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4 mobilitymgmt.comjuly 2013 | mobilitymanagement

july

Mobility Management (ISSN 1558-6731) is published monthly by 1105 Media, Inc., 9201 Oakdale Avenue, Ste. 101, Chatsworth, CA 91311. Periodicals postage paid at Chatsworth, CA 91311-9998, and at additional mailing offi ces. Complimentary subscriptions are sent to qualifying subscribers. Annual subscription rates payable in U.S. funds for non-qualifi ed subscribers are: U.S. $119.00, International $189.00. Subscription inquiries, back issue requests, and address changes: Mail to: Mobility Management, P.O. Box 2166, Skokie, IL 60076-7866, email [email protected] or call (847) 763-9688. POSTMASTER: Send address changes to Mobility Management, P.O. Box 2166, Skokie, IL 60076-7866. Canada Publications Mail Agreement No: 40612608. Return Undeliverable Canadian Addresses to Circulation Dept. or XPO Returns: P.O. Box 201, Richmond Hill, ON L4B 4R5, Canada.

© Copyright 2013 by 1105 Media, Inc. All rights reserved. Printed in the U.S.A. Reproductions in whole or part prohibited except by written permission. Mail requests to “Permissions Editor,” c/o Mobility Management, 14901 Quorum Dr, Ste. 425, Dallas, TX 75254

The information in this magazine has not undergone any formal testing by 1105 Media, Inc. and is distributed without any warranty expressed or implied. Implementation or use of any information contained herein is the reader’s sole responsibility. While the information has been reviewed for accuracy, there is no guarantee that the same or similar results may be achieved in all environments. Technical inaccuracies may result from printing errors and/or new developments in the industry.

Corporate Headquarters: 1105 Media9201 Oakdale Ave. Ste 101 Chatsworth, CA 91311www.1105media.com

Media Kits: Direct your Media Kit requests to Lynda Brown, 972-687-6781 (phone), 972-687-6769 (fax), [email protected]

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On the CoverThe unique assessment, seating & mobility chal-lenges posed by osteo-genesis imperfecta.Cover by Dudley Wakamatsu. Cover concept by Elisha Bury.

15 2013 Best Picks ATPs and clinicians reveal the innovative, creative, hard-working

seating & mobility products they choose to help solve their toughest cases.

20 cover feature Osteogenesis Imperfecta For clients with OI — aka, Brittle Bone disease — everyday actions as simple as transfer-

ring from one surface to another can be dangerous. And the challenges can carry over

to the clinicians and providers working to assess and meet their mobility needs.

volume 12 • number 7

What’s New Online: MobilityMgmt.comWhat’s new with your industry? See what’s trending (and

what we’ve been Tweeting about) on MobilityMgmt.com.

Between monthly issues of the magazine, you can stay up to

date on breaking news, see what stories and topics are most

popular among your professional peers, and catch up on

stories and new products you might have missed. Look for

educational opportunities, too, such as our Webinar series

on seating & mobility issues.

6 Editor’s Note

8 MMBeat

28 Marketplace: Senior Mobility

29 Classifi eds/Ad Index

30 Product Revue

26 New Discoveries What happens when a defense contractor and a seating & positioning manufacturer

combine their talents?

mobilitymgmt.com

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As big a fan as I am of this industry, it’s interesting to occasionally step back and see seating & mobility the way others do. How does this world of pressure relief, propulsion effi ciency

and HCPCS codes look to someone who doesn’t know tilt from recline? New Discoveries — our column reporting on research, outcome measures, and emerging

technologies — takes a look at a partnership between Stealth Products and Trident Research. Stealth, of course, is known for its seating & positioning components, many of them highly customized. Trident Research is a military defense contractor specializing in test instrumenta-tion… as in “Laurie, I’ll be with you as soon as I'm off my conference call with the Navy." (That really happened as I was lining up an interview with Trident Research President Mike Cardoza.)

At March’s International Seating Symposium, Gabe Romero, Stealth’s director of sales & marketing, introduced me to Andy Adamez, senior software engineer for Trident Research. The two companies, based near each other in Burnet and Austin, Texas, respectively, have collabo-rated on a new head array called the I-Drive (see page 26). I-Drive has a “smart switch” design that can be set up to basically anticipate a wheelchair user’s commands. That ability to anticipate, and prepare accordingly, can result in a smoother overall driving experience.

What's most amazing about this partnership is how immediately accepting Trident was when Gabe pitched his idea. The two companies had worked together before, when Adamez was seeking machining assistance from Stealth. That worked out so well that Trident staff ers pondered returning the favor. But Gabe still had to sell Trident on his idea for a new head array. And he was brutally honest about the realm they’d have to work within.

Head array users would have severe diffi culties with muscle control and strength, he said. They’d fatigue easily, have tremors, have severe muscle tone. Their conditions might worsen.

Other companies might have run away. Trident staff ers barely blinked.“We’re used to dealing with military customers who say, ‘We’ve got to fi gure out a way to

measure the humidity on Mars’ kinds of things,” Andy explains. “We get these requirements, and sometimes they are off the wall, and we have to scratch our heads for awhile.”

