5th Nordic Seating Symposium - Sitsite - Hjælpemidler

conference book 

5th Nordic Seating 

Symposium 

22–24 may 2012 in Stockholm

Table of content 

3 Welcome to the Nordic Seating Symposium 

5 Symposium activities 

6 Presymposium workshops 

10 Symposium Moderator 

11 Symposium programme Tuesday, May 22 

12–14 Presentations in Room M2 Tuesday, May 22 

16–17 Symposium programme Wednesday, May 23 

18–25 Presentations in Room M2 Wednesday, May 23 

26–34 Presentations in Room M1 Wednesday, May 23 

35–42 Presentations in Room E4 Wednesday, May 23 

44–48 Presentations in Room E8 Wednesday, May 23 

50 Symposium programme Thursday, May 24 

51–54 Presentations in Room M2 Thursday, May 24

oom m2 

Welcome to the Nordic Seating Symposium 

The first nordic seating symposium was held in Stockholm in October 2001. Since then it has 

been held in Oslo, Copenhagen and Reykjavik and now the fifth Symposium is to be held in 

Stockholm. On this occasion the venue will be Kista mässan where in conjunction with the 

Symposium an exhibition, Hjultorget, will be held for two days of the three day event. 

This is a symposium for professionals and will focus on seating and positioning for persons XXXXXXXX with 

Xxxxxxxx 

disabilities. Welcome to participate in several interesting presentations and workshops held by speakers 

from all the Nordic countries, Europe and USA. The main purpose of the symposium is to share 

experiences, increase knowledge and form new friendships and networks. Presentations and workshops 

are based upon practical experience, research as well as ideas. 

Four workshops were held prior to the symposium. These workshops gave the participants an 

opportunity to go in depth into particular subjects. 

During the first day, May 22th, and the third day, May 24th, all lectures will be given in plenum. 

During the second day, May 23th, participants can choose between four different parallel sessions. 

We hope that the programme for this year’s Nordic Seating Symposium will create new insights and 

inspire you in your daily work. There will be plenty of opportunities both to obtain the latest knowledge 

in the area and to meet colleagues in informal exchanges of experiences across the Nordic countries. 

We warmly welcome you to Nordic Seating Symposium 2012 in Stockholm! 

The Swedish Institute of Assistive Technology 

Organizer of the symposium 

Jan Grönlund 

Director 

Swedish Institute 

of Assistive Technology – SIAT 

3

adaM ScoTTi/flickR 

4

Symposium activities 

Below you can read more about the different activities that will take place during the Nordic 

Seating Symposium. 

Nordic Seating Symposium, 22–24 May 

Lectures during the Symposium will take place both in plenum and in parallel sessions. Almost all 

parallel sessions will start and end at the same time, which makes it possible to alternate between them 

during the day. This means that it will be possible to go from one room to another during the day and 

therefore put together a programme shaped to suit personal interests. 

An English description in the programme means that the presentation will be given in English. 

A description in a Nordic language means that the presentation will be given in that specific language. 

Poster exhibition 

A poster exhibition will be arranged during the symposium at the lunch and coffee area. 

Each exhibitor will give a five minute presentation during the coffee break on Thursday, May 24. 

Exhibition Hjultorget 

The Exhibition has been arranged by Rekryteringsgruppen Active Rehabilitation (RG) and The Swedish 

Association for Survivors of Accident and Injury (RTP). RG and RTP are both non-profit organizations. 

RG focuses on motivating people with disabilities, especially those with spinal cord injuries, to lead an 

active and independent life. RTP concentrates on the promotion of participation and accessibility in 

society for the survivors of road traffic accidents, accidents in general and polio. 

It will be possible to visit the exhibition parallel to the presentations at the Nordic Seating Symposium 

–due to breaks structures into the programme. 

Activities at Hjultorget 

A competition, open to all participants, will take place at the fair. This will consist of double poling 

ergometer, wheelchair basketball, shooting and armbike. Competition starts at booth C10. Participation 

in all of the events together with the submission of results ensures automatic participation in a prize draw. 

During our breaks, why not take the opportunity to enjoy other attractions such as wheelchair dance 

and wheelchair basket. Why not challenge yourself to maneuver a wheelchair through a specially 

constructed apartment. The apartment is open all day and can be located at booth C12. 

5

Monday • May 21 • 9.00–16.00 kiStamäSSan 

John högberg 

RG aktiv Rehabilitering 

6 

Pre-SymPoSium workShoP 

Rullstolens möjligheter 

(In Swedish) 

en PraktiSkt kurS där du får lära dig hur man som rullstolsanvändare kan leva 

ett aktivt liv med optimal livskvalitet. Utgångspunkten är rullstolen som möjlighet 

– inte en begränsning. 

På kursen får du lära dig hur man som rullstolsanvändare kan leva ett aktivt liv 

med optimal livskvalitet. Utgångspunkten är rullstolen som möjlighet – inte en 

begränsning. 

Kursinnehållet är optimerat så att du ska få tips och idéer om hur man kan lära ut 

körteknik med mera till användare samt hur man kan inspi rera till en aktiv fritid. 

Genom kursen får du möjlighet att öka din kompetens, samtidigt som du får 

inspiration till ditt fortsatta arbete. 

Kursinnehåll: 

• Rullstolsteori manuella rullstolar 

• Mekning manuella rullstolar 

• Rullstolsmanövrering manuella rullstolar


The evidence basis of using 

gait trainers to improve activity 

and participation 

– in Infants, Children and Adults with 

GMFCS Levels IV and V 

target audience: Intermediate, Participants should be familiar with body weight 

support gait training (BWSGT) and the concept of central pattern generators (CPG). 

Much has been learned about BWSGT, but many clinicians are missing crucial 

information about the significance of transferring this approach to over ground in 

natural environments to improve activity and participation for infants, children 

and adults who are non-ambulatory (GMFCS Levels 4 and 5) This method of 

facilitating activity (NOT walking!) must be part of any and every 24 hour postural 

management program. 

This course will begin with a systematic review of the literature (sorted by ICF category) 

. Videos and case stories will be used to show how the central pattern generator 

(CPG) can be used to facilitate activity and participation in nonambulatory children 

(GMFCS Level 4 and 5). GMFCS will be reviewed in the context of determining 

which child will be non-ambulatory and benefit most from this intervention. 

Session objectives: 

• (Knowledge) Participants will be able to describe the stimulus that 

triggers the stepping response (CPG). 

• (Comprehension) Participants will be able to understand why it is important to 

stimulate the CPG early and often 

• (Application) Participants will be able to apply BWSGT research to 

their decision making process for frequency, speed, assistance/ postural support, 

bracing and amount of unweighting to all brands and models of gait trainers 

• (Analysis) Participants will be able to assess any gait trainer for its ability to 

accomplish or adapt to the desired clinical parameters to optimize the child/ 

adult’s activity and participation in a natural environment 

• (Synthesis) Participants will be able to incorporate new information presented 

into their current understanding and approach to using gait trainers to increase 

activity and participation in natural environments 

room e7 

Tuesday • May 22 • 9.00–12.00 

ginny Paleg 

dScPT, MPT, PT 

Physiotherapist 

Montgomery county infants 

and Toddlers, 

Maryland, USa 

E-mail ginny@paleg.com 

Tel: 001-301-452-4656 

7

Tuesday • May 22 • 9.00–12.00 rooM e6 

Karen M. Kangas 

oTR/l 

Nationally certified 

and State licensed 

occu pational therapist 

Seating, Positioning, 

and Mobility Specialist, 

assistive Technology 

Specialist, clinical 

Educator, consultant 

Tel: 570-644-1032; 

Email: kmkangas@ptd.net 

8 


Sensory Processing, Sensory 

Integration, Seating and 

Independent Task Engagement 

and Performance 

SenSory ProceSSing and utilizing sensation in an integrated mode is how the 

human body interprets and utilizes postures to support active task engagement or 

managing tasks and work. 

Without active control and movement and an active relationship with gravity 

(vestibular processing), the human body can only move with range of motion, 

(tactile processing) lacking power, intention and strength. 

Seating systems created for skeletal symmetry only can actually prevent task 

endurance, and in children, task attention. Symmetry does relax the body, but a 

relaxed body cannot work it can only relax. We need seating systems which allow 

bodies to work, to gain endurance, and to function within the gravity our planet and 

our postures require. 

Currently, seating systems are created from an anatomical perspective with the 

focus on managing the body’s skeletal system, particularly “controlling” or “aligning” 

the spine and pelvis with the same plane, creating the “right” and “optimal” postural 

position. When providing seating systems, especially for children, who are growing 

and changing, it is vital that seating be created from a neurophysiological perspective. 

Learning objectives: 

• define the two primary sensory modes of processing: tactile processing and 

vestibular processing. 

