5th Nordic Seating Symposium - Sitsite - Hjælpemidler
5th Nordic Seating Symposium - Sitsite - Hjælpemidler
5th Nordic Seating Symposium - Sitsite - Hjælpemidler
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conference book<br />
<strong>5th</strong> <strong>Nordic</strong> <strong>Seating</strong><br />
<strong>Symposium</strong><br />
22–24 may 2012 in Stockholm
Table of content<br />
3 Welcome to the <strong>Nordic</strong> <strong>Seating</strong> <strong>Symposium</strong><br />
5 <strong>Symposium</strong> activities<br />
6 Presymposium workshops<br />
10 <strong>Symposium</strong> Moderator<br />
11 <strong>Symposium</strong> programme Tuesday, May 22<br />
12–14 Presentations in Room M2 Tuesday, May 22<br />
16–17 <strong>Symposium</strong> programme Wednesday, May 23<br />
18–25 Presentations in Room M2 Wednesday, May 23<br />
26–34 Presentations in Room M1 Wednesday, May 23<br />
35–42 Presentations in Room E4 Wednesday, May 23<br />
44–48 Presentations in Room E8 Wednesday, May 23<br />
50 <strong>Symposium</strong> programme Thursday, May 24<br />
51–54 Presentations in Room M2 Thursday, May 24
oom m2<br />
Welcome to the <strong>Nordic</strong> <strong>Seating</strong> <strong>Symposium</strong><br />
The first nordic seating symposium was held in Stockholm in October 2001. Since then it has<br />
been held in Oslo, Copenhagen and Reykjavik and now the fifth <strong>Symposium</strong> is to be held in<br />
Stockholm. On this occasion the venue will be Kista mässan where in conjunction with the<br />
<strong>Symposium</strong> an exhibition, Hjultorget, will be held for two days of the three day event.<br />
This is a symposium for professionals and will focus on seating and positioning for persons XXXXXXXX with<br />
Xxxxxxxx<br />
disabilities. Welcome to participate in several interesting presentations and workshops held by speakers<br />
from all the <strong>Nordic</strong> countries, Europe and USA. The main purpose of the symposium is to share<br />
experiences, increase knowledge and form new friendships and networks. Presentations and workshops<br />
are based upon practical experience, research as well as ideas.<br />
Four workshops were held prior to the symposium. These workshops gave the participants an<br />
opportunity to go in depth into particular subjects.<br />
During the first day, May 22th, and the third day, May 24th, all lectures will be given in plenum.<br />
During the second day, May 23th, participants can choose between four different parallel sessions.<br />
We hope that the programme for this year’s <strong>Nordic</strong> <strong>Seating</strong> <strong>Symposium</strong> will create new insights and<br />
inspire you in your daily work. There will be plenty of opportunities both to obtain the latest knowledge<br />
in the area and to meet colleagues in informal exchanges of experiences across the <strong>Nordic</strong> countries.<br />
We warmly welcome you to <strong>Nordic</strong> <strong>Seating</strong> <strong>Symposium</strong> 2012 in Stockholm!<br />
The Swedish Institute of Assistive Technology<br />
Organizer of the symposium<br />
Jan Grönlund<br />
Director<br />
Swedish Institute<br />
of Assistive Technology – SIAT<br />
3
adaM ScoTTi/flickR<br />
4
<strong>Symposium</strong> activities<br />
Below you can read more about the different activities that will take place during the <strong>Nordic</strong><br />
<strong>Seating</strong> <strong>Symposium</strong>.<br />
<strong>Nordic</strong> <strong>Seating</strong> <strong>Symposium</strong>, 22–24 May<br />
Lectures during the <strong>Symposium</strong> will take place both in plenum and in parallel sessions. Almost all<br />
parallel sessions will start and end at the same time, which makes it possible to alternate between them<br />
during the day. This means that it will be possible to go from one room to another during the day and<br />
therefore put together a programme shaped to suit personal interests.<br />
An English description in the programme means that the presentation will be given in English.<br />
A description in a <strong>Nordic</strong> language means that the presentation will be given in that specific language.<br />
Poster exhibition<br />
A poster exhibition will be arranged during the symposium at the lunch and coffee area.<br />
Each exhibitor will give a five minute presentation during the coffee break on Thursday, May 24.<br />
Exhibition Hjultorget<br />
The Exhibition has been arranged by Rekryteringsgruppen Active Rehabilitation (RG) and The Swedish<br />
Association for Survivors of Accident and Injury (RTP). RG and RTP are both non-profit organizations.<br />
RG focuses on motivating people with disabilities, especially those with spinal cord injuries, to lead an<br />
active and independent life. RTP concentrates on the promotion of participation and accessibility in<br />
society for the survivors of road traffic accidents, accidents in general and polio.<br />
It will be possible to visit the exhibition parallel to the presentations at the <strong>Nordic</strong> <strong>Seating</strong> <strong>Symposium</strong><br />
–due to breaks structures into the programme.<br />
Activities at Hjultorget<br />
A competition, open to all participants, will take place at the fair. This will consist of double poling<br />
ergometer, wheelchair basketball, shooting and armbike. Competition starts at booth C10. Participation<br />
in all of the events together with the submission of results ensures automatic participation in a prize draw.<br />
During our breaks, why not take the opportunity to enjoy other attractions such as wheelchair dance<br />
and wheelchair basket. Why not challenge yourself to maneuver a wheelchair through a specially<br />
constructed apartment. The apartment is open all day and can be located at booth C12.<br />
5
Monday • May 21 • 9.00–16.00 kiStamäSSan<br />
John högberg<br />
RG aktiv Rehabilitering<br />
6<br />
Pre-SymPoSium workShoP<br />
Rullstolens möjligheter<br />
(In Swedish)<br />
en PraktiSkt kurS där du får lära dig hur man som rullstolsanvändare kan leva<br />
ett aktivt liv med optimal livskvalitet. Utgångspunkten är rullstolen som möjlighet<br />
– inte en begränsning.<br />
På kursen får du lära dig hur man som rullstolsanvändare kan leva ett aktivt liv<br />
med optimal livskvalitet. Utgångspunkten är rullstolen som möjlighet – inte en<br />
begränsning.<br />
Kursinnehållet är optimerat så att du ska få tips och idéer om hur man kan lära ut<br />
körteknik med mera till användare samt hur man kan inspi rera till en aktiv fritid.<br />
Genom kursen får du möjlighet att öka din kompetens, samtidigt som du får<br />
inspiration till ditt fortsatta arbete.<br />
Kursinnehåll:<br />
• Rullstolsteori manuella rullstolar<br />
• Mekning manuella rullstolar<br />
• Rullstolsmanövrering manuella rullstolar
Pre-SymPoSium workShoP<br />
The evidence basis of using<br />
gait trainers to improve activity<br />
and participation<br />
– in Infants, Children and Adults with<br />
GMFCS Levels IV and V<br />
target audience: Intermediate, Participants should be familiar with body weight<br />
support gait training (BWSGT) and the concept of central pattern generators (CPG).<br />
Much has been learned about BWSGT, but many clinicians are missing crucial<br />
information about the significance of transferring this approach to over ground in<br />
natural environments to improve activity and participation for infants, children<br />
and adults who are non-ambulatory (GMFCS Levels 4 and 5) This method of<br />
facilitating activity (NOT walking!) must be part of any and every 24 hour postural<br />
management program.<br />
This course will begin with a systematic review of the literature (sorted by ICF category)<br />
. Videos and case stories will be used to show how the central pattern generator<br />
(CPG) can be used to facilitate activity and participation in nonambulatory children<br />
(GMFCS Level 4 and 5). GMFCS will be reviewed in the context of determining<br />
which child will be non-ambulatory and benefit most from this intervention.<br />
Session objectives:<br />
• (Knowledge) Participants will be able to describe the stimulus that<br />
triggers the stepping response (CPG).<br />
• (Comprehension) Participants will be able to understand why it is important to<br />
stimulate the CPG early and often<br />
• (Application) Participants will be able to apply BWSGT research to<br />
their decision making process for frequency, speed, assistance/ postural support,<br />
bracing and amount of unweighting to all brands and models of gait trainers<br />
• (Analysis) Participants will be able to assess any gait trainer for its ability to<br />
accomplish or adapt to the desired clinical parameters to optimize the child/<br />
adult’s activity and participation in a natural environment<br />
• (Synthesis) Participants will be able to incorporate new information presented<br />
into their current understanding and approach to using gait trainers to increase<br />
activity and participation in natural environments<br />
room e7<br />
Tuesday • May 22 • 9.00–12.00<br />
ginny Paleg<br />
dScPT, MPT, PT<br />
Physiotherapist<br />
Montgomery county infants<br />
and Toddlers,<br />
Maryland, USa<br />
E-mail ginny@paleg.com<br />
Tel: 001-301-452-4656<br />
7
Tuesday • May 22 • 9.00–12.00 rooM e6<br />
Karen M. Kangas<br />
oTR/l<br />
Nationally certified<br />
and State licensed<br />
occu pational therapist<br />
<strong>Seating</strong>, Positioning,<br />
and Mobility Specialist,<br />
assistive Technology<br />
Specialist, clinical<br />
Educator, consultant<br />
Tel: 570-644-1032;<br />
Email: kmkangas@ptd.net<br />
8<br />
Pre-SymPoSium workShoP<br />
Sensory Processing, Sensory<br />
Integration, <strong>Seating</strong> and<br />
Independent Task Engagement<br />
and Performance<br />
SenSory ProceSSing and utilizing sensation in an integrated mode is how the<br />
human body interprets and utilizes postures to support active task engagement or<br />
managing tasks and work.<br />
Without active control and movement and an active relationship with gravity<br />
(vestibular processing), the human body can only move with range of motion,<br />
(tactile processing) lacking power, intention and strength.<br />
<strong>Seating</strong> systems created for skeletal symmetry only can actually prevent task<br />
endurance, and in children, task attention. Symmetry does relax the body, but a<br />
relaxed body cannot work it can only relax. We need seating systems which allow<br />
bodies to work, to gain endurance, and to function within the gravity our planet and<br />
our postures require.<br />
Currently, seating systems are created from an anatomical perspective with the<br />
focus on managing the body’s skeletal system, particularly “controlling” or “aligning”<br />
the spine and pelvis with the same plane, creating the “right” and “optimal” postural<br />
position. When providing seating systems, especially for children, who are growing<br />
and changing, it is vital that seating be created from a neurophysiological perspective.<br />
Learning objectives:<br />
• define the two primary sensory modes of processing: tactile processing and<br />
vestibular processing.<br />
• identify the seating postures of their AT users as to positions of rest and tactile<br />
processing or positions of active engagement or vestibular processing.<br />
• identify seating equipment as to its “postural management” (tactile<br />
processing) vs. “postural control” capabilities (vestibular processing).<br />
• perform a “feature/match” with a comparison and contrast of equipment, both for<br />
“access” and for physical configuration and its features to match the needs and<br />
skills of their children.<br />
• apply and implement assessment and treatment strategies for the the use of AT<br />
equipment including access to AAC, powered mobility and computer use which<br />
will include adequate seating with sensory processing.