So when Gabe made his pitch, Andy says, “I don’t think there was any doubt in our minds that we could make a device that would work.”

But there’s more than just confi dence behind that sentiment. Mike Cardoza explains, “In work we do with the Navy, we're sitting across the table from Lockheed Martin, L-3 Communications. Our guys don't know the answer of ‘It can't be done.’ We want to be able to solve those chal-lenging problems that other companies or other agencies might not be able to solve. Everything we've done pretty much has been a unique, one-of-a-kind solution for our customers. We can step in and provide a high-quality product without it costing the Navy a fortune.”

Customized solutions? Could Trident Research be the equivalent of complex rehab in the parallel universe of military defense?

After working with Stealth on the I-Drive, Trident staff ers were hooked. Gabe says engineers are asking when the next collaboration will happen. That attitude is echoed by their president, who says he created Trident after years of working under a Navy research lab and wanting more.

“I wanted to be able to look back at an engineering career,” Mike notes, “and say we did some-thing that had an impact on service to our country or people’s lives, made their lives easier or better. It isn’t that the work we do isn’t appreciated, but it doesn’t touch people personally.”

Gabe suggests other companies look outside the industry for partnerships “to improve what we have.” In other parallel universes, are there companies yearning to help our universe’s kids and adults? What a wonderful possibility that would be. ●

Laurie Watanabe, [email protected]

Making Friends & Infl uencing Outcomes

Editor Laurie Watanabe (949) 265-1573

Associate Editor Cindy Horbrook (972) 687-6573

Group Publisher Karen Cavallo (760) 610-0800

Group Art Director Dudley Wakamatsu

Director, David Seymour Print & Online Production

Director, Jenny Hernandez-Asandas Print Production

Production Coordinator Charles Johnson

Director of Online Marlin Mowatt Product Development

National Sales Manager Caroline Stover (323) 605-4398

SECURITY, SAFETY & HEALTH GROUP

President & Group Publisher Kevin O’Grady

Group Publisher Karen Cavallo

Group Circulation Director Margaret Perry

Group Marketing Manager Susan May

President & Neal Vitale Chief Executive Offi cer

Senior Vice President & Richard Vitale Chief Financial Offi cer

Executive Vice President Michael J. Valenti

Vice President, Christopher M. Coates Finance & Administration

Vice President, Erik A. Lindgren Information Technology & Application Development

Vice President, David F. Myers Event Operations

Chairman of the Board Jeff rey S. Klein

REACHING THE STAFF

Staff may be reached via e-mail, telephone, fax, or mail. A list of editors and contact information is also available online at mobilitymgmt.com.

E-mail: To e-mail any member of the staff , please use the following form: [email protected]

Dallas Offi ce (weekdays 8 a.m. - 5 p.m. CT)Telephone 972-687-6700; Fax 866-779-909514901 Quorum Drive, Suite 425, Dallas, TX 75254

Corporate Offi ce (weekdays, 8:30 a.m.-5:30 p.m. PT) Telephone 818-814-5200; Fax 818-734-1522

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mobilitymgmt.com

Volume 12, No. 7

JULY 2013

editor’s note



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SCOTTSDALE, Ariz. — Summer came early to this desert community, which has become a home away from home for National Seating & Mobility's executives and ATPs coming together for their annual business meeting and symposium.

NSM 2013: Finding All the Right Resources

Event Coverage

attended a general session that included remarks from National Seating & Mobility (NSM) CEO/President Mike Ballard.

In addressing his team of ATPs, Ballard noted they were the right people for the job, and that NSM as an entity had the right people, the right experience, the right suppliers and the right technology.

“We’re committed to being the best,” Ballard said. “Th ere’s no argu-ment that we’re making a conscientious eff ort to be the best.”

But Ballard also paid tribute to the unique qualities each ATP brings to work every day.

“Everybody in this room has a little diff erent shade of lens about how they view the world,” Ballard said.

The Science Behind CEUs Saturday was devoted to continuing education courses presented by executive sponsors Permobil, Quantum Rehab and Sunrise Medical, and associate sponsor Invacare Corp. (Ki Mobility and TiLite, also associate sponsors, gave their educational presentations on Monday.)

Several presentations were aimed directly at the event’s “Th e Science of Rehab” theme.

For example, Steve Boucher, OT, clinical educator for Sunrise Medical, led an exercise that had ATPs assuming the perspectives of a clinician, consumer, caregiver, supplier or funding source while assessing a 31-year-old T12 spinal cord injury patient who works as a retail manager and already needs shoulder repair. (Th e client was revealed to be Anne Marie Hochhalter, injured in the 1999 Columbine High School shootings in

David Pietrzak, NSM’s director of clinical operations, helped welcome ATPs to the 2013 “The Science of Rehab” event.

NSM CEO/President Mike Ballard told assembled ATPs, “There’s no argument that we’re making a conscientious eff ort to be the best.”

Freedom Designs’ seating now off ers a back/headrest insert from The ROHO Group. The ATP can specify the number and pattern of ROHO air cells on the order form.