• identify the seating postures of their AT users as to positions of rest and tactile 

processing or positions of active engagement or vestibular processing. 

• identify seating equipment as to its “postural management” (tactile 

processing) vs. “postural control” capabilities (vestibular processing). 

• perform a “feature/match” with a comparison and contrast of equipment, both for 

“access” and for physical configuration and its features to match the needs and 

skills of their children. 

• apply and implement assessment and treatment strategies for the the use of AT 

equipment including access to AAC, powered mobility and computer use which 

will include adequate seating with sensory processing.


Posture management 

and clinical assessment 

PeoPle with PhySical disabilities may have a reduced ability to align 

and stabilize the body against gravity. An asymmetric posture increases 

the risk of tissue adaptation and contractures. 

This workshop will guide you through a clinical assessment of posture 

and postural ability in order to provide appropriate support throughout a 

24 hour cycle. 

room e5 

Tuesday • May 22 • 9.00–12.00 

eliSabet rodby 

bouSquet 


E-mail: elisabet.rodby 

_bousquet@med.lu.se 

department of orthopaedics, 

lund University 

centre for clinicial research, 

Västerås 

guðný JónSdóttir 


Endurhæfing – Rehabilitation 

centre of excellence 

E-mail: gudny@endurhaefing.is 

Tel: +354 4144500 

www.endurhaefing.is 

atli ÁgúStSSon 


Endurhæfing - Þekkingarsetur 


E-mail: atli@endurhaefing.is 

9

10 

Symposium Moderator 

Gunilla hammarskiöld is an occupational therapist who has worked in the field of assistive 

technology during forty years. She has always had an interest in seating and positioning for 

people with disabilities and held many seating courses at the Swedish Institute of Assistive 

Technology. In 1995, Gunilla Hammarskiöld and Bengt Andersson initiated “Sitnet Sweden”. 

They also arranged the first Nordic Seating Symposium in October 2001, together with the 

Nordic partners. 

Gunilla Hammarskiöld 

Occupational Therapist 

E-mail: gunilla.hammarskiold@hi.se

Programme tueSday, may 22 

room m2 

12.00 

Registration for the Nordic Seating Symposium 

13.00 

Opening of the Nordic Seating Symposium 

Jan Grönlund, Director, Swedish Institute of Assistive Technology, SIAT 

A CP good life 

Jonas Helgesson, Author, Sweden 

Sensory Processing, Sensory Integration, Seating and Access, 

an Introduction 

Karen M. Kangas, Occupational Therapist, USA 

15.15 

Coffee, exhibition and show 

16.00 

Windsurfing for all– Increasing participation and accessibility through 

equipment modification 

Kati Karinharju, Senior Lecturer Satakunta University of applied sciences 

17.00 

Closure 

5th nordic Seating SymPoSium 

11

Tuesday • May 22 room m2 

JonaS helgeSSon 

author, Sweden 

E-mail: info@jonas 

helgesson.se 

www.jonashelgesson.se 

12 

A CP good life 

JonaS iS 33 years old and speaks about his life with cerebral palsy. What is it 

like to be treated as different? How can the right attitude help to live life to 

the fullest? Why is respect better than kindness? Jonas speaks personally 

and with great sens of humor. He is a popular speaker in Sweden and author 

of two books about his life.

Sensory Processing, Sensory 

Integration, Seating and Access 

an Introduction 

SenSory ProceSSing controls visual convergence, focus, attention, postural 

control and isolated, graded movement. Its subsequent sensory integration must 

be supported within the structural components of seating systems, if we intend 

to provide seating for task engagement. The support of movement, not simply 

skeletal symmetry must be provided in seating systems. 

Sensory processing is how the body interprets and uses its relationship to 

gravity to support task involvement. Seating systems have focused on skeletal 

symmetry, which does not support independent functioning. 

To assist these children in wheelchairs in developing and using “access” to 

AT devices, we must also better understand how their bodies work functionally, 

(rather than pathologically) and what different seating equipment is needed. 

I will share strategies and equipment which work and which provide children 

opportunities to use their sensory processing so that increased, consistent access 

to AT can be supported and become efficient. 

room m2 Tuesday • May 22 

Karen M. Kangas 

oTR/l 

Nationally certified 

and State licensed 

occu pational therapist 

Seating, Positioning, 

and Mobility Specialist, 

assistive Technology 

Specialist, clinical 

Educator, consultant 

Tel: 570-644-1032; 

Email: kmkangas@ptd.net 

13

Tuesday • May 22 

kati karinharJu 

Senior lecturer, MSc 

Satakunta University of 

applied Scienses, ltd 

faculty of Social Services 

and Health care Pori, 

finland 

Mobile: +35844 710 3868 

Email: kati.karinharju 

@samk.fi 

14 

room m2 

Windsurfing for all 

Increasing participation and accessibility 

through equipment modification 

the SataeSteetön project responds to the needs of a society and supports 

everyone to have an independent and unrestricted life in every stage of their life. 

Yyteri for all was part of this project and its objective was to examine and 

develop accessibility and increase participation in the area of the Yyteri beach 

in Pori, Finland. This research presents the ways of developing wind surfing 

suitable for persons surfing in the seated position. 

Adapted windsurfing pilot courses were organized on summer 2010 and 2011 

at the Yyteri Surfcentre. The purpose of these pilot courses was to create and 

modify appropriate equipment for surfing in a seated position and to test these 

modifications for wheelchair users. Equipment modifications are necessary 

when surfing in the seated position. These modifications increase the opportunities 

of physical activity for people with disability. 

Moreover, this presentation shares ideas of different adapted summer and 

winter activities and modifications created during the project.

15 

bEacHy/flickR


16 

Programme wedneSday, may 23 

room m2 max 600 room m1 max 400 

9.00 

The effect of a shaped wheelchair cushion 

and a detachable lumbar support 

Anna-Karin Hansson 

Effect of a Dynamic Seating Surface 

Erna Rosenlund Meyer and Lisa Trew 

10.00 


10.45 

Relationship between “tilt in space” wheelchair 

function and risk of pressure ulcer development 

Christian Gammelgaard Olesen 

Evaluation of the suitability in which anti - 

de cubitus cushions meet defined user needs 

Gunn Limandvik 

12.00 

Lunch 

13.00 

Sit as you are, drive as you can 

Elin Berg 

Use of manual and powered wheelchair in 

children with cerebral palsy 

Elisabet Rodby Bousquet 

Powered mobility practice-A gate to 

tool use learning 

Lisbeth Nilsson 

15.00 

Coffee 

15.45 

Accurate seating measures and size of 

wheelchair optimizing function in everyday life 

Lotte Wemmenborn 

17.00 

Closure 

9.00 

”Sid godt” – oplysningsmateriale fra 

Hjælpemiddelinstituttet i Danmark 

Else-Marie Hansen 

Får du formidlet dine budskaber, 

så de forstås af modtagerne? 

Conni Schmidt 

10.00 


10.45 

Sitt och ryggstödets inverkan på äldre 

personers sittande i rullstol 

Marina Timm 

Hur äldre rullstolsanvändares drivteknik 

påverkar sittpositionen och vice verca 

Maria Amnell 

12.00 

Lunch 

13.00 

Är rullstolskörande med viss abduktion i höften 

möjligt och önskvärt för barn med cerebral pares 

Eva Jönsson och Karin Thews 

Sittande hos barn med funktionsned sättning 

som får korrigerande korsett 

Annika Blomkvist och Kristina Olsson 

Siddestillningnsanalyse og rehabilitering 

Mette Hornbäck Söderberg 

15.00 

Coffee 

15.45 

Spasticitet, påverkar det sittandet? 