Pre-SymPoSium workShoP<br />
Posture management<br />
and clinical assessment<br />
PeoPle with PhySical disabilities may have a reduced ability to align<br />
and stabilize the body against gravity. An asymmetric posture increases<br />
the risk of tissue adaptation and contractures.<br />
This workshop will guide you through a clinical assessment of posture<br />
and postural ability in order to provide appropriate support throughout a<br />
24 hour cycle.<br />
room e5<br />
Tuesday • May 22 • 9.00–12.00<br />
eliSabet rodby<br />
bouSquet<br />
Physiotherapist<br />
E-mail: elisabet.rodby<br />
_bousquet@med.lu.se<br />
department of orthopaedics,<br />
lund University<br />
centre for clinicial research,<br />
Västerås<br />
guðný JónSdóttir<br />
Physiotherapist<br />
Endurhæfing – Rehabilitation<br />
centre of excellence<br />
E-mail: gudny@endurhaefing.is<br />
Tel: +354 4144500<br />
www.endurhaefing.is<br />
atli ÁgúStSSon<br />
Physiotherapist<br />
Endurhæfing - Þekkingarsetur<br />
www.endurhaefing.is<br />
E-mail: atli@endurhaefing.is<br />
9
10<br />
<strong>Symposium</strong> Moderator<br />
Gunilla hammarskiöld is an occupational therapist who has worked in the field of assistive<br />
technology during forty years. She has always had an interest in seating and positioning for<br />
people with disabilities and held many seating courses at the Swedish Institute of Assistive<br />
Technology. In 1995, Gunilla Hammarskiöld and Bengt Andersson initiated “Sitnet Sweden”.<br />
They also arranged the first <strong>Nordic</strong> <strong>Seating</strong> <strong>Symposium</strong> in October 2001, together with the<br />
<strong>Nordic</strong> partners.<br />
Gunilla Hammarskiöld<br />
Occupational Therapist<br />
E-mail: gunilla.hammarskiold@hi.se
Programme tueSday, may 22<br />
room m2<br />
12.00<br />
Registration for the <strong>Nordic</strong> <strong>Seating</strong> <strong>Symposium</strong><br />
13.00<br />
Opening of the <strong>Nordic</strong> <strong>Seating</strong> <strong>Symposium</strong><br />
Jan Grönlund, Director, Swedish Institute of Assistive Technology, SIAT<br />
A CP good life<br />
Jonas Helgesson, Author, Sweden<br />
Sensory Processing, Sensory Integration, <strong>Seating</strong> and Access,<br />
an Introduction<br />
Karen M. Kangas, Occupational Therapist, USA<br />
15.15<br />
Coffee, exhibition and show<br />
16.00<br />
Windsurfing for all– Increasing participation and accessibility through<br />
equipment modification<br />
Kati Karinharju, Senior Lecturer Satakunta University of applied sciences<br />
17.00<br />
Closure<br />
<strong>5th</strong> nordic <strong>Seating</strong> SymPoSium<br />
11
Tuesday • May 22 room m2<br />
JonaS helgeSSon<br />
author, Sweden<br />
E-mail: info@jonas<br />
helgesson.se<br />
www.jonashelgesson.se<br />
12<br />
A CP good life<br />
JonaS iS 33 years old and speaks about his life with cerebral palsy. What is it<br />
like to be treated as different? How can the right attitude help to live life to<br />
the fullest? Why is respect better than kindness? Jonas speaks personally<br />
and with great sens of humor. He is a popular speaker in Sweden and author<br />
of two books about his life.
Sensory Processing, Sensory<br />
Integration, <strong>Seating</strong> and Access<br />
an Introduction<br />
SenSory ProceSSing controls visual convergence, focus, attention, postural<br />
control and isolated, graded movement. Its subsequent sensory integration must<br />
be supported within the structural components of seating systems, if we intend<br />
to provide seating for task engagement. The support of movement, not simply<br />
skeletal symmetry must be provided in seating systems.<br />
Sensory processing is how the body interprets and uses its relationship to<br />
gravity to support task involvement. <strong>Seating</strong> systems have focused on skeletal<br />
symmetry, which does not support independent functioning.<br />
To assist these children in wheelchairs in developing and using “access” to<br />
AT devices, we must also better understand how their bodies work functionally,<br />
(rather than pathologically) and what different seating equipment is needed.<br />
I will share strategies and equipment which work and which provide children<br />
opportunities to use their sensory processing so that increased, consistent access<br />
to AT can be supported and become efficient.<br />
room m2 Tuesday • May 22<br />
Karen M. Kangas<br />
oTR/l<br />
Nationally certified<br />
and State licensed<br />
occu pational therapist<br />
<strong>Seating</strong>, Positioning,<br />
and Mobility Specialist,<br />
assistive Technology<br />
Specialist, clinical<br />
Educator, consultant<br />
Tel: 570-644-1032;<br />
Email: kmkangas@ptd.net<br />
13
Tuesday • May 22<br />
kati karinharJu<br />
Senior lecturer, MSc<br />
Satakunta University of<br />
applied Scienses, ltd<br />
faculty of Social Services<br />
and Health care Pori,<br />
finland<br />
Mobile: +35844 710 3868<br />
Email: kati.karinharju<br />
@samk.fi<br />
14<br />
room m2<br />
Windsurfing for all<br />
Increasing participation and accessibility<br />
through equipment modification<br />
the SataeSteetön project responds to the needs of a society and supports<br />
everyone to have an independent and unrestricted life in every stage of their life.<br />
Yyteri for all was part of this project and its objective was to examine and<br />
develop accessibility and increase participation in the area of the Yyteri beach<br />
in Pori, Finland. This research presents the ways of developing wind surfing<br />
suitable for persons surfing in the seated position.<br />
Adapted windsurfing pilot courses were organized on summer 2010 and 2011<br />
at the Yyteri Surfcentre. The purpose of these pilot courses was to create and<br />
modify appropriate equipment for surfing in a seated position and to test these<br />
modifications for wheelchair users. Equipment modifications are necessary<br />
when surfing in the seated position. These modifications increase the opportunities<br />
of physical activity for people with disability.<br />
Moreover, this presentation shares ideas of different adapted summer and<br />
winter activities and modifications created during the project.
15<br />
bEacHy/flickR
<strong>5th</strong> nordic <strong>Seating</strong> SymPoSium<br />
16<br />
Programme wedneSday, may 23<br />
room m2 max 600 room m1 max 400<br />
9.00<br />
The effect of a shaped wheelchair cushion<br />
and a detachable lumbar support<br />
Anna-Karin Hansson<br />
Effect of a Dynamic <strong>Seating</strong> Surface<br />
Erna Rosenlund Meyer and Lisa Trew<br />
10.00<br />
Coffee, exhibition and show<br />
10.45<br />
Relationship between “tilt in space” wheelchair<br />
function and risk of pressure ulcer development<br />
Christian Gammelgaard Olesen<br />
Evaluation of the suitability in which anti -<br />
de cubitus cushions meet defined user needs<br />
Gunn Limandvik<br />
12.00<br />
Lunch<br />
13.00<br />
Sit as you are, drive as you can<br />
Elin Berg<br />
Use of manual and powered wheelchair in<br />
children with cerebral palsy<br />
Elisabet Rodby Bousquet<br />
Powered mobility practice-A gate to<br />
tool use learning<br />
Lisbeth Nilsson<br />
15.00<br />
Coffee<br />
15.45<br />
Accurate seating measures and size of<br />
wheelchair optimizing function in everyday life<br />
Lotte Wemmenborn<br />
17.00<br />
Closure<br />
9.00<br />
”Sid godt” – oplysningsmateriale fra<br />
Hjælpemiddelinstituttet i Danmark<br />
Else-Marie Hansen<br />
Får du formidlet dine budskaber,<br />
så de forstås af modtagerne?<br />
Conni Schmidt<br />
10.00<br />
Coffee, exhibition and show<br />
10.45<br />
Sitt och ryggstödets inverkan på äldre<br />
personers sittande i rullstol<br />
Marina Timm<br />
Hur äldre rullstolsanvändares drivteknik<br />
påverkar sittpositionen och vice verca<br />
Maria Amnell<br />
12.00<br />
Lunch<br />
13.00<br />
Är rullstolskörande med viss abduktion i höften<br />
möjligt och önskvärt för barn med cerebral pares<br />
Eva Jönsson och Karin Thews<br />
Sittande hos barn med funktionsned sättning<br />
som får korrigerande korsett<br />
Annika Blomkvist och Kristina Olsson<br />
Siddestillningnsanalyse og rehabilitering<br />
Mette Hornbäck Söderberg<br />
15.00<br />
Coffee<br />
15.45<br />
Spasticitet, påverkar det sittandet?<br />
Britt-Marie Rydh Berner<br />
Exhibition and activities at Hjultorget<br />
17.00<br />
Closure
Programme wedneSday, may 23<br />
room e4 max 200 room e8 max 120<br />
9.00<br />
Evaluation of a Clinical assessment tool<br />
for posture and postural ability<br />
Elisabet Rodby Bousquet<br />
Supine lying support<br />
Atli Agustsson<br />
10.00<br />
Coffee, exhibition and show<br />
10.45<br />
Developing an elearning Module for<br />
Allied Health Professionals:<br />
benefits, problems and reflections<br />
Paul Hewett and Jo Jex<br />
A tool to find the appropriate assistive product<br />
Mary Petersen<br />
12.00<br />
Lunch<br />
13.00<br />
Clinical uses / appropriate uses of secondary<br />
positioning systems<br />
Bart Van der Heyden<br />
On an equal footing: “Adults accounts of the<br />
experience of using assistive devices for standing”<br />
Birgitta Nordström<br />
Landing in the chair from a standing hoist<br />
Mary Petersen<br />
15.00<br />
Coffee<br />
15.45<br />
Sitting on a horse make a change in life<br />
Charlotte von Arbin, Margareta Håkanson, Ulrika<br />
Stengard Olsson, Pia Tillberg<br />
17.00<br />
Closure<br />
9.00<br />
<strong>Seating</strong> Interventions for Users with<br />
Amyotrophic Lateral Sclerosis (ALS)<br />
Bart Van der Heyden and Anni Bank Agger<br />
10.00<br />
Coffee, exhibition and show<br />
10.45<br />
Sit properly! Experiences in use of seat<br />
cushions for children and adolescents<br />
with sensory integration dysfunction<br />
Lotte Wemmenborn<br />
Adaptive seating in work rehabilitation<br />
Karen Lyng<br />
12.00<br />
Lunch<br />
13.00<br />
Influences on the Seated Position<br />
Menno van Etten<br />
Exhibition and activities at Hjultorget<br />
15.00<br />
Coffee<br />
15.45<br />
Clinical practice project from Norway<br />
Kari Borgen, Henriette A. Sjølett,<br />
Britt Tornes and Rikke Damkjær Moen<br />
17.00<br />
Closure<br />
<strong>5th</strong> nordic <strong>Seating</strong> SymPoSium<br />
17
wednesday • May 23<br />
anna-karin hanSSon<br />
Physiotherapist<br />
Sjukgymnastiken<br />
rehabiliteringsmedicinska<br />
kliniken, Universtitets<br />
sjukhuset i lindköping<br />
Tel: 013-22 15 48<br />
E-mail: anna-karin.hansson<br />
@lio.se<br />
18<br />
room m2 TARGET GROUP: ALL<br />
The effect of a shaped wheelchair<br />
cushion and a detachable lumbar<br />
support<br />
on underseat pressure, estimated comfort,<br />
and pelvic rotation<br />
in order to optimize independence for clients with seating and mobility needs it<br />
is most important to get a wheelchair individually fitted and adjusted. We know<br />
that load on the spine will increase with a kyphotic or scoliotic posture and that<br />
a deformity might reduce lung function, cardiovascular function as well as<br />
ROM in the upper extremities. As therapists, one responsibility is to optimize an<br />
assistive device with the objective to prevent future complications.<br />
A shaped wheelchair cushion is often used to support a neutral pelvic tilt,<br />
together with a lumbar support this might be the best way to give the client a<br />
good support but what about comfort?<br />
Learning Objectives:<br />
• Be able to identify relevant seating outcome variables.<br />
• Be able to understand the connections between pelvic rotation and under-seat<br />
pressure.<br />
• Be able to identify the importance of assessing; posture, pressure and comfort<br />
and how to prioritize among those when necessary.