Th is year’s event was called “Th e Science of Rehab,” in keeping with escalating calls from funding sources for outcomes measures and other concrete data related to complex rehab technology interventions.

But before the CEU courses began, ATPs arrived at the Doubletree Paradise Valley Resort under blue skies and warm temperatures, and kicked off the festivities with a reception on Friday evening, May 17.

Education started early the next morning, as ATPs had breakfast and

Seating Dynamics displayed dynamic lower-extremity positioning options, including footrests that fl ex when the wheelchair user goes into extension.

Ride Designs’ popular Java seat back is now available in pediatric sizes…the kid’s version is called the Decaf Java.

PLUG N PLAYRemovable “quick charge” lithium battery is available with every Independence lift. No wires and no lengthy installation, just unbox and go!

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Colorado.)“If we can’t stay viable as a company, we can’t provide the equipment,”

said one ATP who was speaking from the supplier perspective.“Sometimes it’s such a new experience for the client that they don’t

know what they want,” said another ATP who had been assigned a consumer’s point of view.

Permobil fi elded both a PT (Amy Morgan, national clinical education manager) and an OT (Todd Novak, Houston-area sales manager) for its presentation: Th e Science of Using Powered Mobility to Improve Visual/Perceptual Defi cits. Th ey explained the anatomy of vision — which begins to develop in the third trimester as diff erentiation of brain matter begins — and noted that a visual system develops better if the person has indepen-dent mobility vs. dependent mobility. Another interesting statistic linking mobility and vision: 40 percent of adults with traumatic brain injury are said to also have vision problems…and that may be a low estimate.

All the Right ResourcesAft er fi lling up on CEUs on Saturday, ATPs devoted Sunday to a complex rehab technology exhibit hall. Here was an all-day opportunity to try out everything from new alternate driving controls to pediatric manual chairs to seat cushions.

At the opening address, when Mike Ballard told his ATPs , “Th e resources are here,” he might have been referring to the classes and exhibit hall. Actually, though, Ballard was referring the wealth of seating & mobility knowledge and experiences of NSM’s ATPs. NSM, Ballard noted, has added branches in Montana, Idaho and Colorado, and recently added four Virginia branches when it acquired Rehab Health Care.

In fact, Ballard said, while the weekend in Scottsdale was meant to get ATPs caught up on CEUs and to give them time to test out new products, it was also the place to form and grow “lasting, lifetime friendships.”

Th ose friendships, he added might be the event’s greatest benefi t. ●

Steve Boucher of Sunrise Medical led ATPs in an equipment-assessment exercise with varying perspectives.

Amy Morgan and Todd Novak, both from Permobil, discussed visual and perceptual defi cits in consumers with cerebral palsy or cerebral vascular accident.

Prism Medical off ered both portable and permanent patient lift solutions.

Mark Richter (left) of Max Mobility was busy showing off the SmartDrive (see this issue’s Best Picks on page 15).

Sunrise Medical’s Christy Shimono (center) demon-strated the new Zippie Voyage.

Healthwares invited ATPs to take a seat on its new Health-Airs air-cell cushion.

National Sales Manager Mark Scott (right) worked the Stealth Products booth.

Will Olstad (center) of NSM’s Billings, Mont., location tests out a Stealth Products head array.

NSM 2013

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Reports: VPG HaltsMV-1 Vehicle Production

Vehicle Production Group (VPG) has stopped producing the wheelchair-accessible MV-1 car, according to multiple news and

automotive publications.Th ose reporting the company’s shutdown included USA Today,

Autoweek and Motor Trend. While reports said nearly all VPG employees had been laid off , they added that VPG had not fi led for bankruptcy (as of press time).

A U.S. Department of Energy report said it fi nalized a $50 million loan to VPG in March 2011 based on the vehicle’s use of compressed natural gas, a fuel choice with lower emissions than standard gaso-line. Th e report also quoted a VPG estimate that the company would produce 22,000 vehicles a year — though some of that number would use regular gasoline rather than natural gas — and would create 900 permanent jobs.

USA Today reported that VPG’s most recent CEO, John Walsh, said the shutdown was caused by cashfl ow issues and a dealer network that wasn’t robust enough.

Who Needs a Dealer Network?Th at comment had to sound ironic to mobility dealers who’d been originally told that VPG didn’t want a dealer network.

Th e manufacturer took MV-1 on a 2010 nationwide tour that visited shopping malls and rehabilitation hospitals. While at Rancho Los Amigos National Rehabilitation Center in Downey, Calif., then-CEO Dave Schembri told Mobility Management that VPG was opting to sell the MV-1 online rather than through automotive or mobility dealers. Buyers were asked to pay a $250 down payment and fi ll out an order form at the company’s vpgautos.com Web site.