Britt-Marie Rydh Berner 

Exhibition and activities at Hjultorget 

17.00 

Closure

Programme wedneSday, may 23 

room e4 max 200 room e8 max 120 

9.00 

Evaluation of a Clinical assessment tool 

for posture and postural ability 

Elisabet Rodby Bousquet 

Supine lying support 

Atli Agustsson 

10.00 


10.45 

Developing an elearning Module for 

Allied Health Professionals: 

benefits, problems and reflections 

Paul Hewett and Jo Jex 

A tool to find the appropriate assistive product 

Mary Petersen 

12.00 

Lunch 

13.00 

Clinical uses / appropriate uses of secondary 

positioning systems 

Bart Van der Heyden 

On an equal footing: “Adults accounts of the 

experience of using assistive devices for standing” 

Birgitta Nordström 

Landing in the chair from a standing hoist 

Mary Petersen 

15.00 

Coffee 

15.45 

Sitting on a horse make a change in life 

Charlotte von Arbin, Margareta Håkanson, Ulrika 

Stengard Olsson, Pia Tillberg 

17.00 

Closure 

9.00 

Seating Interventions for Users with 

Amyotrophic Lateral Sclerosis (ALS) 

Bart Van der Heyden and Anni Bank Agger 

10.00 


10.45 

Sit properly! Experiences in use of seat 

cushions for children and adolescents 

with sensory integration dysfunction 

Lotte Wemmenborn 

Adaptive seating in work rehabilitation 

Karen Lyng 

12.00 

Lunch 

13.00 

Influences on the Seated Position 

Menno van Etten 

Exhibition and activities at Hjultorget 

15.00 

Coffee 

15.45 

Clinical practice project from Norway 

Kari Borgen, Henriette A. Sjølett, 

Britt Tornes and Rikke Damkjær Moen 

17.00 

Closure 


17

wednesday • May 23 

anna-karin hanSSon 


Sjukgymnastiken 

rehabiliteringsmedicinska 

kliniken, Universtitets 

sjukhuset i lindköping 

Tel: 013-22 15 48 

E-mail: anna-karin.hansson 

@lio.se 

18 

room m2 TARGET GROUP: ALL 

The effect of a shaped wheelchair 

cushion and a detachable lumbar 

support 

on underseat pressure, estimated comfort, 

and pelvic rotation 

in order to optimize independence for clients with seating and mobility needs it 

is most important to get a wheelchair individually fitted and adjusted. We know 

that load on the spine will increase with a kyphotic or scoliotic posture and that 

a deformity might reduce lung function, cardiovascular function as well as 

ROM in the upper extremities. As therapists, one responsibility is to optimize an 

assistive device with the objective to prevent future complications. 

A shaped wheelchair cushion is often used to support a neutral pelvic tilt, 

together with a lumbar support this might be the best way to give the client a 

good support but what about comfort? 

Learning Objectives: 

• Be able to identify relevant seating outcome variables. 

• Be able to understand the connections between pelvic rotation and under-seat 

pressure. 

• Be able to identify the importance of assessing; posture, pressure and comfort 

and how to prioritize among those when necessary.

Effect of a Dynamic 

Seating Surface 

TARGET GROUP: ALL room m2 

Postural Control, Function and Activity in Children 

and Young people with Cerebral Palsy Experiences 

gained and lessons learned using SPCM, pressure 

mapping, videography and AMPS 

develoPing Seating systems for disabled persons is of great importance as they 

can be used to increase levels of postural control and function which will have 

an impact on daily activities and participation. This study takes its start point in a 

seat back and base made of a dynamic material and analyzing changes in postural 

control. 

The purpose of the study was to investigate if a new dynamic seating surface 

improves postural control, function and activity in youths and children with 

cerebral palsy. No significant statistical results were gained from the quantitative 

methods used: Seated Postural Control measure (SPCM), Force Sensitive Application 

System (FSA) and Assessment of Motor and Process Skills (AMPS) though 

there was slight increase in mean pressure distribution. A supplementary subjective 

evaluation of movement quality showed no clear trend. 

Especially the consequences of adapting the Seated Postural Control Measure 

(SPCM) had our interest. SPCM is described as being able to compare seating systems. 

Our experiences in modifying the measure, use of videography, body markers and 

computer software goniometry for scoring presented various challenges, giving rise 

to questions about SPCM, the seating system tested and the relevance of experience 

and training. We believe our study comprises important areas of interest, especially 

in SPCM development, adaptive seating, and future studies using videography. 


• A new dynamic seat base and back surface, being tested for use in adaptive 

seating systems and studies associated with this system. 

• Challenges associated with the use of alternative methods for clinical assessment 

using a modified Seated Postural Control Measure: how videography, computer 

software and pressure mapping for can be or not be beneficial. 

• Experiences during testing and ideas for use in further studies. 


erna roSenlund 

meyer 

Senior lecurer, MSc, PT 

University collegue of 

Northen denmark 

www.ucnorth.dk 

E-mail: erm@ucn.dk 

Tel: +4572690954 

liSa m trew 


E-mail: lisa.trew@gmail.com 

Tel: +45 29493122 

19

wednesday • May 23 room m2 TARGET GROUP: ALL 

chriStian 

gammelgaard oleSen 

assistant Professor 

The anybody Group, 

department of Mechanical 

and Manufacturing 

Engineering, 

aalborg University, 

denmark 

E-mail: cgo@m-tech.aau.dk 

Tel: +45 9940 3355 

Mob: +45 3033 4553 

20 

Relationship Between 

“Tilt in Space” Wheelchair 

Function and Risk of Pressure 

Ulcer Development 

it iS well acknowledged that sustained mechanical loading of soft tissues causes 

pressure ulcers.The wheelchair adjustments affect the tissue loading in the sense 

that the tissue stresses, and thereby the risk of ulceration, change when the 

seated posture is adapted. This study focuses on a basic wheelchair adjustment 

called the “TiltinSpace” function, which many wheelchairs are equipped with. 

The tiltinspace function enables the cushion and backrest to incline while the 

angle between the cushion and backrest is kept constant. When the tiltinspace 

function is used, the cushion and the backrest reaction forces change, which 

causes a change in tissue deformation under the buttocks. 

Preliminary results show that the reaction forces between the seat and the 

buttocks change, and this leads to a change in buttocks tissue deformation. 

The results indicate that the “TiltinSpace” function found on many wheelchairs 

is not optimal, with respect to risk of developing pressure ulcers. 


• Engineering perspective on wheelchair development with PU focus.

Evaluation of the suitability in 

which antidecubitus cushions 

meet defined user needs 

Comparison of the vendors and the Norwegian 

Labour and Welfare service (NAV)’s evaluation 

of antidecubitus cushions 

nav haS recently awarded contracts for antidecubitus cushions after an open 

tender procedure. NAV’s tender notice described the different user needs the 

cushions should meet and the award criteria was “How well suited are the 

cushions to meet the described user needs?” 

We will show the types of cushions that were offered to meet different user 

needs, how vendors described the cushion and it’s suitability to meet the user 

needs and NAV’s assessment of the same. NAV’s team assessed the actual 

cushion, and compared it to the vendor’s description of its suitability to meet 

the described needs. 

The vendor’s description of the coverage of user needs was usually consistent 

with the cushions appearance and properties. In some cases, the NAV team 

disagreed with the vendor’s description and decided to make an independent 

assessment. We will demonstrate examples of how the NAV team and vendors 

evaluated the cushions differently and which features NAV consider are 

necessary to meet the user requirements. 

The lecture is the result of a cooperation between the team members but will be 

presented by a single member of the team. 


• Examples of how you may be able to find out if the descriptions of the cushions 

correspond to how they appear. 

• Examples on which qualities we found were most important to meet 

the user needs. 

TARGET GROUP: ALL room m2 wednesday • May 23 

gunn limandvik 

Senior adviser/o.T. 

The Norwegian labour 

and Welfare service (NaV) 

E-mail: Gunn.limandvik@ 

nav.no 

Tel: 22 07 09 64 

Mob: 909 61 998 

www.nav.no 

Solveig baardSgaard 

Head of section/nurse 

NaV centre for Sssistive 

technology Nordland 

E-mail:Solveig. 

baardsgaard@nav.no 

Tel: 75 42 67 00 

www.nav.no 

kari-anne lorentzen 

Senior adviser/o.T. 

NaV centre for Sssistive 

technology Møre og Romsdal 

Tel: 70 32 19 50 

www.nav.no 

21


elin berg 

occupational therapist 

The Norwegian labour 

and Welfare Service (NaV) 

E-mail: Elin.berg2@nav.no 

Tel: +47 41575135, 

+47 21069944 

unni norheim 

Seniorrådgiver/ergoterapeut 

NaV (arbeids og 

Velferdsetaten) 

E-mail: unni.norheim 

@nav.no 

Tel: +47 21069700, 

+47 21069942 

Mobil: +47 917 62 403 

22 

Sit as you are, drive as you can 

About seating positioning in an dynamic activity 

where safety comes first 

Introduction: 

This is a presentation from practise, and we invite the participants of this lecture 

to join the discussion of what we see and observe in the videos from driving 

situations. We are working and cooperating with people with complex disabilities 

who are driving their own car from an adapted carseat or from their own 

wheelchair. They all have that in common that they have a serious degree of 

physical handicap and an adapted seating position. Driving demands up and 

downhill affection, breaking and accelerating characteristic, road structure 

and topographic curves are all aspects which are affecting the seating position, 

and therefore the quality of driving a car. We have observed different sitting 

positions and the consequences of lack of support when it comes to driving. 

For the Seating symposium we would like to systematize our findings to share 

our experiences with other clinical workers. 

Background: 

In our daily work we choose and recommend advanced driving equipment for 

persons with complex and serious degree of disabilities. The work is most often 

based upon very well prepared seating postures. Our work is based on evidence, 

experience and clinical reasoning and within both medicine and Assistive 

Technology. 