Effect of a Dynamic<br />
<strong>Seating</strong> Surface<br />
TARGET GROUP: ALL room m2<br />
Postural Control, Function and Activity in Children<br />
and Young people with Cerebral Palsy Experiences<br />
gained and lessons learned using SPCM, pressure<br />
mapping, videography and AMPS<br />
develoPing <strong>Seating</strong> systems for disabled persons is of great importance as they<br />
can be used to increase levels of postural control and function which will have<br />
an impact on daily activities and participation. This study takes its start point in a<br />
seat back and base made of a dynamic material and analyzing changes in postural<br />
control.<br />
The purpose of the study was to investigate if a new dynamic seating surface<br />
improves postural control, function and activity in youths and children with<br />
cerebral palsy. No significant statistical results were gained from the quantitative<br />
methods used: Seated Postural Control measure (SPCM), Force Sensitive Application<br />
System (FSA) and Assessment of Motor and Process Skills (AMPS) though<br />
there was slight increase in mean pressure distribution. A supplementary subjective<br />
evaluation of movement quality showed no clear trend.<br />
Especially the consequences of adapting the Seated Postural Control Measure<br />
(SPCM) had our interest. SPCM is described as being able to compare seating systems.<br />
Our experiences in modifying the measure, use of videography, body markers and<br />
computer software goniometry for scoring presented various challenges, giving rise<br />
to questions about SPCM, the seating system tested and the relevance of experience<br />
and training. We believe our study comprises important areas of interest, especially<br />
in SPCM development, adaptive seating, and future studies using videography.<br />
Learning Objectives:<br />
• A new dynamic seat base and back surface, being tested for use in adaptive<br />
seating systems and studies associated with this system.<br />
• Challenges associated with the use of alternative methods for clinical assessment<br />
using a modified Seated Postural Control Measure: how videography, computer<br />
software and pressure mapping for can be or not be beneficial.<br />
• Experiences during testing and ideas for use in further studies.<br />
wednesday • May 23<br />
erna roSenlund<br />
meyer<br />
Senior lecurer, MSc, PT<br />
University collegue of<br />
Northen denmark<br />
www.ucnorth.dk<br />
E-mail: erm@ucn.dk<br />
Tel: +4572690954<br />
liSa m trew<br />
Physiotherapist<br />
E-mail: lisa.trew@gmail.com<br />
Tel: +45 29493122<br />
19
wednesday • May 23 room m2 TARGET GROUP: ALL<br />
chriStian<br />
gammelgaard oleSen<br />
assistant Professor<br />
The anybody Group,<br />
department of Mechanical<br />
and Manufacturing<br />
Engineering,<br />
aalborg University,<br />
denmark<br />
E-mail: cgo@m-tech.aau.dk<br />
Tel: +45 9940 3355<br />
Mob: +45 3033 4553<br />
20<br />
Relationship Between<br />
“Tilt in Space” Wheelchair<br />
Function and Risk of Pressure<br />
Ulcer Development<br />
it iS well acknowledged that sustained mechanical loading of soft tissues causes<br />
pressure ulcers.The wheelchair adjustments affect the tissue loading in the sense<br />
that the tissue stresses, and thereby the risk of ulceration, change when the<br />
seated posture is adapted. This study focuses on a basic wheelchair adjustment<br />
called the “TiltinSpace” function, which many wheelchairs are equipped with.<br />
The tiltinspace function enables the cushion and backrest to incline while the<br />
angle between the cushion and backrest is kept constant. When the tiltinspace<br />
function is used, the cushion and the backrest reaction forces change, which<br />
causes a change in tissue deformation under the buttocks.<br />
Preliminary results show that the reaction forces between the seat and the<br />
buttocks change, and this leads to a change in buttocks tissue deformation.<br />
The results indicate that the “TiltinSpace” function found on many wheelchairs<br />
is not optimal, with respect to risk of developing pressure ulcers.<br />
Learning objectives:<br />
• Engineering perspective on wheelchair development with PU focus.
Evaluation of the suitability in<br />
which antidecubitus cushions<br />
meet defined user needs<br />
Comparison of the vendors and the Norwegian<br />
Labour and Welfare service (NAV)’s evaluation<br />
of antidecubitus cushions<br />
nav haS recently awarded contracts for antidecubitus cushions after an open<br />
tender procedure. NAV’s tender notice described the different user needs the<br />
cushions should meet and the award criteria was “How well suited are the<br />
cushions to meet the described user needs?”<br />
We will show the types of cushions that were offered to meet different user<br />
needs, how vendors described the cushion and it’s suitability to meet the user<br />
needs and NAV’s assessment of the same. NAV’s team assessed the actual<br />
cushion, and compared it to the vendor’s description of its suitability to meet<br />
the described needs.<br />
The vendor’s description of the coverage of user needs was usually consistent<br />
with the cushions appearance and properties. In some cases, the NAV team<br />
disagreed with the vendor’s description and decided to make an independent<br />
assessment. We will demonstrate examples of how the NAV team and vendors<br />
evaluated the cushions differently and which features NAV consider are<br />
necessary to meet the user requirements.<br />
The lecture is the result of a cooperation between the team members but will be<br />
presented by a single member of the team.<br />
Learning objectives:<br />
• Examples of how you may be able to find out if the descriptions of the cushions<br />
correspond to how they appear.<br />
• Examples on which qualities we found were most important to meet<br />
the user needs.<br />
TARGET GROUP: ALL room m2 wednesday • May 23<br />
gunn limandvik<br />
Senior adviser/o.T.<br />
The Norwegian labour<br />
and Welfare service (NaV)<br />
E-mail: Gunn.limandvik@<br />
nav.no<br />
Tel: 22 07 09 64<br />
Mob: 909 61 998<br />
www.nav.no<br />
Solveig baardSgaard<br />
Head of section/nurse<br />
NaV centre for Sssistive<br />
technology Nordland<br />
E-mail:Solveig.<br />
baardsgaard@nav.no<br />
Tel: 75 42 67 00<br />
www.nav.no<br />
kari-anne lorentzen<br />
Senior adviser/o.T.<br />
NaV centre for Sssistive<br />
technology Møre og Romsdal<br />
Tel: 70 32 19 50<br />
www.nav.no<br />
21
wednesday • May 23 room m2 TARGET GROUP: ALL<br />
elin berg<br />
occupational therapist<br />
The Norwegian labour<br />
and Welfare Service (NaV)<br />
E-mail: Elin.berg2@nav.no<br />
Tel: +47 41575135,<br />
+47 21069944<br />
unni norheim<br />
Seniorrådgiver/ergoterapeut<br />
NaV (arbeids og<br />
Velferdsetaten)<br />
E-mail: unni.norheim<br />
@nav.no<br />
Tel: +47 21069700,<br />
+47 21069942<br />
Mobil: +47 917 62 403<br />
22<br />
Sit as you are, drive as you can<br />
About seating positioning in an dynamic activity<br />
where safety comes first<br />
Introduction:<br />
This is a presentation from practise, and we invite the participants of this lecture<br />
to join the discussion of what we see and observe in the videos from driving<br />
situations. We are working and cooperating with people with complex disabilities<br />
who are driving their own car from an adapted carseat or from their own<br />
wheelchair. They all have that in common that they have a serious degree of<br />
physical handicap and an adapted seating position. Driving demands up and<br />
downhill affection, breaking and accelerating characteristic, road structure<br />
and topographic curves are all aspects which are affecting the seating position,<br />
and therefore the quality of driving a car. We have observed different sitting<br />
positions and the consequences of lack of support when it comes to driving.<br />
For the <strong>Seating</strong> symposium we would like to systematize our findings to share<br />
our experiences with other clinical workers.<br />
Background:<br />
In our daily work we choose and recommend advanced driving equipment for<br />
persons with complex and serious degree of disabilities. The work is most often<br />
based upon very well prepared seating postures. Our work is based on evidence,<br />
experience and clinical reasoning and within both medicine and Assistive<br />
Technology.<br />
Conclusions:<br />
There is no science on this matter and we do not conclude in this presentation.<br />
The videos speak for themselves. Can we learn something about positioning by<br />
studying the driving activity? The other way around: We have learned about<br />
adaptation advice for advanced driving equipment by studying the driving<br />
activity and the videos we here present
Use of manual and powered<br />
wheelchair in children with<br />
cerebral palsy<br />
TARGET GROUP: ALL room m2<br />
mobility iS important for the cognitive and psychosocial development of children.<br />
Almost one third of children with cerebral palsy (CP) are nonambulant.<br />
Wheelchairs can provide independent mobility, allowing them to explore their<br />
environment. Independent mobility is vital for activity and participation and<br />
reduces the dependence on caregivers. The purpose of this study was to describe<br />
the use of manual and powered wheelchair indoors and outdoors in relation to<br />
the degree of independent wheelchair mobility or need for assistance in a total<br />
population of children with CP.<br />
A cross-sectional study was performed including all 562 children aged 3-18 years<br />
with CP living in southern Sweden during 2008. Data was extracted from a register<br />
and national health care programme for children with CP (CPUP). Information<br />
on the child’s use of manual and powered wheelchair indoors and outdoors<br />
and the performance in selfpropelling or need for assistance were analysed.<br />