Th e MV-1’s claim to fame was its purpose-built design. Th is car, VPG would trumpet with the mainstream media magnifying that cry, was no converted minivan that had started life as a standard model, then had a ramp added to it. Every MV-1 was accessible, with the front passenger space left seat-less and designated for wheelchair use. VPG touted this design as giving wheelchair users the supposedly all-new

chance to “ride shotgun.”But VPG’s claims didn’t stop there. Schembri was quoted by msnbc.

com as saying converted minivans suff ered from diminished ride quality and poorer handling versus the MV-1, and called the crash-worthiness of converted vehicles into question.

Th ose sorts of claims were published by multiple mainstream news outlets much to the ire of manufacturers in the adaptive automotive equipment sector. Manufacturers and other stakeholders created a Web site to refute those claims.

Riding Into the Sunset?What’s next for VPG?

Autoweek reported in early May that the company was in the process of being sold, and theorized that AM General could be the new owner. AM General is best known for manufacturing military Humvees and the now-defunct civilian Hummer, and the company assembled the MV-1. A story by the Detroit Free Press said a new owner would be responsible for paying back the Department of Energy loan.

Meanwhile, two automotive conversion manufacturers made announcements in light of the VPG reports.

Braun Corp.’s Kevin McMahon, EVP of sales & marketing, noted “repeated examples of start-up companies ultimately failing due to faulty product concepts and ill-defi ned business models,” and noted that when such companies closed down, “it is the customer who suff ers the most damage.” One of Braun’s primary concerns, the company said, was an August 2012 ruling by the Federal Transit Authority (FTA) in favor of VPG, “eff ectively eliminating accessible Chrysler minivans as an option for hundreds of state and local transit agencies nationwide.” Braun has submitted “exhaustive documenta-tion proving our status as a fi nal-stage assembler under provision of FTA rules and federal law,” and at press time was hoping for a decision that would allow it to “fulfi ll the needs of wheelchair and scooter users who depend on accessible minivans for daily transportation.”

Vantage Mobility International (VMI) announced that the company and its dealers created a program to help consumers who’ve purchased VPG vehicles. By calling (855) VPG-VANS or visiting vpgcrisis.com, consumers can get advice on topics such as MV-1 repairs and warranties. “Our top priority has always been to take care of our customers,” said Doug Eaton, CEO/president of VMI. “Th at’s why we appreciate our Select Dealer Network taking the initiative to create a support program for MV-1 owners and help ensure that none of them are stranded.” ●

— Laurie Watanabe

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TRU-Balance 3: Seating Th rough the Eyes of the ConsumerOnce upon a time, practicality was the focus of all things medical.

Medical environments and devices were utilitarian, and aesthetics — in a hospital room or a wheelchair — were an aft erthought, at best.

Today, that mindset has changed for the better, and consumers are much more likely to speak up about healthcare decisions aff ecting them. Th at includes the seating & mobility equipment they choose to use — and this new perspective has sent engineers to their drawing boards to recon-sider how important aesthetics can be.

For instance, take a look at Quantum Rehab’s new TRU-Balance 3 power positioning system. Yes, it’s designed for clients with complex posi-tioning needs. But it also understands that clients have other needs, too.

With a Blank SlateQuantum Rehab VP Jay Brislin, MSPT, says the TRU-Balance 3 — aka, TB3 — isn’t merely a cosmetic upgrade of previous seating systems.

“We pretty much started with a blank slate,” he says. “We looked at the pros and cons that all the other seating systems including our current one have, and we really took a very collaborative approach with the industry. We took the feedback that our reps received from our providers, our ther-apists and consumers. We had a lot of focus groups. We went across the country asking questions, asking what people wanted.”

Once the Quantum Rehab team analyzed all that information, it was time to develop goals for the TB3.

“From a big-picture perspective, we wanted to create a lot more of an integrated system,” Brislin says, so that the look of the TB3 would largely remain the same whether a client needed multiple powered seating options or just one. Also, “We wanted to create a lot of parts commonality so that those parts went across diff erent applications or functions.”

From the beginning, creating the TB3 had to be done while consid-ering what was important not just to the clinician, but also to the equip-ment provider and the client. Take, for example, the potentially tricky issue of adjustability.

“We always talk about adjustments: Th is is adjustable or that’s adjust-able,” Brislin points out. “Technically, a lot of things are adjustable, but the ease of that adjustment probably would be in question in many cases.

“We wanted to make adjustments really easy. We wanted to focus on really big adjustment factors. But we also wanted to look at the fi ne-tuning adjustments. We wanted quick adjustments, things that you can do with the person in the chair.”

Brislin says adjustments for TB3’s armrest widths and heights, back angles for tilt, and lower leg lengths can be made as the client remains in the system — which not only cuts down on the number of transfers the client has to make, but encourages providers to do as much fi ne-tuning as needed to fi t each client.

Through the Consumer’s EyesOn that all-important aesthetics end, Brislin says, “Th e system’s clean. Th ere’s not a lot of wires hanging out, and there’s a lot of the same parts being used across the board on whatever confi guration you have. Th e overall look and cleanliness of the system really bodes well for when somebody’s looking at it and wants that chair.”

Th e Quantum team also looked at TB3 clients as consumers: Putting aside the clinical needs for a moment, what could the TB3 do to make everyday life a bit easier?