Conclusions: 

There is no science on this matter and we do not conclude in this presentation. 

The videos speak for themselves. Can we learn something about positioning by 

studying the driving activity? The other way around: We have learned about 

adaptation advice for advanced driving equipment by studying the driving 

activity and the videos we here present

Use of manual and powered 

wheelchair in children with 

cerebral palsy 


mobility iS important for the cognitive and psychosocial development of children. 

Almost one third of children with cerebral palsy (CP) are nonambulant. 

Wheelchairs can provide independent mobility, allowing them to explore their 

environment. Independent mobility is vital for activity and participation and 

reduces the dependence on caregivers. The purpose of this study was to describe 

the use of manual and powered wheelchair indoors and outdoors in relation to 

the degree of independent wheelchair mobility or need for assistance in a total 

population of children with CP. 

A cross-sectional study was performed including all 562 children aged 3-18 years 

with CP living in southern Sweden during 2008. Data was extracted from a register 

and national health care programme for children with CP (CPUP). Information 

on the child’s use of manual and powered wheelchair indoors and outdoors 

and the performance in selfpropelling or need for assistance were analysed. 

Of these children, 29% used a wheelchair indoors and 41% outdoors. A majority 

using manual wheelchairs needed adult assistance (86%) while powered wheelchairs 

provided independent mobility in most cases (86%). To achieve a high 

level of independent mobility, both manual and powered wheelchairs should be 

considered at an early age for children with impaired walking ability. 



bouSquet 






centre for clinicial 

research, Västerås 

gunnar hägglund 



23


liSbeth nilSSon 

Phd, specialist in 

occupational Therapy 

associated to lund University 

barn- och ungdoms - 

habiliteringen, 

Gällivare sjukhus 

E-mail: lisbeth.nilsson 

@med.lu.se 

lisbeth.nilsson@kiruna.nu 

Tel: +46 705838596 

www.lisbethnilsson.se 

24 

Powered mobility practice 

A gate to tool use learning 

Practice in a powered wheelchair may have effects other than independent 

mobility. These effects may be essential for people with cognitive disabilities, 

a population frequently excluded from access to powered mobility. 

The research project Driving to Learn focused on what could be achieved if 

children and adults with profound cognitive disabilities got access to practice 

in a joystickoperated powered wheelchair. The project engaged a total of 126 

participants: 45 with profound cognitive disabilities, 64 with milder degrees of 

cognitive disabilities and 17 infants with typical development. 

The findings involved: development of a one-for-all powered wheelchair for 

practice; identification of an eight-phase process of learning joystick-use; 

identification of strategies facilitating learning powered mobility use; a tool for 

assessment of phase in the process; and a grounded theory of de-plateauing. 

Eight of the 45 participants with profound cognitive disabilities reached control 

of steering and 33 reached control of onset of movement. 

Focus for this session: important characteristics of the one-for-all powered 

wheelchair for practice; how seating characteristics influence on activity; 

general effects of practice other than independent mobility; and necessary 

properties for deplateauing.


Accurate seating measures and 

size of wheelchair optimizing 

function in everyday life 

a workShoP on measuring body size with a proper technique and choosing 

the right sized wheelchair, which is basic knowledge but not as simple and 

obvious as you would wish. If the wheelchair is poorly adapted in size it affects 

comfort, body control and activity level. Reduced stability and balance affects 

head control and function in upper limb. There will be an increased risk for 

developing pressure ulcer in the improperly fitted wheelchair. Concentration, 

stamina and communication are other affected body functions. 

The workshop will share examples on how patients with various sitting ability 

have different effect from an improperly sized wheelchair. It highlights some 

issues told by both experienced and novice prescribers: how to measure safely 

and correctly, how much space you should calculate for clothes, how much you 

should press soft tissue around the hips, how the pelvic position affects the 

depth of seat. Different measuring techniques will be shown. 


• Identify the most important body measures for choosing a wheelchair in 

optimum size. 

• Identify level of sitting ability and relate to choice of wheelchair model. 

• Techniques of measuring body size. 

• Describe the risks with an incorrect size of wheelchair. 


lotte wemmenborn 

leg sjukgymnast/ 

Physio therapist 

fysionord ab 

E-mail: lotte@fysionord.se 

Tel: +46 (0)730- 32 92 99 

www.fysionord.se 

25


elSe marie hanSen 

konsulent, ergoterapeut, 

MPk 

Hjælpemiddelinstituttet/ 

Socialstyrelsen 

E-post:emh@hmi.dk 

www.hmi.dk 

http://www.hmi.dk/sidgodt 

= Sid godt (på dansk) 

http://www.hmi.dk/ 

page2581.aspx = Sitt bra 

(svenska) 

26 

Sid godt – Har du tjekket 

kørestolen og siddestillingen 

i dag? 

Informationsmateriale om siddestillinger 

rigtig mange menneSker i samfundet har brug for viden om, hvordan ældre 

kørestolsbrugere skal sidde i deres kørestole for at opnå størst mulig funktionalitet 

og forebygge, at der opstår skader på deres kroppe. Men typisk er det 

eksperterne, der har den viden, og som bliver tilkaldt, når noget er gået meget 

galt. Det behøver dog ikke at være sådan, for meget viden kan kanaliseres ud til 

brugere, deres hjælpere og plejepersonalet, så mange flere kan være med til at 

forbedre de ældre menneskers funktion i deres kørestole. 

For at udbrede kendskabet til emnet, har Hjælpemiddelinstituttet i Danmark 

udarbejdet et informationsmateriale. Materialet består bl.a. af to plakater 

– ”Sid godt! Har du tjekket kørestolen i dag?” henvender sig især til brugere og 

pårørende, mens plakaten ”Sid godt! Har du tjekket siddestillingen i dag?” 

henvender sig til sygeplejesker og plejepersonale. Til brug for intern undervisning 

på fx plejehjemmet findes et slideshow med en uddybende og lettilgængelig 

beskrivelse af emnet. Det enkelte slide suppleres af teoribaserede 

forklaringer, som den kørestolsansvarlige terapeut på plejehjemmet kan bruge 

i undervisningssituationen. Dette oplæg vil dels beskrive, hvordan materialet 

blev skabt og dels præsentere det for deltagerne på Nordisk Siddesymposium 


• Hvordan man kan fremstille et materiale, der er teoribaseret og mål rettet til 

at løse en bestemt problematik. 

• Hvordan materialet konkret kan bruges til at forbedre ældre menneskers 

siddestillinger i kørestole.


Får du formidlet dine budskaber 

så de forstås af modtagerne? 

Overvejelser og tiltag i forhold til formidling af 

siddestillingsanalysens resultater 

en SiddeStillingSanalySe kan betragtes som en del af en Rehabiliteringsproces, 

der kendetegnes ved at være en tidsbestemt samarbejdsproces mellem borger, 

pårørende og forskellige aktører. Udbyttet af en siddestillingsanalyse er fuldstændig 

afhængig af hvordan samarbejdet mellem de forskellige aktører fungerer, 

og hvor godt det lykkes at få implementeret de foreslåede tiltag i borgerens 

hverdag. 

En meget vigtig aktør i siddestillingssager er borgerens hjælpere. Fra egen praksis 

oplever jeg, at selvom der er givet en instruktion i anvendelsen af kørestol o 

g tilbehør, ser vi ofte, at tilpasningerne på kørestolen ikke bruges hensigtsmæssigt, 

og at borgeren er placeret forkert i den specialtilrettede kørestol. Ergo og 

fysioterapeuter bør således overveje, om der er brug for en mere systematisk 

tilgang, når hjælpere omkring borgeren skal undervises, for at sikre at alle 

– uanset uddannelse forstår de foreslåede tiltag og kan anvende dem i praksis. 


• I mit oplæg vil jeg med udgangspunkt i en konkret siddestillingsanalyse 

fortælle om overvejelser i forhold til implementering af siddestillingsanalysens 

resultater. 

• Overvejelserne omfatter bl.a. et eksempel på en arbejdsmodel, der kan anvendes, 

når borger og hjælpere skal undervises i brugen af hjælpemidlet. 


conni Schmidt 

fysioterapeut 

center for Hjælpemidler 

og kommunikation i 

Sønderjylland 

E-post: cs.chk@ 

aabenraa.dk 

www.chksyd.dk 

27


marina timm 

legitimerad arbetsterapeut/ 

hjälpmedelskonsulent 

Hjälpmedelscentralen 

Västra Götalandsregionen/ 

Skövde 

Tel. 0500-499109 

E-post: marina.timm@ 

vgregion.se 

www.vgregion.se/hmf 

28 

Sitt och ryggstödets inverkan på 

äldre personers sittande i rullstol 

antalet äldre har under de senaste årtiondena mer än fördubblats. Till åldrandet 

hör en rad kroppsliga förändringar så som att lungfunktion och hudens egenskaper 

förändras. För många äldre ökar bröstkyfosen vilket i sin tur innebär en 

ökad risk för nedsatt lungfunktion. Studier visar att en ”dålig” sittposition i 

rullstol ökar risken för felställningar, ryggsmärtor, trycksår, nedsatt lungfunktion 

och cirkulation. Rullstolens sittenhet och därmed bäckenets position, har sannolikt 

en stor inverkan på hur dessa komplikationer uppkommer. 

