Last month, I talked about the importance of the hands on assessment as a mat assessment provides so much information regarding a client’s seating needs. It is a step in the assessment process that cannot be missed.
This month, I would like to carry on from there. What do you do with the information that you have gathered from the overall assessment? Well, the next step is to use your clinical reasoning skills to determine what the goals of seating are for your client. What is it that you would like the seating to achieve for your client? Of course, as a client-centered therapist, you will collaborate with your client to determine what the goal or goals of seating are for that individual. Possible goals for seating may include one or more of the following: positioning, stability, skin integrity, managing tone, function/mobility and sitting tolerance/comfort.
Once you have established the goals of seating for your individual client, you need to think about the generic product parameters that are required to achieve those goals. Think about the level of skin protection that is needed and consider the method of load distribution that is best for your client. Think about the amount of positioning that is needed. Is there a fixed abnormal posture, such as posterior pelvic tilt or pelvic obliquity, which requires accommodation in the seating? Is the abnormal posture flexible and requires correction? Can the client tolerate correction? In addition, think about the amount of stability that is needed for function. Consider both lateral and forward stability. There are other factors to keep in mind as well, such as the client’s ability to perform any needed maintenance for a cushion and his/her ability to transfer in/out of the seating. So, a lot of clinical reasoning is used even before you get to the seating and equipment trial phase.
As always, please provide your comments, questions and suggestions regarding Clinical Corner on my blog. I look forward to hearing from you!
Sheilagh Sherman, BA, BHScOT, OT Reg. (Ont.)
Sunrise Medical Canada
Note: The content of this article is not meant to be prescriptive; rather, it is meant as a general resource for clinicians to then use clinical reasoning skills to determine optimal seating and mobility solutions for individual clients. Sheilagh is unable to answer questions from members of the general public. Members of the general public are directed to their own therapists or other health care professionals to ask questions regarding seating and mobility needs.
This article is © Sunrise Medical, Inc., 2011 and cannot be copied, distributed, or otherwise reproduced in whole or in part without the express written permission of Sunrise Medical Canada.