“We created an accessory program,” Brislin says, “so at launch we plan to have 12 to 16 diff erent client accessories that can go on this chair: Th ings like cupholders, rearview mirrors, hydration systems, backpack holders, gloveboxes, cell phone holders, all those things we take for granted.” More accessory options are on the way, and even better: Consumers get to choose two free accessories to personalize their TB3 systems.

Clinical IntegrationNot to worry, rehab professionals: Th e TB3’s got your needs covered, too.

In fact, one of the things Brislin is most excited about is TB3’s versa-tility: It fi ts into Group 3 codes, but can “also go up to 450 lbs. with tilt, recline and power articulating foot platforms, which will allow it go to onto your heavy-duty bases and up to 28" wide, 28" deep.”

Th e system’s subframe structure enables providers to “interlock” power positioning modules instead of stacking them. Th at design helps keep seat-to-fl oor height down to about 18" or lower, depending on the base, “even when you have tilt, recline, 10" power elevating seat,” Brislin adds.

Adding a power positioning function is relatively quick: “If you have a tilt system and you need to add a 10" lift or recline, we feel this can be done by one person in a very reasonable timeframe — probably an hour or less,” he says. “I can do a width adjustment in less than fi ve minutes.”

By the numbers, TB3 off ers 50° tilt, 158° recline, and 10" of seat lift (300-lb. weight limit). Seat and back sizes are independent of each other, so a 22" wide seat with an 18" back is no problem. Th ere’s 3" of seat depth adjustment, and 4" of built-in width adjustment. Multi-adjustable canti-lever arms enable providers to fi nd optimal positions, including midline.

Yes, a cupholder is available, too: Accessories mount on tracks on the seat rail, back and arm.

Is that cupholder going to change lives? No, but the convenience it brings is a bit of proof that today’s clinicians, providers and product devel-opers are listening to consumers… and hearing them loud and clear. ●

— Laurie Watanabe

mobilitymgmt.com 15 mobilitymanagement | july 2013

In an industry as customized and individualized as seating & mobility, “favorites” can be a loaded word. What is a wonderful solution for one client may not work at all for

another — even when diagnoses, prognoses or clinical conditions are similar.But while a complete consensus about a product may be impossible, among ATPs and

clinicians who spend their days working with complex rehab clients, there are trends — products that have worked repeatedly, or ones that have proven to be especially easy to adjust, particularly convenient to service, blessedly durable even for active clients.

Th is year’s “Best Picks” as named by clinicians and ATPs certainly have those traits in common. Many of them also multi-task — they accomplish more than one function — or they put independent mobility within reach for more clients. Our thanks to the professionals who shared their experiences…and if you have a “Best Pick” of your own, just let me know.

— Laurie Watanabe

HeadPodThis is a wonderful device for children who struggle with head control. It off ers gravity relief to help kids hold up their heads, without propping and doing it all for them (like more traditional collars). It can actually help develop stronger head control while letting kids participate in activities with their heads up! This is the most positive option for kids with challenging head control situations that I have seen in ages. — Tamara Kittelson-Aldred, MS, OTR/L, ATP/SMS,

Community Medical Center, Missoula, Mont.

Pacifi c Rehab (distributor)(888) 222-9040pacifi crehabinc.com

SmartDriveThis is truly an innovative design/solution for individuals striving to stay independent in a manual wheelchair. The design is lightweight, easy to put in place and remove by the individual, and provides the speed to truly engage in outdoor mobility.

— Lois Brown, MPT, ATP/SMS, Rehab Clinical Education Specialist, Invacare Corp.

Great alternative to power assist for many people. It’s lightweight, easy to use, and easier to load into a vehicle than many of the other systems out there.

— Lauren Rosen, PT, MPT, MSMS, ATP/SMS, Program Coordinator, Motion Analysis Center,

St. Joseph’s Children’s Hospital of Tampa

We have seen exceptional outcomes paired with a great consumer response. This power-assist device is quite universal, lightweight and intuitive to use.

— Ryan Hagy, MOT, OTR/L, ATP, Area VP of Sales, Numotion

Max Mobility(800) 637-2980max-mobility.com

QuickieQM-710I love the smooth ride of this chair, and it handles rough terrain, curbs and obstacles beautifully. The SpiderTrac suspension is incredible. One of my clients is driving this chair with a Peachtree head control unit, and the smooth ride is perfect for that driving mode. — Tamara Kittelson-Aldred, MS, OTR/L, ATP/SMS,

Community Medical Center, Missoula, Mont.

Sunrise Medical(800) 333-4000sunrisemedical.com

Clinicians & ATPs Name Their CRT Favorites


RogueThis is pretty innovative, especially with the relax-position back angle.

— Joe McKnight, ATP/SMS, VP Business Development, Aero Mobility, Anaheim, Calif.

Ki Mobility(800) 981-1540kimobility.com

TRAMThe Rifton TRAM is an amazing all-in-one transfer and mobility device. The features that make the TRAM so unique are the versatility and easy-to-use design.