Under hösten 2011 genomfördes en studie på friska äldre män och kvinnor i 

åldrarna 67–85 år (n=40). 

Syftet med studien var att studera hur friska äldre individer påverkades av en 

manuell rullstols sitt och ryggstöd avseende tryck, bäckenrotation, lungfunktion 

samt upplevd sittkomfort. Två manuella rullstolsfabrikat tillsammans med 

tre olika rullstolsdynor utgjorde fyra rullstolsuppställningar. Datainsamlingen 

skedde med hjälp av tryckmatta (FSA) bäckenrotationsmätare, Micro-spirometri 

samt frågeformulär om upplevd sittkomfort på varje rullstolsuppställning. 

Resultatet av mätningarna visade på signifikanta skillnader både vad gäller 

maxtryck och bäckenrotation. Inga signifikanta skillnader kunde uppmätas vad 

gäller vitalkapacitet (VC) eller forcerad expiratorisk volym (FEV) i någon av de 

testade rullstolsuppställningarna. Däremot kunde vissa tendenser ses till minskad 

lungvolym.

Att sitta rätt och rulla lätt 


Hur äldre rullstolsanvändares framdrivningsteknik 

påverkar sittpositionen och vice versa 

en rullStol är ett rullande förflyttningshjälpmedel och ska ställas in för bästa 

möjliga sittposition och aktivet vilket innefattar förflyttning. Är rullstolen 

inte individuellt optimerad för framdrivningen, kommer det att påverka sittpositionen 

negativt. 

En äldre person har inte samma förutsättningar vad gäller aktivt sittande och 

framdrivning som en yngre rullstolsburen person. Avståndet skuldra – hand på 

drivring, räckvidd, grepp om drivring, och för fotframdrivning; stegisättning 

och steglängd är några exempel på parametrar som man måste tas hänsyn till. 

Men det räcker inte med rätt inställningar, framdrivningstekniken måste tränas. 

Att börja använda rullstol är omvälvande i sig. Att få möjlighet till träning gör att 

rullstolsanvändaren känner sig tryggare. Att göra en rullstolsutprovning ställer 

höga krav på våra analytiska och tekniska kunskaper samt att kunna omsätta 

dem i praktiken. Hur bra är du på att köra rullstol? 

Föreläsningen behandlar följande: 

• Äldre personers rörelsemönster 

• Nödvändiga rullstolsinställningar 

• Anpassning för handframdrivning 

• Anpassning för fotframdrivning 

• Körteknik 


maria amnell 

leg arbetsterapeut och 

utbildningsledare på Etac 

E-post: 

maria.amnell@etac.se 

www.etac.se 

29


karin thewS 

Physiotherapist MSc 

Tel: 0704 837873 

E-post: karin@thews.se 

eva JönSSon 

occupational therapist 

karolinska universitetssjukhuset 

Tel: 08-517 77531 

E-post: eva.b.jonsson 

@karolinska.se 

30 

Är rullstolskörande med 

viss abduktion i höften möjligt 

och önskvärt för barn med 

cerebral pares? 

barn med cerebral PareS (CP) har ofta ökad muskeltonus i vissa muskelgrupper. 

Det kan t.ex. innebära att benen förs ihop och korsas både då man ligger, sitter, 

står och går med försämrad motorisk funktion som resultat. Med tiden kan detta 

också leda till ökad migration i höften och risk för höftluxation. 

I sjukvården och habiliteringen arbetar man aktivt för att öka/bibehålla motorisk 

funktion och om möjligt förhindra höftluxation. Regelbunden klinisk 

undersökning utförs av sjukgymnast och arbetsterapeut. Höftröntgen utförs 

också enligt program (www.cpup.se). 

I behandlingen av barnen strävar man efter att hålla en god höftrörlighet, 

bland annat god abduktion för att minska risken för ökad migration i höften. 

God abduktion i sittande ger också större understödsyta och därigenom kan 

arnet få bättre balans och motorisk funktion. 

Vi tror att man skulle kunna arbeta mer med hur barnet sitter i sin vardag. Vi ser 

ofta barn sitta i rullstolar där möjlighet till abduktion inte finns. Förklaringen 

till det är att rullstolar som barn kan köra själva är konstruerade så att de är lätta 

att köra, men alltför trånga i sitsen vilket gör att man sitter tätt ihop med benen. 

Presentationen kommer att visa resultat av intervjuer med professionella inom 

området och slutsatser från litteratursökning.

Sittande hos barn med 

funktionsnedsättning och 

korsettbehandlad skolios 


SkolioS är vanligt förekommande hos barn som saknar gångförmåga. I Västra 

Götalandsregionen är korrigerande korsett av typ modifierad Bostonkorsett 

en vanlig behandlingsform för barn med skolios och neurologisk funktionsnedsättning. 

Under inprovningen undersöks hur sittförmågan påverkas av 

korsetten. Systematiserad tryckregistrering på bänk ingår i analysen. 

Studien genomfördes som en retrospektiv granskning av journaler hos 122 barn 

som provat in korrigerande korsett. 

Syftet var att beskriva hur sittförmågan påverkas av korrigerande korsett och 

identifiera för vilka grupper sittandet förbättras. 

Studien visar att korsett har en positiv inverkan på sittfunktion. Störst effekt 

syns hos barn som inte kan sitta utan stöd, de som har grav skolios och de som 

inte är gångare. Barn med CP påverkades mer positivt än barn med MMC. 

Klinisk betydelse: Med korsett minskar behovet av stöd i sittande och ett 

mer upprätt sittande med förbättrad huvudkontroll ökar möjligheten till 

delaktighet. Tryckregistrering vid sittanalys kan identifiera behov av 

åtgärder som korrigering av stol eller korsett. Motivationen hos barn och 

familj att använda korsett och förståelsen för anpassningar ökas. 


annika blomkviSt 

leg sjukgymnast 

E-post: annika.blomkvist 

@vgregion.se 

kriStina olSSon 

leg arbetsterapeut 

E-post: kristina.l.olsson 

@vgregion.se 

31


mette hornbæk 

Söderberg 

Ergoterapeut 

center for kommunikation 

og Hjælpemidler 

E-post: Mette.soderberg 

@soc.regionsyddanmark.dk 

Tlf: 79436060 

direkte 79436022 

www.ckhm.dk 

32 

Siddestillingsanalyse 

og Rehabilitering 

mange årS PraktiSk erfaring har lært os, at det er vigtigt med rehabilitering i 

vores specialrådgivning indenfor siddestillingsområdet. Vi har på Center for 

Kommunikation og Hjælpemidler i Vejle set, at det er afgørende for et godt 

resultat, at rehabiliteringen når hele vejen rundt om personen samt de aspekter, 

der er tilknyttet siddestillingen. Man må i den enkelte sag vurdere, hvilke 

fagfolk og specialister, der skal inddrages. 

Jeg vil i korte træk gennemgå, hvordan vi arbejder med rehabiliteringstanken i 

vores siddestillingssager, og jeg kommer ind på hvilke udfordringer, vi oplever. 

Via case-eksempler vil jeg belyse, hvordan vi konkret har grebet det an i den 

enkelte sag. 

Formålet med vores oplæg er: 

• at få fokus på rehabiliterings-tanken i siddestillingssager. 

• at gennemgå, hvilke aspekter man skal ind omkring for at komme i mål med 

et godt og helhedsorienteret resultat, således at siddestillingen fungerer i 

hverdagen. 

• at belyse vores metode, og hvilke udfordringer, som vi har. Dette via case 

eksempler.

33 

Rick mccHaRlES/flickR


britt-marie rydh 

berner 

leg. Sjukgymnast 

Tonusmottagningen R61 

Rehabiliteringsmedicinska 

Universitetskliniken 

Stockholm danderyds Sjukhus 

ab 

karolinska Universitetssjukhuset 

Huddinge 

Tel: 08 585 822 02 

Tel: 073 917 97 03 

britt-marie.rydh-berner 

@ds.se 

34 

Spasticitet, påverkar 

det sittandet? 

SPaSticitet är en mycket komplex problematik som påverkar det mesta i en 

persons vardag. Många diagnosgrupper har denna problematik och dessa kan 

för oss behandlare förefalla mycket olika. Men då det gäller tonusökningen och 

spasticiteten finns det vissa gemensamma nämnare. 

