Careflex - Educational Videos

Part One – Introduction

Footage was taken at one of our recent specialist seating seminars at the Occupational Therapy Adaptations Conference in Llanelli, South Wales. The training event was facilitated by our Clinical Specialist, Rebecca Dunstall, and supported by our Business Development Manager, Les Jones.

Learning outcomes included:

  • Reviewing the basics of posture and pressure

  • Understanding the vital role of specialist seating

  • Appreciating the impact of seating on daily living and ultimately quality of life

  • Key tips for comprehensive assessment and prescription

Part Two – 24 Hour Postural Management

As a person grows and develops they learn from and respond to information that is sent from various sources, including visual, vestibular (sensory) and proprioceptive (movement sensations from muscles and tendons) input. Damage to any of these systems, through age, injury, illness or disease, can affect their ability to interact with the information; therefore, they will find it increasingly difficult to achieve a good posture.

Failure to protect an individual’s posture can result in many secondary complications, including pain, fatigue, deteriorating health, decreased independence, and ultimately reduced quality of life. Postural management is the use of any intervention to promote comfort, enhance function and reduce the risk of postural deterioration across the full 24 hours.

Part Three – Posture and Pressure are Inextricably Linked

Pressure care is a crucial aspect of specialist seating, as posture and pressure are inextricably linked.

Posture and positioning have a direct influence on the pressure going through specific body sites. High interface pressures over prolonged periods of time causes the skin and underlying tissues to become compressed; consequently, blood cannot circulate and the cells do not get their vital oxygen and nutrients, resulting in cell death. The body can only withstand these high interface pressures for a short period of time, and when the loading of tissues is unequal and/or the pressure is not regularly relieved pressure injury can occur.

This video discusses the link between posture and pressure, and how we cannot manage one effectively without addressing the other.

Part Four – Secondary Complications

Failure to appropriately and effectively manage an individual’s posture and pressure care needs can result in many secondary complications, including:

  • Pain and discomfort

  • Contractures and deformities

  • Poor physiological function

  • Deterioration in health

  • Reduced function and independence

  • Social isolation and limited opportunity for participation

  • Reduced quality of life

  • Death

It is imperative to identify the individuals at risk of difficulty achieving a good sitting posture so that management plans can be put in place to reduce the risk of the above complications occurring in the first place. When identifying those at risk we must consider those who either lack the physical ability to change position, lack the cognitive awareness to know that they need to change position, or lack the communication skills to convey that they need to change position. Prevention is the best form of management!

Our series of educational videos will guide you through the assessment and prescription of specialist seating, and offer useful hints and tips –keep a look out for the new videos being added.

Part Five – Bony Landmarks – The Pelvis

Due to the variability among people it is acknowledged that a universal seating position is not practical and an individual assessment and prescription is recommended.

Why do we need to assess?

We also need a baseline upon which to measure the effectiveness of any prescribed specialist seating during the review process.

The pelvis is the foundation for a good sitting posture as it dictates what happens to the body segments above and below. This video illustrates the importance of assessing the pelvis and how best to identify any pelvic challenges during the assessment process using key bony prominences.

Part Six – Bony Landmarks Ischial Tuberosities

We also need a baseline upon which to measure the effectiveness of any prescribed specialist seating during the review process.

The pelvis is the foundation for a good sitting posture as it dictates what happens to the body segments above and below.

 

The ischial tuberosities of the pelvis are a key bony landmark to refer to during the assessment process as their position can indicate pelvic instability and potential weight distribution problems. This video demonstrates how best to identify these key bony prominences.

Part Seven – Objective Assessment

We also need a baseline upon which to measure the effectiveness of any prescribed specialist seating during the review process.

Pelvic stability is the foundation for a good sitting posture as it enables good postural control and dictates what happens to the body segments above and below.

 

This video demonstrates how best to identify any pelvic stability or postural control problems during the assessment process and provides some hints and tips to address these problems.

Part Eight – Critical Angles for Sitting

We also need a baseline upon which to measure the effectiveness of any prescribed specialist seating during the review process.

There are specific critical angles that we need to be able to achieve a typical seated posture: 90° hip flexion and 90° knee flexion.

 

If an individual is unable to achieve these ranges of movement then their specialist seating prescription will need to accommodate this. This video shows how to assess for these critical angles for sitting.

Part Nine – Objective Assessment and the Importance of Chair Measurements

We also need a baseline upon which to measure the effectiveness of any prescribed specialist seating during the review process.

Incorrect chair measurements can disrupt an individual’s posture, regardless of whether they have any known damage to the body systems.

 

This video discusses the importance of ensuring the chair is set-up for the individual and how best to measure their dimensions during the assessment process.

Part Ten – Comfort

Regardless of the clinical benefits, a chair may not be used if the user is not comfortable1.

Comfort should be the main objective when prescribing specialist seating. Ensuring comfort, which includes energy conservation and pain management, is essential for successful prescription as it can ultimately improve quality of life for an individual.