For example, one customer needed a lift device that she could use alone to care for her mother. She also wanted to give her mother the opportunity to safely bear weight. With standard lift devices she would need another caregiver to assist. Lift-to-stand transfer devices would not work due to her diagnosis; however, the TRAM was versatile enough to adapt to her daily needs.

Another customer needed several devices such as a transfer device, stander, gait trainer and scale. His large stature and instability had halted gait training, required two to three staff for transfers, and weight monitoring was impossible. The TRAM has allowed him to resume gait training, transfer safely and be weighed, all while being safely supported in one device that can be operated with one staff instead of two or three. The scale also allows physical therapists to measure weight-bearing progress.

— Kelly Mackenhausen, RTS, Wheelchairs Plus, Grand Rapids, Minn.

Rifton(800) 571-8198rifton.com

F-SeriesThe new Motion Concepts F-Series gives clients up to 12" of lift for environmental access without any sacrifi ce in seat-to-fl oor height. Systems with tilt, recline and 12" power elevating seat can now have seat-to-fl oor heights as low as 17" with no sacrifi ce in function.

— Lois Brown, MPT, ATP/SMS, Rehab Clinical Education Specialist, Invacare Corp.

Motion Concepts(888) 433-6818motionconcepts.com

RodeoThe folding and tilt features are very convenient for parents of special needs children who cannot aff ord a van and need to put the chair into the back of a car.

— Joe McKnight, ATP/SMS, VP Business

Development, Aero Mobility,

Anaheim, Calif.

Convaid(888) CONVAIDconvaid.com

M300We like the M300 for its compact size and tight turning radius. It has a climbing and traction link system that gives it excellent maneuver-ability, and it has a quick-access design that makes it easier to service. We had a patient with a very tight 90° turn in his home who also needed power tilt, and this unit was able to make the turns and meet his medical need.

— Jennifer Bithell, Rick Graver & Randy Morris, ATPs, Medtech Services, Reno, Nev.

Permobil(800) 736-0925permobil.com

TRU-Balance 3The new TRU-Balance 3 Power Positioning System provides a client-friendly seating system that off ers the option to easily add addi-tional seating in the future. The system provides everything an individual could need from a power tilt, recline, or scissor-lift elevating seating system. The ease of adjustability is a feature that therapists and ATPs will truly appreciate. Features of the TRU-Balance 3 include the ability to order seat width independent of back width; the ability to make fi ne adjustments while the client is in the chair (depth, armrests, back angle); width pack-ages of 4" with ease of adjustability; seat sizes of 12"x12" up to 28"x28"; a weight capacity of up to 450 lbs. The client can pick two no-charge accessories at the time of order.

Quantum Rehab(800) 800-8586quantumrehab.com

Touch Drive 2The Switch-It Touch Drive 2 is a proportional touch pad that allows a user to drive a power wheelchair. The benefi t to this device is that the user continues to have proportional control over the power wheelchair with use of a joystick-type device. This device is based on the user providing touch to the device, not pressure, and off ers a large touch pad size for someone who uses more of a gross motor type of movement. Any location on the touch pad the person initially touches becomes the start point on this device, so accuracy for a starting position is not critical for use. The Touch Drive 2 can allow indi-viduals with weakness but who still have movement with their fi ngers/hands to independently drive a power wheelchair.

— Jay Doherty, OTR, ATP/SMS, Clinical Education Manager, Quantum Rehab

Switch-It(800) 376-9888switchit-inc.com

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Evofl ex The Evofl ex pelvic support has a more “rigid” attachment and proximal aspect of the belt. It can make a tremendous diff er-ence in keeping the belt accessible to a consumer. I have always been frustrated with the webbing/strap being so pliable that the pelvic positioners can drop down away from the user… diffi cult to retrieve for many people, especially when you are sitting in the chair.

— Stephanie Tanguay, OTR, ATP, Clinical Education Specialist, Motion Concepts

Bodypoint(800) 547-5716bodypoint.com/evofl ex

Lower-Extremity ComponentsSeating Dynamics, home of the Dynamic Rocker Back, has been busy with some new dynamic lower-extremity positioning/support components. I love the variety of wheelchairs these items are available on. They have improved some of their designs and increased the number of manufacturers they are working with. Unique lower-extremity supports!


Seating Dynamics(303) 986-9300seatingdynamics.com

Micro MiniASL’s Micro Mini is an isometric joystick that requires almost no force to activate. If a consumer with very limited movement can rest a fi nger on the top of the joystick, just a slight defl ec-tion in any direction will allow them to operate a power wheelchair.


Adaptive Switch Laboratories(800) 626-8698 asl-inc.com

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M300 HDI love having another option for my bariatric clients. It’s a very clean-looking system, and so far my clients have been very happy with the chair.



Permobil(800) 736-0925permobil.com

Matrx MX-1The Matrx MX-1 Carbon Fiber Back support with the new Super-lite hardware for rigid chair applications is the lightest of the four hard-ware options available for this product. When every ounce of weight matters, this product off ers great support with the least additional product weight.