Så är det till exempel då det gäller spasticitet och sittproblematik. Finns det en 

spasticitet av betydelse så kan man vara säker på att den påverkar sittandet. 

Det som händer i kroppen vid spasticitet är ju bland annat att det blir en obalans 

mellan muskelgrupper. Sträckare respektive böjare kan ta överhand i både 

armar och ben. En viktig del av vår kropp att få grepp om då det gäller sittandet 

är bäckenet och kring detta finns det ett otal muskelgrupper som kan påverkas 

av spasticitet. Till detta kommer ofta en skolios som även den kan ha uppstått ur 

samma problematik. 

På vår mottagning – Tonusmottagningen tittar vi på spasticitet och hur den 

påverkar personer i vardagen. Där den ställer till med för mycket bekymmer kan 

vi hjälpa till på flera olika sätt för att minska den.

Evaluation of a Clinical 

assessment tool for posture 

and postural ability 

TARGET GROUP:ALL room e4 

there are Several professions working with the assessment for, and prescription 

of, equipment to support people with severe disabilities in sitting, standing 

and lying. There is a need for a valid and reliable clinical assessment tool to facilitate 

assessment of posture and postural ability in order to provide appropriate 

support and evaluate therapeutic inter ventions. 

To evaluate reliability and validity of a clinical assessment tool for posture 

and postural ability we performed a study using photos and films of 30 young 

adults with cerebral palsy born 1988–1991. The adults were categorized into five 

different groups using the gross motor classification system (GMFCS). Inter-rater 

reliability for the assement tool was evaluated by independent ratings of photos 

and films by three Physiotherapists. The internal consistency and homogenity of 

the instrument was evaluated using Cronbach’s alpha. The construct validity was 

examined through the ability to differ between known-groups (GMFCS levels). 

The assessment tool is reliable and valid for assessment of posture and postural 

ability in people with postural deficits. It’s quick to administer and do not 

require any special equipment and therefor easy to use in a clinical setting. 



bouSquet 





lund University centre for 

clinicial research, Västerås 






guðný JónSdóttir 


Endurhæfing- Rehabilitation 

centre of excellence, 

E-mail: gudny 

@endurhaefing.is 

Tel: +354 4144500 


ann-chriStin 

JohanSSon 

gunnar hägglund 

PhiliPPe wagner 

35

wednesday • May 23 room e4 TARGET GROUP:INTERMEDIATE 






una birna 

guðJónSdóttir 

rannveig 

baldurSdóttir 

36 

Supine lying support 

in iceland children with severe and complex neurological disability, commonly 

use orthoses and custom made seating systems most of their life. However the 

majority seem to have developed severe deformation of the trunk, pelvis and 

hips, by the time they enter adulthood. The time children and adults spend in 

custom made seating systems and orthoses is much shorter than the time they 

spend not using it. Recently the focus of management has shifted more to the 

time individuals are not using their assistive devices. 

The design principle behind the lying support is that the severe deformations 

of the trunk, pelvis and hips that are observed in individuals with complex 

neurological disability are a secondary complication to the original impairment, 

and as such can be prevented. In the supine position, gravity exerts uniform 

pressure on the trunk, the so called human sandwich effect. There are there fore 

no destructive external rotational moments present in the horizontal and 

sagittal planes. The lying support gives side support that stops destructive 

internal rotational moments in the frontal plane. 

The long term goal of the lying support is to minimize these secondary 

complications. 

The presentation will cover the design principle behind the lying support 

and the short terms effects of the use of the lying support. It will also cover 

the secondary versus primary complication associated with the original 

impairment, the biomechanical aspect of supine lying versus side and prone 

lying and its association to trunk symmetry. 

Learning Objective 

• Introducing a new type of lying support for supine lying.

TARGET GROUP: ALL room e4 

Developing an elearning Module 

for Allied Health Professionals 

Benefits, problems and reflections 

elearning can Provide significant benfits and flexibility to AHP professionals. 

Modules are not difficult to develop, and can be successfully achieved with 

careful planning and decisionmaking, and with a clear vision of the scope. 

Social media developments could be used to develop learner and professional 

networks, either new or existing. 

In recent years, training budgets in the UK have become more tightly 

constained, and professionals have found it increasingly difficult to incorporate 

the growing number of relevant courses and conferences into a hectic clinical 

schedule. It can also be difficult to put into practice new skills developed at 

conference or at a specific training event. Elearning can help to address some of 

these issues. We have developed an elearning module for the Chailey Levels of 

Ability Assessment Charts. This is a useful outcome measure that can be used to 

assess and record postural ability. It forms an important part of our twoday 

course, but delegates often find it is helpful to have a follow-up session once the 

measure has been used in practice. 

Our second key decision was the ‘platform’ that would be best suited to deliver 

the content. We felt that a web page (html) based tool would be the most 

appropriate. 

We will also briefly discuss delivery platforms that were excluded and why. 

Learning Objectives 

• To have a broad understanding of delivery platforms available for eLearning 

• To understand some of the problems associated with developing an eLearning 

programme. 

• Have a broad idea of the planning and decision-making required in developing 

content. 


Paul hewett 

bSc MSc, industrial 

designer 

active design ltd, Uk 

E-mail: paul@activedesign.co.uk/ 

Tel: +44 121 326 7506 

www.activedesign.co.uk 

www.posturalmanagement.com 

Jo JeX 

McSP SRP PGcert, 

clinical Educator, 


active design ltd 

E-mail: jo@activedesign.co.uk 

Tel: 07798842511 

www.activedesign.co.uk 

37

wednesday • May 23 room e4 TARGET GROUP: ALL 

mary PeterSen 

consultant, Physiotherapist 

Tel: 41 91 81 54 

E-mail: mpe@hmi.dk 

38 

A tool to find the appropriate 

assistive product 

assist data iS a web based data base on assistive devices on the Danish market. 

Although AssistData is a data base of products on the Danish market the presentation 

will be of interest for all participants as a great portion of the products are 

sold both in other European and even overseas countries. In addition AssistData 

is now also available in an English version. AssistData has advanced search 

functions facilitating the sorting or filtering of products within the various 

types, e.g. wheelchairs, seating cushions etc. 

By means of the various tools in the data base it is possible to filter among this 

vast amount of e.g. wheelchairs to gain a somewhat smaller portion consisting of 

all wheelchairs meeting the requirements set for the specific situation regarding 

properties, dimensions, equipment etc. 


This presentation is an online demonstration of AssistData and the 

different entries for searching and other functions on the site. 

• The focus of the presentation is a demonstration of the facilities for search 

and filtering where the participants will be shown step-by-step how to utilize 

AssistData to find appropriate products for a specific seating situation.


Clinical uses/appropriate uses of 

secondary positioning systems 

an intermediate to advanced level seminar designed for individuals currently 

working in the field of seating and positioning focusing on improving functional 

outcomes by controlling pelvic position, the trunk and head and the lower 

extremities. 

We’ll go over a clinical examination and seating assessment in order to get an 

accurate understanding of the different aspects involved with common seating 

problems. The impact of single body segments on global posture will be 

discussed and illustrated with cases and examples of seating problems such as 

kyphosis, sliding, poor head control and scoliosis will be analyzed. The impact of 

spasticity has on secondary support systems will be discuss and illustrated with 

several case studies of children with Cerebral Palsy. 

The biomechanics of the pelvis, trunk, head and lower extremities will be 

reviewed in relation to positioning of the pelvis, lower body and upper upper 

body.The correct biomechanical placement and the clinical indications of the 

following types of secondary support systems will be analyzed and discussed; 

Hip belts, Sub ASIS (Anterior Superior Illiac Spine) Pads, Leg harnesses, Ankle 

fixation belts, Adjustable Angle Footplates, Calf panels and calf staps, Thoracic 

and shoulder harnesses and Chest Belts 


• Understand how the anatomical placement of secondary support systems 

impacts the users postural ability, functional ability and comfort. 

• Understand the applications of postural supports in order to control posture 

and obtain functional outcomes. 


bart van der heyden 

Physical Therapist 

Seating and Wound care 

Specialist / consultant 

director Training & 

Education The RoHo 

Group Europe 

clinical advisor EU and ME 

bodypoint (US) & Xsensor 

(canada) 

director, Training & 

Education Europe 

The RoHo Group 

E-mail: bvanderheyden 

@attglobal.ne 

www.therohogroup.com 

39


birgitta nordStröm 

Physiotherapist/doctoral 

student at lTU 

E-mail: 

birgitta.nordstrom@ltu.se 

40 

On an equal footing 

“Adults accounts of the experience of using assistive 

devises for standing” and a short summary of the use of 

standing devices for persons with disabilities. 

today the PhySiotheraPiSt and/or occupational therapist prescribe the standing 

device mainly focusing on the physical/physiological body. Since there are 

largely absence of studies focusing on users’ experiences on standing in standing 

devices it is important to study this phenomenon further. 

