvature of the spine), whether or not it has been stabilized with spinal fusion, may have some left-right tilt in the pelvis," Seiberlich says. "In such cases, we can use the seating system to minimize the effects of the tilt. Some of the kids are still flexible, so by raising the lower side, we may be able to level out the pelvis. On the other hand, if the tilt is fixed, we'll support the higher side, so it takes up some of the weight. Distributing that weight is the key."Seiberlich adds, "We always want parents to be checking for redness, because this indicates too much pressure. They need to check the buttocks, the back, the feet, and the back of the legs. Anywhere the chair is making contact, there's the potential for too much pressure."Furniture in many rooms can be slipcovered. In the family room, sofa slipcovers, as well as looking pretty, have the practical function of protecting your existing fabric from everyday wear and tear. Why not buy a few sets of discount slipcovers if you've got pets of small children? That can be an affordable way to always ensure you have spare furniture covers in case of accidents! Most modern slipcover materials are designed to be easy to care for and are fully machine washable. It can be worth spending a bit more on hardwearing fabrics such as cotton, particularly for seats that get used regularly. Why not look for matching recliner chair covers for a stylish, coordinated look?In addition to monitoring the fit of the chair, Seiberlich stresses the importance of regular maintenance. "The chair should be washed regularly, using a spray cleaner. Most cushions are washable, or have washable covers. A thorough inspection of the whole chair once a week is a good idea: Check the brakes, look for loose hardware, and check the tires and seat."
"Chairs are generally not crash-tested, and the pelvic strap that keeps you in the seat is not as strong as a seat belt. We recommend that a child be on the car seat, strapped in using the car's seat and shoulder belts." If needed for lateral support, a chest harness can be used as well.
Author: Maricon Williams