Invacare Corp.(800) 333-6900 invacare.com

Planar SeatingFreedom Designs has been our choice for planar seating systems for some time. The ability to integrate their seating with their frames makes the setup easier with fewer adjustments later. The quality of their seating is excellent, and the representation from the factory is among the best.


Freedom Designs(800) 331-8551freedomdesigns.com

Swing-away Amputee SupportIt is padded and adjustable with a swing-away feature. We have found it to be durable and a great value for the patient.


Comfort Company(800) 564-9248comfortcompany.com

Agility BackThis solid positioning backrest can be used on any wheel-chair: manual or power. Due to its unique attachment style, installa-tion and adjustments can be done quickly and easily — even with the client in the chair. Additionally, clinicians can be assured that where they set the backrest, it will stay for years to come because of the grooves/teeth in all of the adjustable hardware. Furthermore, the backrest material is made of an upgraded composite that is even stronger and lighter than aluminum. Altogether, this equates to an extremely strong and stable back support for the user. Within the backrest are adjustable air-fi lled ROHO cells for improved comfort and a custom-ized fi t! The backrests come in a variety of sizes and heights, and can even be fl ipped top to bottom to ensure the most appropriate fi t for individual users. One of my favorite things is the color swatch options that are in the backrest! These can also be changed to coordinate with an outfi t or special occasion, which makes it more fun for users, too!

— Amy Morgan, PT, ATP, National Clinical Education Manager, Permobil

The ROHO Group(800) 851-3449therohogroup.com

FlexLocThe Ride Designs custom back supports with their FlexLoc multi-axial interface hardware off er an amazing orthopedic approach to back support in an aesthetically sleek method.


Ride Designs(866)781-1633 ridedesigns.com

PivotFitI like the new Bodypoint PivotFit Shoulder Harness: I think it will provide a better contour and fi t for a variety of trunk shapes. (I wish I had that option for my personal backpack as well!)


Bodypoint(800) 547-5716bodypoint.com/pivotfi t

Best Picks 2013


Mobility has a name.

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Quadtro Select High-Profi leThe high-profi le ROHO Quadtro Select cushion remains our choice of cushions for patients with existing skin breakdown or who are highly susceptible to skin breakdown. The Floatation tech-nology provides excellent performance for pressure relief, and the Quadtro feature allows for fi ne-tuned positioning while the patient is seated.


The ROHO Group(800) 851-3449therohogroup.com

Q-GripI really like this alterna-tive to plastic-coated handrims. I have a few friends who are using them now, and they fi nd them more comfortable and more durable than standard plastic-coated handrims.

— Lauren Rosen, PT, MPT, MSMS, ATP/SMS, Program Coordinator, Motion Analysis Center, St. Joseph’s

Children’s Hospital of Tampa

Out-Front(480) 833-1829 out-front.com/qgrip/

Aero TI like having another aluminum option for my clients. The weight stats are really good, and for an aluminum chair, the ride is really comfortable.



TiLite(800) 545-2266tilite.com/wchairs_aerot.php

Quickie Q7We like this ultralight manual wheelchair because it is easy to confi gure and is among the lightest in weight. The oval-shaped 7000 series aluminum tubing gives this chair a strong, rigid ride at an aff ordable price.



http://www.numotion.com


To understand osteogenesis imperfecta (OI) — a condition commonly referred to as brittle bone disease — fi rst picture the

walls inside your home.“In a basic wall, for it to stand up, you have to have certain-size studs,

and they have to be a particular number of inches apart so that wall will stand,” explains Mary Beth Huber, director of program services for the Osteogenesis Imperfecta (OI) Foundation. “To that you attach your wall-board, your mineral.”

Th ink of those wall studs as collagen, the most prevalent protein in the human body, responsible for giving bones structure.

Some people with OI have normal collagen, but they have only a third or half as many “studs” in their walls as they need, Huber says. Th erefore, when you attach mineral to those studs, the walls are likely to fall.

Th at is an apt metaphor for type 1 OI, which accounts for 50 percent of all cases and manifests with mild symptoms including bone fragility, some fractures and minimal limb deformities, according to the OI Foundation.

In other types of OI, the collagen, or wall stud, is simply not as sturdy as it should be. Huber says these wall studs are constructed of a material

more akin to balsa wood than 2x4s.Genetic abnormalities cause these changes in the body’s production

of collagen. Eleven types of OI have been identifi ed based on diff erent genetic mutations (of which there are hundreds) as well as the severity of symptoms — ranging from mild to moderate to severe, according to the OI Foundation.

“Th e part that we always encourage people to understand is that OI is so variable,” Huber says.

The Collagen ChallengeWhile OI does cause a fragile skeleton with frequent broken bones or fractures, those symptoms describe only half the story.

“All collagen-rich tissues are aff ected,” Huber says. “So additional symptoms include loose joints, low muscle strength, and weak tendons and ligaments. Shoulders and elbows may dislocate. Bone deformity and signifi cant short stature are seen in the moderate and severe forms. Additional symptoms include respiratory complications, fatigue, hearing loss, dentinogenesis imperfecta and other oral cavity problems.”