The aim of this study was to illuminate the adult users’ experiences of standing 

in standing devices. The participants in this study were older adults who had 

received a standing device and could be found in the register of assistive 

technology. Fifteen participants with diagnosis such as stroke, traumatic spinal 

cord injury, traumatic brain injury, cerebral palsy and multiple sclerosis were 

interviewed. 

The results of study indicated that standing in standing devices for persons 

with severe disabilities seemed to be more than just a treatment of the biological 

body; it also affected the social interplay and contributed to a changed relationship 

to the outside world.

Landing in the chair 

from a standing hoist 


vitSi – the interdiSciPlinary Evidence Generating Network for Seating has 

carried out a pilot study with the purpose of discovering which factors, when 

using a standing hoist, influence the quality of the seated position. The focus has 

been to point out to transfer instructors and occupational and physiotherapists 

the central aspects to be used in connection with the planning and dissemination 

of the information on adopting the sitting position by use of a standing hoist. 

The conclusion of our study so far is that the distinctive characteristic of landing 

in a chair by use of a standing hoist, as opposed to e.g. a stationary hoist in the 

ceiling, is the fact that the user is changing his position from standing to sitting 

in the process of the transfer. This change of position is influenced by the person’s 

functional ability – incl. possible pathological patterns. In connection with the 

dissemination of the information to transfer instructors and therapists it is 

therefore important to include the fact that the assistant needs to possess 

knowledge on and, in the guidance of the user, take into account the individual 

and perhaps pathological patterns of movement in the user. 


mary PeterSen 

consultant, Physiotherapist 

Tel: 41 91 81 54 

E-mail: mpe@hmi.dk 

41


charlotte von arbin 

PT av iRT certifierad 

ridterapeut 

E-mail: von.arbin.charlotte 

@telia.com 

Tel: +46(0)31-406047 

Göteborgs Handikappridklubb, 

www.ghrk.se 

margareta håkanSon 

leg sjukgymnast, 

Med lic, specialist i 

psykiatri och psykosomatik 

inst för tillämpad iT, 

kollegium SSkkii 

Göteborgs universitet 

E-mail: margareta. 

hakanson@comhem.se 

Tel: 0709 46 10 35 

www.sskkii.gu.se 

ulrika Stengard-olSSon 

leg sjukgymnast/ridsjuk gymnast, 

Söderåsens forsgård, 

E-mail: ulrika@soderasensforsgard.se 

Tel: +46 (0)435 191 19 

0706-191192 

www.soderasensforsgard.se 

42 

Sitting on a Horse make 

a change in life! 

the movement that occurs between horse and rider can be used to influence the 

rider’s functionality. Effects described in international studies are, besides improved 

balance and coordination of the trunk, reduced need for walking aids, enhanced 

function for personal hygiene during toilet visits and an increasing discomfort at 

the long break in between riding among riders with cerebral palsy. Riders suffering 

from stroke and MS point out enhanced wellbeing and improved quality of life as 

important effects from riding, in rehabilitation and as leisure activity. There are no 

studies on the everyday effects of regular riding for disabled riders in the Nordic 

countries, but the clinical experiences describes similar stories on valuable impact 

on everyday life. 

In this workshop we will highlight the effects of riding to seating and positioning 

and functional mobility (physical, mental and social) for persons with disabilities. 


Give a brief description of the current body of knowledge according healtpro motive 

effects from horseback riding, equine assisted therapy, horse connected leisure 

activities and sports related to functional limitations of different origin 

• Initiate a discussion on how to increase access to therapy, leisure activity and 

sports within the field of riding, driving and other kinds of horse related activities. 

• Highlight security issues, aids and adaptation of equipment for riders with 

functional limitations. 

Pia tillberg 

leg.sjukgymnast, 

iRT-certifierad ridterapeut, 

projektansvarig Stiftelsen Hippocampus 

E-mail: pia.tillberg@comhem.se 

Tel: 070-403 71 09 

www.stiftelsenhippocampus.se

43 

HoUNzaSoUcUP/flickR


bart van der heyden 

Physical Therapist 

Seating and Wound care 

Specialist / consultant 

director Training & 

Education The RoHo 

Group Europe 

clinical advisor EU and ME 

bodypoint (US) & Xsensor 

(canada) 

director, Training & 

Education Europe 

The RoHo Group 

E-mail: bvanderheyden 

@attglobal.ne 

www.therohogroup.com 

anni bank agger 

occupational Therapist 

Holstebro kommune, 

denmark. 

E-mail: SSREaba 

@Holstebro.dk 

annibanka@gmail.com 

Tel: 96114822 

44 

Seating Interventions for users 

with Amyotrophic Lateral 

Sclerosis (ALS) 

amyotroPhic lateral ScleroSiS is a progressive Motor Neuron Disease, causing 

many medical challenges like muscle weakness, dysarthria, dysphagia and 

respiratory problems. Seating interventions should focus on promoting functional 

independence, preventing medical complications and provide a comfort. 

Seating interventions and assistive technology can enhance independence and 

safety of the individual but it remains key to keep in mind that each person has 

an individual mind set and different attitudes, so seating interventions should 

be giving the user a feeling of empowerment, not losing hope or control. 

During this presentation we’ll show individuals suffering from ALS and we’ll 

discuss the wheelchair user’s perspectives, motivation and needs on seating and 

mobility and how these needs are integrated with the functional requirements 

and the progressive medical needs of the individual.


Sit properly! Experiences in use 

of seat cushions for children 

and adolescents with sensory 

integration dysfunction 

many children with 

sensory integration dysfunction may constantly be told that they should 

“sit properly” – without any effect. This may be children with diagnoses such 

as ADHD, ADD, mental retardation and CP. 

When we study what causes the problems with hyperactivity, hypo activity and 

poor posture, we find not only neuropsychological causes, but also impaired 

coordination and balance. Even when the gross motor function and fine motor 

skills is within the normal range seating can be an issue. 

This lecture presents how PT and OT at the Child Psychiatry Clinic at the 

hos pital of Sollefteå worked with seat cushions such as a ball cushion in a project 

2011. The aim was to give children a good sitting position in various activities in 

everyday life. Adaptation of chairs providing a dynamic support stimulates joint 

and muscle sense and helped some children improve sitting skills and ability to 

focus. For some children it reduced restlessness and improved dealing with 

everyday situations in both at school and at home. 


• See postural control and its function from a sensory motor perspective. 

• Get an introduction to adaptation possibilities. 


lotte wemmenborn 

leg sjukgymnast/ 


fysionord ab 

E-mail: lotte@fysionord.se 

Tel: +46 (0)730- 32 92 99 

www.fysionord.se 

45


karen lyng 

occupational Therapist, 

Master of Rehabilitation 

VEla, Vermund larsen a/S 

E-mail: kly@vela.dk 

Phone:+45 9634 7600 

www.vela.eu 

46 

room e8 TARGET GROUP: ALL 

Adaptive seating in work 

rehabilitation 

workPlace accommodation including adaptive seating makes a difference to 

persons with mobility disabilities and their participation in work. 

In a qualitative study it have been found that physical demands at the workplace 

are reported as barriers to working for people with mobility disabilities. The 

results indicate that adaptive seating, assistive tech nology and adaptation of the 

workplace are important parts of work 

rehabilitation. 

The conclusion is that adaptive seating may facilitate work rehabilitation and 

that general ergonomic principles for seated, semiseated and standing working 

positions should be considered. Work rehabilitation should be part of the general 

rehabilitation process, and adaptive seating at the workplace is just as important 

as seating at home. 


• Consider in their daily practice the crucial importance of employment to people 

with disabilities. 

• Counsel clients and employers that the importance of adaptive seating at the 

workplace is on a par with seating for any other activity in daily life. 

• Consider and include work rehabilitation as an important and integral part of 

the rehabilitation process in general. 

• Start planning and implementing seating solutions for work environments.


Influences on the Seated Position 

how to Sort out all the parameters which influence on the seated position? 

What are all these parameters? How do parameters like gravity or the position of 

the head or the backrest shape influence the seated position? How do these and 

all those other functions influence on the clients ability to function as intended? 

How does a wheelchair set up like a seat angle influence the client’s ability to eat 

or to propel a wheelchair or to keep stable while seated? 

We will recognize and analyze these functions; we will experience these functions 

and possibly see how little difference there is between reaction patterns 

in able bodied person’s and those with a disability. We will discuss seating 

intervention strategies and define the equipment properties needed to address 

the client’s objectives; is the client able to function as intended? 


• Provide a different look at the client seated position, without getting lost in 

the amount of problems they might experience. 