Of these children, 29% used a wheelchair indoors and 41% outdoors. A majority<br />
using manual wheelchairs needed adult assistance (86%) while powered wheelchairs<br />
provided independent mobility in most cases (86%). To achieve a high<br />
level of independent mobility, both manual and powered wheelchairs should be<br />
considered at an early age for children with impaired walking ability.<br />
wednesday • May 23<br />
eliSabet rodby<br />
bouSquet<br />
Physiotherapist<br />
E-mail: elisabet.rodby<br />
_bousquet@med.lu.se<br />
department of orthopaedics,<br />
lund University<br />
centre for clinicial<br />
research, Västerås<br />
gunnar hägglund<br />
department of orthopaedics,<br />
lund University<br />
23
wednesday • May 23 room m2 TARGET GROUP: ALL<br />
liSbeth nilSSon<br />
Phd, specialist in<br />
occupational Therapy<br />
associated to lund University<br />
barn- och ungdoms -<br />
habiliteringen,<br />
Gällivare sjukhus<br />
E-mail: lisbeth.nilsson<br />
@med.lu.se<br />
lisbeth.nilsson@kiruna.nu<br />
Tel: +46 705838596<br />
www.lisbethnilsson.se<br />
24<br />
Powered mobility practice<br />
A gate to tool use learning<br />
Practice in a powered wheelchair may have effects other than independent<br />
mobility. These effects may be essential for people with cognitive disabilities,<br />
a population frequently excluded from access to powered mobility.<br />
The research project Driving to Learn focused on what could be achieved if<br />
children and adults with profound cognitive disabilities got access to practice<br />
in a joystickoperated powered wheelchair. The project engaged a total of 126<br />
participants: 45 with profound cognitive disabilities, 64 with milder degrees of<br />
cognitive disabilities and 17 infants with typical development.<br />
The findings involved: development of a one-for-all powered wheelchair for<br />
practice; identification of an eight-phase process of learning joystick-use;<br />
identification of strategies facilitating learning powered mobility use; a tool for<br />
assessment of phase in the process; and a grounded theory of de-plateauing.<br />
Eight of the 45 participants with profound cognitive disabilities reached control<br />
of steering and 33 reached control of onset of movement.<br />
Focus for this session: important characteristics of the one-for-all powered<br />
wheelchair for practice; how seating characteristics influence on activity;<br />
general effects of practice other than independent mobility; and necessary<br />
properties for deplateauing.
TARGET GROUP: ALL room m2<br />
Accurate seating measures and<br />
size of wheelchair optimizing<br />
function in everyday life<br />
a workShoP on measuring body size with a proper technique and choosing<br />
the right sized wheelchair, which is basic knowledge but not as simple and<br />
obvious as you would wish. If the wheelchair is poorly adapted in size it affects<br />
comfort, body control and activity level. Reduced stability and balance affects<br />
head control and function in upper limb. There will be an increased risk for<br />
developing pressure ulcer in the improperly fitted wheelchair. Concentration,<br />
stamina and communication are other affected body functions.<br />
The workshop will share examples on how patients with various sitting ability<br />
have different effect from an improperly sized wheelchair. It highlights some<br />
issues told by both experienced and novice prescribers: how to measure safely<br />
and correctly, how much space you should calculate for clothes, how much you<br />
should press soft tissue around the hips, how the pelvic position affects the<br />
depth of seat. Different measuring techniques will be shown.<br />
Learning objectives:<br />
• Identify the most important body measures for choosing a wheelchair in<br />
optimum size.<br />
• Identify level of sitting ability and relate to choice of wheelchair model.<br />
• Techniques of measuring body size.<br />
• Describe the risks with an incorrect size of wheelchair.<br />
wednesday • May 23<br />
lotte wemmenborn<br />
leg sjukgymnast/<br />
Physio therapist<br />
fysionord ab<br />
E-mail: lotte@fysionord.se<br />
Tel: +46 (0)730- 32 92 99<br />
www.fysionord.se<br />
25
wednesday • May 23 room m1 TARGET GROUP: ALL<br />
elSe marie hanSen<br />
konsulent, ergoterapeut,<br />
MPk<br />
Hjælpemiddelinstituttet/<br />
Socialstyrelsen<br />
E-post:emh@hmi.dk<br />
www.hmi.dk<br />
http://www.hmi.dk/sidgodt<br />
= Sid godt (på dansk)<br />
http://www.hmi.dk/<br />
page2581.aspx = Sitt bra<br />
(svenska)<br />
26<br />
Sid godt – Har du tjekket<br />
kørestolen og siddestillingen<br />
i dag?<br />
Informationsmateriale om siddestillinger<br />
rigtig mange menneSker i samfundet har brug for viden om, hvordan ældre<br />
kørestolsbrugere skal sidde i deres kørestole for at opnå størst mulig funktionalitet<br />
og forebygge, at der opstår skader på deres kroppe. Men typisk er det<br />
eksperterne, der har den viden, og som bliver tilkaldt, når noget er gået meget<br />
galt. Det behøver dog ikke at være sådan, for meget viden kan kanaliseres ud til<br />
brugere, deres hjælpere og plejepersonalet, så mange flere kan være med til at<br />
forbedre de ældre menneskers funktion i deres kørestole.<br />
For at udbrede kendskabet til emnet, har Hjælpemiddelinstituttet i Danmark<br />
udarbejdet et informationsmateriale. Materialet består bl.a. af to plakater<br />
– ”Sid godt! Har du tjekket kørestolen i dag?” henvender sig især til brugere og<br />
pårørende, mens plakaten ”Sid godt! Har du tjekket siddestillingen i dag?”<br />
henvender sig til sygeplejesker og plejepersonale. Til brug for intern undervisning<br />
på fx plejehjemmet findes et slideshow med en uddybende og lettilgængelig<br />
beskrivelse af emnet. Det enkelte slide suppleres af teoribaserede<br />
forklaringer, som den kørestolsansvarlige terapeut på plejehjemmet kan bruge<br />
i undervisningssituationen. Dette oplæg vil dels beskrive, hvordan materialet<br />
blev skabt og dels præsentere det for deltagerne på Nordisk Siddesymposium<br />
Learning objectives:<br />
• Hvordan man kan fremstille et materiale, der er teoribaseret og mål rettet til<br />
at løse en bestemt problematik.<br />
• Hvordan materialet konkret kan bruges til at forbedre ældre menneskers<br />
siddestillinger i kørestole.
TARGET GROUP: ALL room m1<br />
Får du formidlet dine budskaber<br />
så de forstås af modtagerne?<br />
Overvejelser og tiltag i forhold til formidling af<br />
siddestillingsanalysens resultater<br />
en SiddeStillingSanalySe kan betragtes som en del af en Rehabiliteringsproces,<br />
der kendetegnes ved at være en tidsbestemt samarbejdsproces mellem borger,<br />
pårørende og forskellige aktører. Udbyttet af en siddestillingsanalyse er fuldstændig<br />
afhængig af hvordan samarbejdet mellem de forskellige aktører fungerer,<br />
og hvor godt det lykkes at få implementeret de foreslåede tiltag i borgerens<br />
hverdag.<br />
En meget vigtig aktør i siddestillingssager er borgerens hjælpere. Fra egen praksis<br />
oplever jeg, at selvom der er givet en instruktion i anvendelsen af kørestol o<br />
g tilbehør, ser vi ofte, at tilpasningerne på kørestolen ikke bruges hensigtsmæssigt,<br />
og at borgeren er placeret forkert i den specialtilrettede kørestol. Ergo og<br />
fysioterapeuter bør således overveje, om der er brug for en mere systematisk<br />
tilgang, når hjælpere omkring borgeren skal undervises, for at sikre at alle<br />
– uanset uddannelse forstår de foreslåede tiltag og kan anvende dem i praksis.<br />
Learning Objectives:<br />
• I mit oplæg vil jeg med udgangspunkt i en konkret siddestillingsanalyse<br />
fortælle om overvejelser i forhold til implementering af siddestillingsanalysens<br />
resultater.<br />
• Overvejelserne omfatter bl.a. et eksempel på en arbejdsmodel, der kan anvendes,<br />
når borger og hjælpere skal undervises i brugen af hjælpemidlet.<br />
wednesday • May 23<br />
conni Schmidt<br />
fysioterapeut<br />
center for <strong>Hjælpemidler</strong><br />
og kommunikation i<br />
Sønderjylland<br />
E-post: cs.chk@<br />
aabenraa.dk<br />
www.chksyd.dk<br />
27
wednesday • May 23 room m1 TARGET GROUP: ALL<br />
marina timm<br />
legitimerad arbetsterapeut/<br />
hjälpmedelskonsulent<br />
Hjälpmedelscentralen<br />
Västra Götalandsregionen/<br />
Skövde<br />
Tel. 0500-499109<br />
E-post: marina.timm@<br />
vgregion.se<br />
www.vgregion.se/hmf<br />
28<br />
Sitt och ryggstödets inverkan på<br />
äldre personers sittande i rullstol<br />
antalet äldre har under de senaste årtiondena mer än fördubblats. Till åldrandet<br />
hör en rad kroppsliga förändringar så som att lungfunktion och hudens egenskaper<br />
förändras. För många äldre ökar bröstkyfosen vilket i sin tur innebär en<br />
ökad risk för nedsatt lungfunktion. Studier visar att en ”dålig” sittposition i<br />
rullstol ökar risken för felställningar, ryggsmärtor, trycksår, nedsatt lungfunktion<br />
och cirkulation. Rullstolens sittenhet och därmed bäckenets position, har sannolikt<br />
en stor inverkan på hur dessa komplikationer uppkommer.<br />
Under hösten 2011 genomfördes en studie på friska äldre män och kvinnor i<br />
åldrarna 67–85 år (n=40).<br />
Syftet med studien var att studera hur friska äldre individer påverkades av en<br />
manuell rullstols sitt och ryggstöd avseende tryck, bäckenrotation, lungfunktion<br />
samt upplevd sittkomfort. Två manuella rullstolsfabrikat tillsammans med<br />
tre olika rullstolsdynor utgjorde fyra rullstolsuppställningar. Datainsamlingen<br />
skedde med hjälp av tryckmatta (FSA) bäckenrotationsmätare, Micro-spirometri<br />
samt frågeformulär om upplevd sittkomfort på varje rullstolsuppställning.<br />
Resultatet av mätningarna visade på signifikanta skillnader både vad gäller<br />
maxtryck och bäckenrotation. Inga signifikanta skillnader kunde uppmätas vad<br />
gäller vitalkapacitet (VC) eller forcerad expiratorisk volym (FEV) i någon av de<br />
testade rullstolsuppställningarna. Däremot kunde vissa tendenser ses till minskad<br />
lungvolym.