Good positioning can promote comfort and decrease fatigue2, which can increase tolerance of a desired seating position that is essential for consistency and compliance. Specialist seating and the way in which it is set-up can be effective in both inhibiting abnormal muscle tone and in accommodating its sequelae3, which can have a significant impact on reducing pain levels.

Part Eleven – Seating Prescription – Pelvic Stability

A good stable sitting posture, especially one that promotes postural alignment and control, is a critical requirement for function. Use of the upper limbs is vital to the successful performance of tasks and participation in activities of daily living1.

 

Freedom of movement in the upper limbs is achieved through effective stabilisation of the pelvis and trunk2, which can be achieved with the correct seating system. Specialist seating and the way in which it is set-up can also reduce the influence of abnormal tone and reflexes3,4, consequently encouraging normal movement.

Part Twelve – Seating Prescription – Thigh Support

Once pelvic stability is achieved, it is important to ensure that the thighs are fully supported in a level and as midline position as possible. It is especially important for the ischial tuberosities to be supported, ensuring equal weight distribution, to reduce the risk of pressure injury.

Remember, even if an individual is able to achieve the gold standard 90-90-90 sitting position, their weight distribution is as follows1:

  1. Through the buttocks & thighs: 75%

  2. Through the feet: 19%

  3. Through the arms rests: 2%

  4. Through the back: 4%

 

This video introduces the postures that can challenge thigh support and discusses the different options for their management.

Part Thirteen – Seating Prescription – Lower Legs and Feet

Unsupported lower legs can affect the position of the thighs and therefore the stability at the pelvis. Insufficient foot support can also negatively impact on postural stability; we naturally seek support through our feet to obtain the proprioceptive feedback required.

Remember, even if an individual is able to achieve the gold standard 90-90-90 sitting position, their weight distribution is as follows1:

  1. Through the buttocks & thighs: 75%

  2. Through the feet: 19%

  3. Through the arms rests: 2%

  4. Through the back: 4%                                     

 

Without the feet supported, where does 19% of the individual’s body weight go? They could potentially have 94% of their body weight just going through their buttocks and thighs, and we wonder why individuals are sadly developing pressure injuries.

This video demonstrates the importance of ensuring adequate lower leg and foot support, and discusses the need to ensure appropriate chair set-up and use of functions based on the user’s posture and range of movement.

Part Fourteen – Seating Prescription – Thorax and Shoulder

After addressing pelvic instability and ensuring the lower limbs and feet are supported, it is essential to encourage trunk alignment and control.

 

The position of the trunk will dictate the position of the head, which a crucial body segment to consider during seating prescription to ensure not only the user’s safety but also their ability to interact with their environment.

Part Sixteen – Seating Prescription – Head Support

Head support is essential for safety during eating and drinking, for optimum respiratory function when breathing, and for achieving the best position for interaction with the outside world. It is important to always start at the pelvis to create a stable base and support the trunk adequately as the pelvis and spine will determine the position of the head.

This video introduces the different options available for the management of head control and alignment. 

Disclaimer: Ensure the assessment and prescription is completed by an experienced and qualified professional who has the competence and confidence required. Or contact us to book a free no-obligation assessment with our own seating assessors.

Part Seventeen – Pressure Care

Pressure care is a vital aspect of successful specialist seating prescription – and prevention is key! This video discusses the intrinsic and extrinsic factors that can affect pressure care and offers solutions for their management. 

At CareFlex we have earned an outstanding reputation for the quality of our products and service. We are confident that in a managed and trained health or care environment our WaterCell Technology will suit users of all risk categories when used as part of a holistic posture and pressure management programme. 

Part Eighteen – Critical Angles for Sitting

There are specific critical angles that we need to be able to achieve a typical seated posture: 90° hip flexion and 90° knee flexion. If an individual is unable to achieve these ranges of movement then their specialist seating prescription will need to accommodate this. This video reiterates the importance of ensuring the chair is set-up for the individual based on their posture and range of movement, and introduces seating options that can manage any challenges.

Disclaimer: Ensure the assessment and prescription is completed by an experienced and qualified professional who has the competence and confidence required. Or contact us to book a free no-obligation assessment with our own seating assessors.

Part Nineteen – Seating Prescription - Chair Measurements

Incorrect chair measurements can disrupt an individual’s posture, regardless of whether they have any known damage to the body systems. This video reiterates the importance of ensuring the chair is set-up for the individual based on their body shape, size and dimensions.

Disclaimer: Ensure the assessment and prescription is completed by an experienced and qualified professional who has the competence and confidence required. Or contact us to book a free no-obligation assessment with our own seating assessors.

Part Twenty – Chair Handover and Training

A chair is only as good as its care plan!

At CareFlex, we take our responsibility as a specialist seating provider seriously and recognise that handover and training is key to ensuring successful seating as part of an individual’s 24 hour postural management and pressure care programme. The user and anyone supporting them to use the chair must know why the chair has been prescribed and how it is used appropriately to ensure safe and consistent use.

This video discusses the importance of thorough chair handover and training, both essential aspects of a specialist seating care plan.

During our involvement throughout the assessment and prescription process we can support the development of a care plan – we are not a delivery service. 

© 2023 by Apollo Healthcare Technologies