• Participants will learn to sort out and analyze seating parameters, 

how these parameters interact and influence each other. 

• Seating intervention strategies are discussed so that at the end of the course, 

participants should be better equipped to determine the 

equipment properties that are required to address the individual’s 

objectives, rather than simply choosing specific product solutions. 


menno van etten 


Product- & Education Manager 

Etac aS 

E-mail: menno.vanetten 

@etac.com 

tel: +47 915 64 233 

47

wednesday • May 23 room e8 TARGET GROUP: INTERMEDIATE 

kari borgen 


Habiliteringssenteret i Vestfold, 

Sykehuset i Vestfold Hf 

E-post: kari.borgen@siv.no 

Tlf: 33308265 

HenrieTTe a. sjøleTT 

occupational Therapist 

Nav Hjelpemidddelsentral 

Vestfold 

E-mail: henriette.andersen 

@nav.no 

Tlf: +47 33513200 

britt torneS 


Habiliteringssenteret i Vestfold, 

Sykehuset i Vestfol Hf 

E-mail: britt.tornes@siv.no 

Tlf: +47 33308265 

rikke damkJær moen 


Medical manager 

Made for Movement Group aS 

Tlf: +47 35 50 51 20 

madeformovement.com 

E-mail: rdm@madefore 

movement.com 

48 

Clinical practice project 

from Norway 

children with diSabilitieS have little or limited possibilities for movement in 

daily life. Consequences of immobility are gastrointestinal disorders, muscle 

atrophy, contractures, pain etc. 

The purpose of the project was to enable assisted movement in a standing 

position for children with former disabilities and evaluate the effect of movement, 

over a period of one year. To provide assisted movement the helping aid 

Inno walk was used. 13 children have completed the project period. All children 

are tested before start up with the helping aid Innowalk, after a 4 week probation 

period, after 4 month and 12 months of use. 


• What effect do children with former disabilities have of regular 

movement in a standing position? 

• Discussion on frequency /duration of movement needed to gain effect! 

• Identify patients who will benefit from assisted movement.

Det enkla 

är det sköna. 

ROHO ® har i snart fyrtio år strävat efter att utveckla de bästa 

tryckavlastande och positionerande dynorna för dig som lever ditt 

liv sittande. För att lyckas krävs en ständig utveckling. Ett exempel 

på det är den geniala, patenterade ISOFLO Memory Control ® som 

reglerar luften mellan de fyra luftkamrarna. Ett enkelt tryck på reglaget 

möjliggör en korrigering och stabilisering av bäckenet, vilket många 

gånger är en förutsättning för en bättre hållning. Med ROHO‘s 

unika DRy FLOatatIOn ® teknik kan du även vara säker på optimal 

tryckavlastning i alla situationer. 

Sitt bättre – på en sittdyna som du kan leva med länge, det finns 

nog ingen som både tryckavlastar och stabiliserar bättre. 

Läs mer om våra unika sittdynor på www.etac.se. 

49


50 

Programme thurSday, may 24 

room m2 

8.30 

Supported Standing: Using Evidence for Clinical Decision Making 

Ginny Paleg, Physiotherapist, USA 

Considerations regarding Lying 

Dorte Støvring, Physiotherapist, Denmark 

10.15 

Coffee and posterexhibition 

11.00 

Are your preventive interventions related to pressure ulcers 

in fact rational at all? 

Helle Dreier, Occupational Therapist, Denmark 

Inclusion Tour 2010 – Casablanca and Stockholm, 

630 mil by wheelchair 

Lars Löfström, Sweden 

13.00 

Closure

Supported Standing, using 

evidence for clinical decision 

making 

much haS been learned about supported standing programs, but many clinicians 

are missing crucial information about the significance of incorporating vibration, 

oscillation, sway, ability to self propel in the device, stepping and movement to 

increase activity and participation for infants, children who are nonambulatory 

(GMFCS Levels 4 and 5). 

This lecture will begin with a systematic review of the literature (sorted by ICF 

category). Case stories with videos will be to share ideas about intervention 

strategies and outcome measures. Content will focus on whole body vibration 

and standers that incorporate movement and activity. Emphasis will be on 

preservation of hips for children with CP GMFCS Levels 4 and 5. Specific dosage 

(frequency and duration of bout) will be linked with specific ICF outcomes. 


• (Knowledge) Participants will be able to describe the benefits of 

standing programs. 

• (Comprehension) Participants will be able to understand why it is important 

to use eviedence to determine dosage and outcomes for standing programs. 

• (Application) Participants will be able to apply current standing research to 

their decision making process for frequency, postural 

supports, bracing and amount of abductionto all brands and models of 

standers. 

• (Analysis) Participants will be able to assess any stander for its ability 

to accomplish or adapt to the desired clinical parameters to optimize 

the child/adult’s activity and participation in a natural environment. 

• (Synthesis) Participants will be able to incorporate new information presented 

into their current understanding and approach to using standers to increase 

activity and participation in natural environments. 

room m2 

THursday • May 24 

ginny Paleg 

dScPT, MPT, PT 


Montgomery county infants 

and Toddlers, 

Maryland, USa 

E-mail ginny@paleg.com 

Tel: 001-301-452-4656 

51

THursday • May 24 room m2 

dorTe sTøvring 


dS consulting 

E-mail: dorte.stovring 

@mail.dk 

Tel: +45 2329 6644 

52 

Considerations regarding lying 

there iS an increaSing focus on 24 hour positioning as many of our wheelchair 

users have complex needs and may require different kinds of postural support 

throughout 24 hours. 

Lying support has been widely used in countries outside Scandinavia, but in 

Scandinavia it has been more randomly applied. 

This presentation will review: 

• Which of our clients may benefit from Lying support? 

• How do we assess the client? (practical demonstration of this via a 

slides series) 

• How do we decide on the goals, we want to achieve? 

• Which considerations do we need to make prior to choosing lying 

postural support?

Are your preventive 

pressure ulcer interventions 

rational at all? 

wheelchair uSerS with poor or missing sensibility are often exposed to pressure 

ulcers related to the seated position. Because of that they are often bedridden for 

months or years which may have detrimental adverse effects on organ systems 

in the body as it may cause muscle loss, joint contractures and deprivation of 

environmental and social stimulation. Overall it may have a very negative 

impact on quality of life and may even be life threatening. It would be sensible 

and rational to avoid this by offering a seating assessment procedure including 

analysis of the individual activity performance in everyday life – meaning in 

everyday life context. 

During years of clinical practice in Holbaek, DK an activity based seating 

assessment (ABSA) procedure has been developed and has shown a potential 

of prevention and healing sitting acquired pressure ulcers while seated. It has 

become clear that a greater part of the pressure problem seem to be about 

inconsistency of pressure ulcer classification as well as a non existing distinction 

between pressure ulcers either caused by physical contact with the chair or 

with the bed. 

Pressure ulcer intervention generally speaking seems to be perceived 

as a matter of picking out the right mattress for the right person suffering from 

pressure ulcers or at risk of having them. This may have had a considerable 

impact on society expenses even though the utility value has been very much 

limited. This requires further focus on the professional ability to distinguish 

sufficiently in order to intervene in the most rational way and this presentation 

will give it a try. 

room m2 

THursday • May 24 

helle dreier 

oT, MSi specialist in 

Sitting acquired 

Pressure Ulcers 

Special advisory, assistive 

devices and disabled 

E-mail: heldr@holb.dk/ 

helle.dreier@gmail.com 

Tel: 0045 72363345 

www.hjaelpemidler.com / 

www.tryksaar.dk 

53

THursday • May 24 room m2 

larS löfStröm 

Physical education teacher 

54 

Inclusion Tour 2010 

– Casablanca and Stockholm, 

630 mil by wheelchair 

Inclusion Tour 2010 Casablanca–Stockholm 

larS löfStröm talkS about the unique journey he made with his friend Mats 

Melin. No one has ever pushed a standard wheelchair so far in so short time, 

6300 km for five months. Mats, on the bike, and Lars, in his wheelchair, passed 

through eleven countries and over the mountain ranges of the Pyrenees and the 

Jura mountains on their way to Stockholm. 

Lars Löfström, age 56, exam: Education Teacher (GIH), with experience as 

Researchers at the Karolinska Institute, Physical Education Teacher and 

Vice Principal. He has also won several gold medals in wheelchair racing both 

in the Paralympic games and in the World Championships.

Space for your own notes 

56

The Nordic Seating Symposium is a coarrangement 

between The Assistive Technology Center in Iceland, Assistive Technology 

and Social Psychiatry in Denmark, The Norwegian Labour and Welfare 

Service (NAV), National Institute for Health and Welfare in Finland (THL) 

and The Swedish Institute of Assistive Technology (SIAT). 

www.sitsite.net

5th Nordic Seating Symposium - Sitsite - Hjælpemidler

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