Att sitta rätt och rulla lätt<br />
TARGET GROUP: ALL room m1<br />
Hur äldre rullstolsanvändares framdrivningsteknik<br />
påverkar sittpositionen och vice versa<br />
en rullStol är ett rullande förflyttningshjälpmedel och ska ställas in för bästa<br />
möjliga sittposition och aktivet vilket innefattar förflyttning. Är rullstolen<br />
inte individuellt optimerad för framdrivningen, kommer det att påverka sittpositionen<br />
negativt.<br />
En äldre person har inte samma förutsättningar vad gäller aktivt sittande och<br />
framdrivning som en yngre rullstolsburen person. Avståndet skuldra – hand på<br />
drivring, räckvidd, grepp om drivring, och för fotframdrivning; stegisättning<br />
och steglängd är några exempel på parametrar som man måste tas hänsyn till.<br />
Men det räcker inte med rätt inställningar, framdrivningstekniken måste tränas.<br />
Att börja använda rullstol är omvälvande i sig. Att få möjlighet till träning gör att<br />
rullstolsanvändaren känner sig tryggare. Att göra en rullstolsutprovning ställer<br />
höga krav på våra analytiska och tekniska kunskaper samt att kunna omsätta<br />
dem i praktiken. Hur bra är du på att köra rullstol?<br />
Föreläsningen behandlar följande:<br />
• Äldre personers rörelsemönster<br />
• Nödvändiga rullstolsinställningar<br />
• Anpassning för handframdrivning<br />
• Anpassning för fotframdrivning<br />
• Körteknik<br />
wednesday • May 23<br />
maria amnell<br />
leg arbetsterapeut och<br />
utbildningsledare på Etac<br />
E-post:<br />
maria.amnell@etac.se<br />
www.etac.se<br />
29
wednesday • May 23 room m1 TARGET GROUP: ALL<br />
karin thewS<br />
Physiotherapist MSc<br />
Tel: 0704 837873<br />
E-post: karin@thews.se<br />
eva JönSSon<br />
occupational therapist<br />
karolinska universitetssjukhuset<br />
Tel: 08-517 77531<br />
E-post: eva.b.jonsson<br />
@karolinska.se<br />
30<br />
Är rullstolskörande med<br />
viss abduktion i höften möjligt<br />
och önskvärt för barn med<br />
cerebral pares?<br />
barn med cerebral PareS (CP) har ofta ökad muskeltonus i vissa muskelgrupper.<br />
Det kan t.ex. innebära att benen förs ihop och korsas både då man ligger, sitter,<br />
står och går med försämrad motorisk funktion som resultat. Med tiden kan detta<br />
också leda till ökad migration i höften och risk för höftluxation.<br />
I sjukvården och habiliteringen arbetar man aktivt för att öka/bibehålla motorisk<br />
funktion och om möjligt förhindra höftluxation. Regelbunden klinisk<br />
undersökning utförs av sjukgymnast och arbetsterapeut. Höftröntgen utförs<br />
också enligt program (www.cpup.se).<br />
I behandlingen av barnen strävar man efter att hålla en god höftrörlighet,<br />
bland annat god abduktion för att minska risken för ökad migration i höften.<br />
God abduktion i sittande ger också större understödsyta och därigenom kan<br />
arnet få bättre balans och motorisk funktion.<br />
Vi tror att man skulle kunna arbeta mer med hur barnet sitter i sin vardag. Vi ser<br />
ofta barn sitta i rullstolar där möjlighet till abduktion inte finns. Förklaringen<br />
till det är att rullstolar som barn kan köra själva är konstruerade så att de är lätta<br />
att köra, men alltför trånga i sitsen vilket gör att man sitter tätt ihop med benen.<br />
Presentationen kommer att visa resultat av intervjuer med professionella inom<br />
området och slutsatser från litteratursökning.
Sittande hos barn med<br />
funktionsnedsättning och<br />
korsettbehandlad skolios<br />
TARGET GROUP: ALL room m1<br />
SkolioS är vanligt förekommande hos barn som saknar gångförmåga. I Västra<br />
Götalandsregionen är korrigerande korsett av typ modifierad Bostonkorsett<br />
en vanlig behandlingsform för barn med skolios och neurologisk funktionsnedsättning.<br />
Under inprovningen undersöks hur sittförmågan påverkas av<br />
korsetten. Systematiserad tryckregistrering på bänk ingår i analysen.<br />
Studien genomfördes som en retrospektiv granskning av journaler hos 122 barn<br />
som provat in korrigerande korsett.<br />
Syftet var att beskriva hur sittförmågan påverkas av korrigerande korsett och<br />
identifiera för vilka grupper sittandet förbättras.<br />
Studien visar att korsett har en positiv inverkan på sittfunktion. Störst effekt<br />
syns hos barn som inte kan sitta utan stöd, de som har grav skolios och de som<br />
inte är gångare. Barn med CP påverkades mer positivt än barn med MMC.<br />
Klinisk betydelse: Med korsett minskar behovet av stöd i sittande och ett<br />
mer upprätt sittande med förbättrad huvudkontroll ökar möjligheten till<br />
delaktighet. Tryckregistrering vid sittanalys kan identifiera behov av<br />
åtgärder som korrigering av stol eller korsett. Motivationen hos barn och<br />
familj att använda korsett och förståelsen för anpassningar ökas.<br />
wednesday • May 23<br />
annika blomkviSt<br />
leg sjukgymnast<br />
E-post: annika.blomkvist<br />
@vgregion.se<br />
kriStina olSSon<br />
leg arbetsterapeut<br />
E-post: kristina.l.olsson<br />
@vgregion.se<br />
31
wednesday • May 23 room m1 TARGET GROUP: ALL<br />
mette hornbæk<br />
Söderberg<br />
Ergoterapeut<br />
center for kommunikation<br />
og <strong>Hjælpemidler</strong><br />
E-post: Mette.soderberg<br />
@soc.regionsyddanmark.dk<br />
Tlf: 79436060<br />
direkte 79436022<br />
www.ckhm.dk<br />
32<br />
Siddestillingsanalyse<br />
og Rehabilitering<br />
mange årS PraktiSk erfaring har lært os, at det er vigtigt med rehabilitering i<br />
vores specialrådgivning indenfor siddestillingsområdet. Vi har på Center for<br />
Kommunikation og <strong>Hjælpemidler</strong> i Vejle set, at det er afgørende for et godt<br />
resultat, at rehabiliteringen når hele vejen rundt om personen samt de aspekter,<br />
der er tilknyttet siddestillingen. Man må i den enkelte sag vurdere, hvilke<br />
fagfolk og specialister, der skal inddrages.<br />
Jeg vil i korte træk gennemgå, hvordan vi arbejder med rehabiliteringstanken i<br />
vores siddestillingssager, og jeg kommer ind på hvilke udfordringer, vi oplever.<br />
Via case-eksempler vil jeg belyse, hvordan vi konkret har grebet det an i den<br />
enkelte sag.<br />
Formålet med vores oplæg er:<br />
• at få fokus på rehabiliterings-tanken i siddestillingssager.<br />
• at gennemgå, hvilke aspekter man skal ind omkring for at komme i mål med<br />
et godt og helhedsorienteret resultat, således at siddestillingen fungerer i<br />
hverdagen.<br />
• at belyse vores metode, og hvilke udfordringer, som vi har. Dette via case<br />
eksempler.
