By Krista Porter, OT
Speciality seating clinic
Stan Cassidy Rehab Center
Fred is 8 years old. He was diagnosed with Athetoid Cerebral Palsy after a complicated delivery, he has high extensor tone and typical athetoid posture. I have been involved with him since he was 3 years old when he was referred due to a poor fit in a special needs stroller. Shortly after I started with him, this lightweight little man broke the back of his stroller with his high extensor tone. He was well below the weight capacity for this stroller and still broke it! Despite his mother’s objections we decided to put him in a tilt frame manual wheelchair, she loved the stroller as it was lightweight and folded easily. In the tilt frame chair we put commercial seating with a Gel cushion with a deep seat well and a 4 point belt and a constant degree of tilt. He was able to shift the gel and slide his butt forward on the cushion slouching in his chair. The belt was moved to different locations with no success at keeping him in place. A foam based cushion was trialed with a wedge at the front in an attempt to keep the pelvis back but he kept sliding forward on this as well. He is also a kid who does not like his feet secure on the footplates, he would rather be without plates then have something at his feet. So the 90/90 rule was not working.
I was leaning towards custom molded seating as I was running out of options. Fred was unhappy in his chair, he had recurring coccyx redness. He was too young for these issues. The Resolve cushion from Physipro was suggested as an option. It was a custom measured option with many options for contouring, I was skeptical but desperate for a solution by this time postural problems were beginning to affect his daily routines as he needed to stay in the chair more.
Physipro designed a cushion based on Fred’s specifics anthropometric measurements. Fred lives 3.5 hours from my clinic in a rural setting and frequent visits are a challenge, so a follow up phone call was made. Mom was asked if the cushion made a difference; her immediate reply was a resounding yes! She said even his school noticed a difference in his posture with this cushion.
The Resolve can still be modified as he grows, extra foam and structure can easily be added if he requires more support.