33<br />
Rick mccHaRlES/flickR
wednesday • May 23 room m1 TARGET GROUP: ALL<br />
britt-marie rydh<br />
berner<br />
leg. Sjukgymnast<br />
Tonusmottagningen R61<br />
Rehabiliteringsmedicinska<br />
Universitetskliniken<br />
Stockholm danderyds Sjukhus<br />
ab<br />
karolinska Universitetssjukhuset<br />
Huddinge<br />
Tel: 08 585 822 02<br />
Tel: 073 917 97 03<br />
britt-marie.rydh-berner<br />
@ds.se<br />
34<br />
Spasticitet, påverkar<br />
det sittandet?<br />
SPaSticitet är en mycket komplex problematik som påverkar det mesta i en<br />
persons vardag. Många diagnosgrupper har denna problematik och dessa kan<br />
för oss behandlare förefalla mycket olika. Men då det gäller tonusökningen och<br />
spasticiteten finns det vissa gemensamma nämnare.<br />
Så är det till exempel då det gäller spasticitet och sittproblematik. Finns det en<br />
spasticitet av betydelse så kan man vara säker på att den påverkar sittandet.<br />
Det som händer i kroppen vid spasticitet är ju bland annat att det blir en obalans<br />
mellan muskelgrupper. Sträckare respektive böjare kan ta överhand i både<br />
armar och ben. En viktig del av vår kropp att få grepp om då det gäller sittandet<br />
är bäckenet och kring detta finns det ett otal muskelgrupper som kan påverkas<br />
av spasticitet. Till detta kommer ofta en skolios som även den kan ha uppstått ur<br />
samma problematik.<br />
På vår mottagning – Tonusmottagningen tittar vi på spasticitet och hur den<br />
påverkar personer i vardagen. Där den ställer till med för mycket bekymmer kan<br />
vi hjälpa till på flera olika sätt för att minska den.
Evaluation of a Clinical<br />
assessment tool for posture<br />
and postural ability<br />
TARGET GROUP:ALL room e4<br />
there are Several professions working with the assessment for, and prescription<br />
of, equipment to support people with severe disabilities in sitting, standing<br />
and lying. There is a need for a valid and reliable clinical assessment tool to facilitate<br />
assessment of posture and postural ability in order to provide appropriate<br />
support and evaluate therapeutic inter ventions.<br />
To evaluate reliability and validity of a clinical assessment tool for posture<br />
and postural ability we performed a study using photos and films of 30 young<br />
adults with cerebral palsy born 1988–1991. The adults were categorized into five<br />
different groups using the gross motor classification system (GMFCS). Inter-rater<br />
reliability for the assement tool was evaluated by independent ratings of photos<br />
and films by three Physiotherapists. The internal consistency and homogenity of<br />
the instrument was evaluated using Cronbach’s alpha. The construct validity was<br />
examined through the ability to differ between known-groups (GMFCS levels).<br />
The assessment tool is reliable and valid for assessment of posture and postural<br />
ability in people with postural deficits. It’s quick to administer and do not<br />
require any special equipment and therefor easy to use in a clinical setting.<br />
wednesday • May 23<br />
eliSabet rodby<br />
bouSquet<br />
Physiotherapist<br />
E-mail: elisabet.rodby<br />
_bousquet@med.lu.se<br />
department of orthopaedics,<br />
lund University centre for<br />
clinicial research, Västerås<br />
atli ÁgúStSSon<br />
Physiotherapist<br />
Endurhæfing - Þekkingarsetur<br />
www.endurhaefing.is<br />
E-mail: atli@endurhaefing.is<br />
guðný JónSdóttir<br />
Physiotherapist<br />
Endurhæfing- Rehabilitation<br />
centre of excellence,<br />
E-mail: gudny<br />
@endurhaefing.is<br />
Tel: +354 4144500<br />
www.endurhaefing.is<br />
ann-chriStin<br />
JohanSSon<br />
gunnar hägglund<br />
PhiliPPe wagner<br />
35
wednesday • May 23 room e4 TARGET GROUP:INTERMEDIATE<br />
atli ÁgúStSSon<br />
Physiotherapist<br />
Endurhæfing - Þekkingarsetur<br />
www.endurhaefing.is<br />
E-mail: atli@endurhaefing.is<br />
una birna<br />
guðJónSdóttir<br />
rannveig<br />
baldurSdóttir<br />
36<br />
Supine lying support<br />
in iceland children with severe and complex neurological disability, commonly<br />
use orthoses and custom made seating systems most of their life. However the<br />
majority seem to have developed severe deformation of the trunk, pelvis and<br />
hips, by the time they enter adulthood. The time children and adults spend in<br />
custom made seating systems and orthoses is much shorter than the time they<br />
spend not using it. Recently the focus of management has shifted more to the<br />
time individuals are not using their assistive devices.<br />
The design principle behind the lying support is that the severe deformations<br />
of the trunk, pelvis and hips that are observed in individuals with complex<br />
neurological disability are a secondary complication to the original impairment,<br />
and as such can be prevented. In the supine position, gravity exerts uniform<br />
pressure on the trunk, the so called human sandwich effect. There are there fore<br />
no destructive external rotational moments present in the horizontal and<br />
sagittal planes. The lying support gives side support that stops destructive<br />
internal rotational moments in the frontal plane.<br />
The long term goal of the lying support is to minimize these secondary<br />
complications.<br />
The presentation will cover the design principle behind the lying support<br />
and the short terms effects of the use of the lying support. It will also cover<br />
the secondary versus primary complication associated with the original<br />
impairment, the biomechanical aspect of supine lying versus side and prone<br />
lying and its association to trunk symmetry.<br />
Learning Objective<br />
• Introducing a new type of lying support for supine lying.
TARGET GROUP: ALL room e4<br />
Developing an elearning Module<br />
for Allied Health Professionals<br />
Benefits, problems and reflections<br />
elearning can Provide significant benfits and flexibility to AHP professionals.<br />
Modules are not difficult to develop, and can be successfully achieved with<br />
careful planning and decisionmaking, and with a clear vision of the scope.<br />
Social media developments could be used to develop learner and professional<br />
networks, either new or existing.<br />
In recent years, training budgets in the UK have become more tightly<br />
constained, and professionals have found it increasingly difficult to incorporate<br />
the growing number of relevant courses and conferences into a hectic clinical<br />
schedule. It can also be difficult to put into practice new skills developed at<br />
conference or at a specific training event. Elearning can help to address some of<br />
these issues. We have developed an elearning module for the Chailey Levels of<br />
Ability Assessment Charts. This is a useful outcome measure that can be used to<br />
assess and record postural ability. It forms an important part of our twoday<br />
course, but delegates often find it is helpful to have a follow-up session once the<br />
measure has been used in practice.<br />
Our second key decision was the ‘platform’ that would be best suited to deliver<br />
the content. We felt that a web page (html) based tool would be the most<br />
appropriate.<br />
We will also briefly discuss delivery platforms that were excluded and why.<br />
Learning Objectives<br />
• To have a broad understanding of delivery platforms available for eLearning<br />
• To understand some of the problems associated with developing an eLearning<br />
programme.<br />
• Have a broad idea of the planning and decision-making required in developing<br />
content.<br />
wednesday • May 23<br />
Paul hewett<br />
bSc MSc, industrial<br />
designer<br />
active design ltd, Uk<br />
E-mail: paul@activedesign.co.uk/<br />
Tel: +44 121 326 7506<br />
www.activedesign.co.uk<br />
www.posturalmanagement.com<br />
Jo JeX<br />
McSP SRP PGcert,<br />
clinical Educator,<br />
Physiotherapist<br />
active design ltd<br />
E-mail: jo@activedesign.co.uk<br />
Tel: 07798842511<br />
www.activedesign.co.uk<br />
37
wednesday • May 23 room e4 TARGET GROUP: ALL<br />
mary PeterSen<br />
consultant, Physiotherapist<br />
Tel: 41 91 81 54<br />
E-mail: mpe@hmi.dk<br />
38<br />
A tool to find the appropriate<br />
assistive product<br />
assist data iS a web based data base on assistive devices on the Danish market.<br />
Although AssistData is a data base of products on the Danish market the presentation<br />
will be of interest for all participants as a great portion of the products are<br />
sold both in other European and even overseas countries. In addition AssistData<br />
is now also available in an English version. AssistData has advanced search<br />
functions facilitating the sorting or filtering of products within the various<br />
types, e.g. wheelchairs, seating cushions etc.<br />
By means of the various tools in the data base it is possible to filter among this<br />
vast amount of e.g. wheelchairs to gain a somewhat smaller portion consisting of<br />
all wheelchairs meeting the requirements set for the specific situation regarding<br />
properties, dimensions, equipment etc.<br />
Learning objectives:<br />
This presentation is an online demonstration of AssistData and the<br />
different entries for searching and other functions on the site.<br />
• The focus of the presentation is a demonstration of the facilities for search<br />
and filtering where the participants will be shown step-by-step how to utilize<br />
AssistData to find appropriate products for a specific seating situation.
TARGET GROUP: ALL room e4<br />
Clinical uses/appropriate uses of<br />
secondary positioning systems<br />
an intermediate to advanced level seminar designed for individuals currently<br />
working in the field of seating and positioning focusing on improving functional<br />
outcomes by controlling pelvic position, the trunk and head and the lower<br />
extremities.<br />
We’ll go over a clinical examination and seating assessment in order to get an<br />
accurate understanding of the different aspects involved with common seating<br />
problems. The impact of single body segments on global posture will be<br />
discussed and illustrated with cases and examples of seating problems such as<br />
kyphosis, sliding, poor head control and scoliosis will be analyzed. The impact of<br />
spasticity has on secondary support systems will be discuss and illustrated with<br />
several case studies of children with Cerebral Palsy.<br />
The biomechanics of the pelvis, trunk, head and lower extremities will be<br />
reviewed in relation to positioning of the pelvis, lower body and upper upper<br />
body.The correct biomechanical placement and the clinical indications of the<br />
following types of secondary support systems will be analyzed and discussed;<br />
Hip belts, Sub ASIS (Anterior Superior Illiac Spine) Pads, Leg harnesses, Ankle<br />
fixation belts, Adjustable Angle Footplates, Calf panels and calf staps, Thoracic<br />
and shoulder harnesses and Chest Belts<br />
Learning Objectives:<br />
• Understand how the anatomical placement of secondary support systems<br />
impacts the users postural ability, functional ability and comfort.<br />
• Understand the applications of postural supports in order to control posture<br />
and obtain functional outcomes.<br />
wednesday • May 23<br />
bart van der heyden<br />
Physical Therapist<br />
<strong>Seating</strong> and Wound care<br />
Specialist / consultant<br />
director Training &<br />
Education The RoHo<br />
Group Europe<br />
clinical advisor EU and ME<br />
bodypoint (US) & Xsensor<br />
(canada)<br />
director, Training &<br />
Education Europe<br />
The RoHo Group<br />
E-mail: bvanderheyden<br />
@attglobal.ne<br />
www.therohogroup.com<br />
39
wednesday • May 23 room e4 TARGET GROUP: ALL<br />
birgitta nordStröm<br />
Physiotherapist/doctoral<br />
student at lTU<br />
E-mail:<br />
birgitta.nordstrom@ltu.se<br />
40<br />
On an equal footing<br />
“Adults accounts of the experience of using assistive<br />
devises for standing” and a short summary of the use of<br />
standing devices for persons with disabilities.<br />
today the PhySiotheraPiSt and/or occupational therapist prescribe the standing<br />
device mainly focusing on the physical/physiological body. Since there are<br />
largely absence of studies focusing on users’ experiences on standing in standing<br />
devices it is important to study this phenomenon further.<br />
The aim of this study was to illuminate the adult users’ experiences of standing<br />
in standing devices. The participants in this study were older adults who had<br />
received a standing device and could be found in the register of assistive<br />
technology. Fifteen participants with diagnosis such as stroke, traumatic spinal<br />
cord injury, traumatic brain injury, cerebral palsy and multiple sclerosis were<br />
interviewed.<br />
The results of study indicated that standing in standing devices for persons<br />
with severe disabilities seemed to be more than just a treatment of the biological<br />
body; it also affected the social interplay and contributed to a changed relationship<br />
to the outside world.
Landing in the chair<br />
from a standing hoist<br />
TARGET GROUP: ALL room e4<br />
vitSi – the interdiSciPlinary Evidence Generating Network for <strong>Seating</strong> has<br />
carried out a pilot study with the purpose of discovering which factors, when<br />
using a standing hoist, influence the quality of the seated position. The focus has<br />
been to point out to transfer instructors and occupational and physiotherapists<br />
the central aspects to be used in connection with the planning and dissemination<br />
of the information on adopting the sitting position by use of a standing hoist.<br />
The conclusion of our study so far is that the distinctive characteristic of landing<br />
in a chair by use of a standing hoist, as opposed to e.g. a stationary hoist in the<br />
ceiling, is the fact that the user is changing his position from standing to sitting<br />
in the process of the transfer. This change of position is influenced by the person’s<br />
functional ability – incl. possible pathological patterns. In connection with the<br />
dissemination of the information to transfer instructors and therapists it is<br />
therefore important to include the fact that the assistant needs to possess<br />
knowledge on and, in the guidance of the user, take into account the individual<br />
and perhaps pathological patterns of movement in the user.<br />
wednesday • May 23<br />
mary PeterSen<br />
consultant, Physiotherapist<br />
Tel: 41 91 81 54<br />
E-mail: mpe@hmi.dk<br />
41
wednesday • May 23 room e4 TARGET GROUP: ALL<br />
charlotte von arbin<br />
PT av iRT certifierad<br />
ridterapeut<br />
E-mail: von.arbin.charlotte<br />
@telia.com<br />
Tel: +46(0)31-406047<br />
Göteborgs Handikappridklubb,<br />
www.ghrk.se<br />
margareta håkanSon<br />
leg sjukgymnast,<br />
Med lic, specialist i<br />
psykiatri och psykosomatik<br />
inst för tillämpad iT,<br />
kollegium SSkkii<br />
Göteborgs universitet<br />
E-mail: margareta.<br />
hakanson@comhem.se<br />
Tel: 0709 46 10 35<br />
www.sskkii.gu.se<br />
ulrika Stengard-olSSon<br />
leg sjukgymnast/ridsjuk gymnast,<br />
Söderåsens forsgård,<br />
E-mail: ulrika@soderasensforsgard.se<br />
Tel: +46 (0)435 191 19<br />
0706-191192<br />
www.soderasensforsgard.se<br />
42<br />
Sitting on a Horse make<br />
a change in life!<br />
the movement that occurs between horse and rider can be used to influence the<br />
rider’s functionality. Effects described in international studies are, besides improved<br />
balance and coordination of the trunk, reduced need for walking aids, enhanced<br />
function for personal hygiene during toilet visits and an increasing discomfort at<br />
the long break in between riding among riders with cerebral palsy. Riders suffering<br />
from stroke and MS point out enhanced wellbeing and improved quality of life as<br />
important effects from riding, in rehabilitation and as leisure activity. There are no<br />
studies on the everyday effects of regular riding for disabled riders in the <strong>Nordic</strong><br />
countries, but the clinical experiences describes similar stories on valuable impact<br />
on everyday life.<br />
In this workshop we will highlight the effects of riding to seating and positioning<br />
and functional mobility (physical, mental and social) for persons with disabilities.<br />
Learning objectives:<br />
Give a brief description of the current body of knowledge according healtpro motive<br />
effects from horseback riding, equine assisted therapy, horse connected leisure<br />
activities and sports related to functional limitations of different origin<br />
• Initiate a discussion on how to increase access to therapy, leisure activity and<br />
sports within the field of riding, driving and other kinds of horse related activities.<br />
• Highlight security issues, aids and adaptation of equipment for riders with<br />
functional limitations.<br />
Pia tillberg<br />
leg.sjukgymnast,<br />
iRT-certifierad ridterapeut,<br />
projektansvarig Stiftelsen Hippocampus<br />
E-mail: pia.tillberg@comhem.se<br />
Tel: 070-403 71 09<br />
www.stiftelsenhippocampus.se
43<br />
HoUNzaSoUcUP/flickR
wednesday • May 23 room e8 TARGET GROUP: ALL<br />
bart van der heyden<br />
Physical Therapist<br />
<strong>Seating</strong> and Wound care<br />
Specialist / consultant<br />
director Training &<br />
Education The RoHo<br />
Group Europe<br />
clinical advisor EU and ME<br />
bodypoint (US) & Xsensor<br />
(canada)<br />
director, Training &<br />
Education Europe<br />
The RoHo Group<br />
E-mail: bvanderheyden<br />
@attglobal.ne<br />
www.therohogroup.com<br />
anni bank agger<br />
occupational Therapist<br />
Holstebro kommune,<br />
denmark.<br />
E-mail: SSREaba<br />
@Holstebro.dk<br />
annibanka@gmail.com<br />
Tel: 96114822<br />
44<br />
<strong>Seating</strong> Interventions for users<br />
with Amyotrophic Lateral<br />
Sclerosis (ALS)<br />
amyotroPhic lateral ScleroSiS is a progressive Motor Neuron Disease, causing<br />
many medical challenges like muscle weakness, dysarthria, dysphagia and<br />
respiratory problems. <strong>Seating</strong> interventions should focus on promoting functional<br />
independence, preventing medical complications and provide a comfort.<br />
<strong>Seating</strong> interventions and assistive technology can enhance independence and<br />
safety of the individual but it remains key to keep in mind that each person has<br />
an individual mind set and different attitudes, so seating interventions should<br />
be giving the user a feeling of empowerment, not losing hope or control.<br />
During this presentation we’ll show individuals suffering from ALS and we’ll<br />
discuss the wheelchair user’s perspectives, motivation and needs on seating and<br />
mobility and how these needs are integrated with the functional requirements<br />
and the progressive medical needs of the individual.
TARGET GROUP: ALL room e8<br />
Sit properly! Experiences in use<br />
of seat cushions for children<br />
and adolescents with sensory<br />
integration dysfunction<br />
many children with<br />
sensory integration dysfunction may constantly be told that they should<br />
“sit properly” – without any effect. This may be children with diagnoses such<br />
as ADHD, ADD, mental retardation and CP.<br />
When we study what causes the problems with hyperactivity, hypo activity and<br />
poor posture, we find not only neuropsychological causes, but also impaired<br />
coordination and balance. Even when the gross motor function and fine motor<br />
skills is within the normal range seating can be an issue.<br />
This lecture presents how PT and OT at the Child Psychiatry Clinic at the<br />
hos pital of Sollefteå worked with seat cushions such as a ball cushion in a project<br />
2011. The aim was to give children a good sitting position in various activities in<br />
everyday life. Adaptation of chairs providing a dynamic support stimulates joint<br />
and muscle sense and helped some children improve sitting skills and ability to<br />
focus. For some children it reduced restlessness and improved dealing with<br />
everyday situations in both at school and at home.<br />
Learning objectives:<br />
• See postural control and its function from a sensory motor perspective.<br />
• Get an introduction to adaptation possibilities.<br />
wednesday • May 23<br />
lotte wemmenborn<br />
leg sjukgymnast/<br />
Physiotherapist<br />
fysionord ab<br />
E-mail: lotte@fysionord.se<br />
Tel: +46 (0)730- 32 92 99<br />
www.fysionord.se<br />
45
wednesday • May 23<br />
karen lyng<br />
occupational Therapist,<br />
Master of Rehabilitation<br />
VEla, Vermund larsen a/S<br />
E-mail: kly@vela.dk<br />
Phone:+45 9634 7600<br />
www.vela.eu<br />
46<br />
room e8 TARGET GROUP: ALL<br />
Adaptive seating in work<br />
rehabilitation<br />
workPlace accommodation including adaptive seating makes a difference to<br />
persons with mobility disabilities and their participation in work.<br />
In a qualitative study it have been found that physical demands at the workplace<br />
are reported as barriers to working for people with mobility disabilities. The<br />
results indicate that adaptive seating, assistive tech nology and adaptation of the<br />
workplace are important parts of work<br />
rehabilitation.<br />
The conclusion is that adaptive seating may facilitate work rehabilitation and<br />
that general ergonomic principles for seated, semiseated and standing working<br />
positions should be considered. Work rehabilitation should be part of the general<br />
rehabilitation process, and adaptive seating at the workplace is just as important<br />
as seating at home.<br />
Learning objectives:<br />
• Consider in their daily practice the crucial importance of employment to people<br />
with disabilities.<br />
• Counsel clients and employers that the importance of adaptive seating at the<br />
workplace is on a par with seating for any other activity in daily life.<br />
• Consider and include work rehabilitation as an important and integral part of<br />
the rehabilitation process in general.<br />
• Start planning and implementing seating solutions for work environments.
TARGET GROUP: ALL room e8<br />
Influences on the Seated Position<br />
how to Sort out all the parameters which influence on the seated position?<br />
What are all these parameters? How do parameters like gravity or the position of<br />
the head or the backrest shape influence the seated position? How do these and<br />
all those other functions influence on the clients ability to function as intended?<br />
How does a wheelchair set up like a seat angle influence the client’s ability to eat<br />
or to propel a wheelchair or to keep stable while seated?<br />
We will recognize and analyze these functions; we will experience these functions<br />
and possibly see how little difference there is between reaction patterns<br />
in able bodied person’s and those with a disability. We will discuss seating<br />
intervention strategies and define the equipment properties needed to address<br />
the client’s objectives; is the client able to function as intended?<br />
Learning Objectives:<br />
• Provide a different look at the client seated position, without getting lost in<br />
the amount of problems they might experience.<br />
• Participants will learn to sort out and analyze seating parameters,<br />
how these parameters interact and influence each other.<br />
• <strong>Seating</strong> intervention strategies are discussed so that at the end of the course,<br />
participants should be better equipped to determine the<br />
equipment properties that are required to address the individual’s<br />
objectives, rather than simply choosing specific product solutions.<br />
wednesday • May 23<br />
menno van etten<br />
Physiotherapist<br />
Product- & Education Manager<br />
Etac aS<br />
E-mail: menno.vanetten<br />
@etac.com<br />
tel: +47 915 64 233<br />
47
wednesday • May 23 room e8 TARGET GROUP: INTERMEDIATE<br />
kari borgen<br />
Physiotherapist<br />
Habiliteringssenteret i Vestfold,<br />
Sykehuset i Vestfold Hf<br />
E-post: kari.borgen@siv.no<br />
Tlf: 33308265<br />
HenrieTTe a. sjøleTT<br />
occupational Therapist<br />
Nav Hjelpemidddelsentral<br />
Vestfold<br />
E-mail: henriette.andersen<br />
@nav.no<br />
Tlf: +47 33513200<br />
britt torneS<br />
Physiotherapist<br />
Habiliteringssenteret i Vestfold,<br />
Sykehuset i Vestfol Hf<br />
E-mail: britt.tornes@siv.no<br />
Tlf: +47 33308265<br />
rikke damkJær moen<br />
Physiotherapist<br />
Medical manager<br />
Made for Movement Group aS<br />
Tlf: +47 35 50 51 20<br />
madeformovement.com<br />
E-mail: rdm@madefore<br />
movement.com<br />
48<br />
Clinical practice project<br />
from Norway<br />
children with diSabilitieS have little or limited possibilities for movement in<br />
daily life. Consequences of immobility are gastrointestinal disorders, muscle<br />
atrophy, contractures, pain etc.<br />
The purpose of the project was to enable assisted movement in a standing<br />
position for children with former disabilities and evaluate the effect of movement,<br />
over a period of one year. To provide assisted movement the helping aid<br />
Inno walk was used. 13 children have completed the project period. All children<br />
are tested before start up with the helping aid Innowalk, after a 4 week probation<br />
period, after 4 month and 12 months of use.<br />
Learning objectives:<br />
• What effect do children with former disabilities have of regular<br />
movement in a standing position?<br />
• Discussion on frequency /duration of movement needed to gain effect!<br />
• Identify patients who will benefit from assisted movement.
Det enkla<br />
är det sköna.<br />
ROHO ® har i snart fyrtio år strävat efter att utveckla de bästa<br />
tryckavlastande och positionerande dynorna för dig som lever ditt<br />
liv sittande. För att lyckas krävs en ständig utveckling. Ett exempel<br />
på det är den geniala, patenterade ISOFLO Memory Control ® som<br />
reglerar luften mellan de fyra luftkamrarna. Ett enkelt tryck på reglaget<br />
möjliggör en korrigering och stabilisering av bäckenet, vilket många<br />
gånger är en förutsättning för en bättre hållning. Med ROHO‘s<br />
unika DRy FLOatatIOn ® teknik kan du även vara säker på optimal<br />
tryckavlastning i alla situationer.<br />
Sitt bättre – på en sittdyna som du kan leva med länge, det finns<br />
nog ingen som både tryckavlastar och stabiliserar bättre.<br />
Läs mer om våra unika sittdynor på www.etac.se.<br />
49
<strong>5th</strong> nordic <strong>Seating</strong> SymPoSium<br />
50<br />
Programme thurSday, may 24<br />
room m2<br />
8.30<br />
Supported Standing: Using Evidence for Clinical Decision Making<br />
Ginny Paleg, Physiotherapist, USA<br />
Considerations regarding Lying<br />
Dorte Støvring, Physiotherapist, Denmark<br />
10.15<br />
Coffee and posterexhibition<br />
11.00<br />
Are your preventive interventions related to pressure ulcers<br />
in fact rational at all?<br />
Helle Dreier, Occupational Therapist, Denmark<br />
Inclusion Tour 2010 – Casablanca and Stockholm,<br />
630 mil by wheelchair<br />
Lars Löfström, Sweden<br />
13.00<br />
Closure
Supported Standing, using<br />
evidence for clinical decision<br />
making<br />
much haS been learned about supported standing programs, but many clinicians<br />
are missing crucial information about the significance of incorporating vibration,<br />
oscillation, sway, ability to self propel in the device, stepping and movement to<br />
increase activity and participation for infants, children who are nonambulatory<br />
(GMFCS Levels 4 and 5).<br />
This lecture will begin with a systematic review of the literature (sorted by ICF<br />
category). Case stories with videos will be to share ideas about intervention<br />
strategies and outcome measures. Content will focus on whole body vibration<br />
and standers that incorporate movement and activity. Emphasis will be on<br />
preservation of hips for children with CP GMFCS Levels 4 and 5. Specific dosage<br />
(frequency and duration of bout) will be linked with specific ICF outcomes.<br />
Learning objectives:<br />
• (Knowledge) Participants will be able to describe the benefits of<br />
standing programs.<br />
• (Comprehension) Participants will be able to understand why it is important<br />
to use eviedence to determine dosage and outcomes for standing programs.<br />
• (Application) Participants will be able to apply current standing research to<br />
their decision making process for frequency, postural<br />
supports, bracing and amount of abductionto all brands and models of<br />
standers.<br />
• (Analysis) Participants will be able to assess any stander for its ability<br />
to accomplish or adapt to the desired clinical parameters to optimize<br />
the child/adult’s activity and participation in a natural environment.<br />
• (Synthesis) Participants will be able to incorporate new information presented<br />
into their current understanding and approach to using standers to increase<br />
activity and participation in natural environments.<br />
room m2<br />
THursday • May 24<br />
ginny Paleg<br />
dScPT, MPT, PT<br />
Physiotherapist<br />
Montgomery county infants<br />
and Toddlers,<br />
Maryland, USa<br />
E-mail ginny@paleg.com<br />
Tel: 001-301-452-4656<br />
51
THursday • May 24 room m2<br />
dorTe sTøvring<br />
Physiotherapist<br />
dS consulting<br />
E-mail: dorte.stovring<br />
@mail.dk<br />
Tel: +45 2329 6644<br />
52<br />
Considerations regarding lying<br />
there iS an increaSing focus on 24 hour positioning as many of our wheelchair<br />
users have complex needs and may require different kinds of postural support<br />
throughout 24 hours.<br />
Lying support has been widely used in countries outside Scandinavia, but in<br />
Scandinavia it has been more randomly applied.<br />
This presentation will review:<br />
• Which of our clients may benefit from Lying support?<br />
• How do we assess the client? (practical demonstration of this via a<br />
slides series)<br />
• How do we decide on the goals, we want to achieve?<br />
• Which considerations do we need to make prior to choosing lying<br />
postural support?
Are your preventive<br />
pressure ulcer interventions<br />
rational at all?<br />
wheelchair uSerS with poor or missing sensibility are often exposed to pressure<br />
ulcers related to the seated position. Because of that they are often bedridden for<br />
months or years which may have detrimental adverse effects on organ systems<br />
in the body as it may cause muscle loss, joint contractures and deprivation of<br />
environmental and social stimulation. Overall it may have a very negative<br />
impact on quality of life and may even be life threatening. It would be sensible<br />
and rational to avoid this by offering a seating assessment procedure including<br />
analysis of the individual activity performance in everyday life – meaning in<br />
everyday life context.<br />
During years of clinical practice in Holbaek, DK an activity based seating<br />
assessment (ABSA) procedure has been developed and has shown a potential<br />
of prevention and healing sitting acquired pressure ulcers while seated. It has<br />
become clear that a greater part of the pressure problem seem to be about<br />
inconsistency of pressure ulcer classification as well as a non existing distinction<br />
between pressure ulcers either caused by physical contact with the chair or<br />
with the bed.<br />
Pressure ulcer intervention generally speaking seems to be perceived<br />
as a matter of picking out the right mattress for the right person suffering from<br />
pressure ulcers or at risk of having them. This may have had a considerable<br />
impact on society expenses even though the utility value has been very much<br />
limited. This requires further focus on the professional ability to distinguish<br />
sufficiently in order to intervene in the most rational way and this presentation<br />
will give it a try.<br />
room m2<br />
THursday • May 24<br />
helle dreier<br />
oT, MSi specialist in<br />
Sitting acquired<br />
Pressure Ulcers<br />
Special advisory, assistive<br />
devices and disabled<br />
E-mail: heldr@holb.dk/<br />
helle.dreier@gmail.com<br />
Tel: 0045 72363345<br />
www.hjaelpemidler.com /<br />
www.tryksaar.dk<br />
53
THursday • May 24 room m2<br />
larS löfStröm<br />
Physical education teacher<br />
54<br />
Inclusion Tour 2010<br />
– Casablanca and Stockholm,<br />
630 mil by wheelchair<br />
Inclusion Tour 2010 Casablanca–Stockholm<br />
larS löfStröm talkS about the unique journey he made with his friend Mats<br />
Melin. No one has ever pushed a standard wheelchair so far in so short time,<br />
6300 km for five months. Mats, on the bike, and Lars, in his wheelchair, passed<br />
through eleven countries and over the mountain ranges of the Pyrenees and the<br />
Jura mountains on their way to Stockholm.<br />
Lars Löfström, age 56, exam: Education Teacher (GIH), with experience as<br />
Researchers at the Karolinska Institute, Physical Education Teacher and<br />
Vice Principal. He has also won several gold medals in wheelchair racing both<br />
in the Paralympic games and in the World Championships.
Space for your own notes<br />
56
The <strong>Nordic</strong> <strong>Seating</strong> <strong>Symposium</strong> is a coarrangement<br />
between The Assistive Technology Center in Iceland, Assistive Technology<br />
and Social Psychiatry in Denmark, The Norwegian Labour and Welfare<br />
Service (NAV), National Institute for Health and Welfare in Finland (THL)<br />
and The Swedish Institute of Assistive Technology (SIAT).<br />
www.sitsite.net