Respiratory complications tend to be the most serious, and those with more severe forms of OI might experience a shortened lifespan because of related respiratory issues.

“Lung tissue contains a signifi cant amount of type I collagen,” says Petra Harvey, health educator for the OI Foundation. “All people with OI have some degree of respiratory compromise and are at risk for serious respiratory infections. Scoliosis and ribcage deformities make respiratory problems more severe.”

Understanding the Challenges of Mobilizing Clients with Osteogenesis Imperfecta By Elisha Bury

Get a free copy of Osteogenesis Imperfecta Foundation’s guide for physical and occupational therapists at oif.org. Click the Information Center page under the Information & Support tab. Download the pdf for “Therapeutic Strategies for OI: A Guide for Physical and Occupational Therapists.”

Pediatrics Series


Plotting a Course for OIMany people with OI live long, full lives that include careers, community involvement and children.

Th e good prognosis brings its own challenges, however, as orthopedists and other healthcare providers must make decisions to plan for the long term. Harvey lists the following as the top considerations to accommo-date a longer lifespan:

● Helping children relearn motor skills aft er rodding surgery or a lengthy cycle of fractures and immobilization.

● Managing fatigue and chronic pain. ● Dealing with scoliosis (the most frequent progressive deformity) and

hip and knee problems possibly caused by awkward walking gait. ● Recognizing that fractures are most common from childhood to

puberty and again aft er menopause, and that tendon, ligament and muscle injuries increase during teen and early adult years.

● Planning for diff erences in stature, as people with severe OI might be in the 3-foot to 4-foot range as adults.In many cases, OI is fi rst suspected around the time toddlers begin

walking. A clinical evaluation helps rule out other conditions, and a DNA analysis confi rms the diagnosis, Huber says.

Th e OI Foundation estimates that OI occurs in one in 15,000 births and that 30,000 to 50,000 people of all ages are currently living with OI in the United States. Approximately 90 percent of OI cases are inherited directly from an aff ected parent or caused by spontaneous mutation.

Depending on the severity of OI, treatment might include repairing

fractures and surgery (rodding) to reinforce long bones or reduce bone curves/deformities, physical and occupational therapy, lifestyle manage-ment strategies including mobility equipment, and bone-building drugs such as bisphosphonates, growth hormones and teriparatide.

Th ese drugs “will treat to some extent the osteoporosis symptoms, but they do not treat the underlying OI issues. It also addresses only half the problem: It looks at the skeleton, which is a huge deal to have a fragile skeleton, but it doesn’t address any of the other collagen-related issues — muscle, tendon, ligament, lung problems — that go along with OI and are not aff ected by bone-building medicines that we currently have,” Huber says. “It makes a huge diff erence, particularly in a child with very severe OI, but it’s not the full answer yet.”

Clinician’s Blueprint: Assessment InsightsBecause the diagnosis of OI is so variable, you might be wondering how to prepare for the seating & mobility evaluation. Th e good news is that when assessing a client with OI you can follow the same course as any other assessment: Pay more attention to the individual in front of you than to the diagnosis on the fi le.

The main thing that’s diff erent with OI is protection, protection, protection

– Jill Monger, Medical University of South Carolina

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Pediatrics Series

“Just like with everyone else, we want to know what their goals are, how they want to live their lives and what we can do to help maximize their function in their world,” says Jill Monger, PT, MS, ATP, wheelchair seating & mobility clinic coordinator at Medical University of South Carolina in North Charleston, S.C.

In fact, the real diff erence lies in the goals of the equipment.“Th e main thing that’s diff erent with OI is protection, protection,

protection,” Monger explains. “Th e other huge issue is transfers. Th ey’ve got to be able to get in and out of the system without someone lift ing them or physically handling them because this puts them at higher risk for fractures.”

Th at means in addition to providing mobility, you also have to look at creating a safe environment for the child through the chair.

For Monger, achieving these goals involves a two-step process: (1) consider making the equipment a bit larger to create a buff er between the

person with OI and his or her surroundings and (2) use power options such as seat elevation and seat-to-fl oor to add variability and indepen-dence in transfers.

However, even clients with the same types of OI can have diff erent goals. Tamara Kittelson-Aldred, MS, OTR/L, ATP/SMS, who works at

Community Medical Center in Missoula, Mont., and is the founder of Eleanore’s Project, has worked with two children with type 1 OI.

One was a young girl in Peru who needed a wheelchair mostly for protection, to prevent falling and fractures, Kittelson-Aldred says. Th e other was a young boy in Missoula who needed a wheelchair only when he had a fracture. Th e rest of the time he walked.

Another critical diff erence in an OI assessment is deciding how much to handle the client. Again, that decision depends greatly on the indi-vidual client.

Kittelson-Aldred is typically very hands on when evaluating chil-dren with mobility conditions to assess head and trunk control, range of motion, sitting and posture.

“I was able to do that with a type 1 kid that I know, but the little girl with type 3, it was actually the fi rst wheelchair evaluation I have ever done where I have not laid my hands on the child,” she says.

Kittelson-Aldred found out that even the child’s father did not pick her up. What’s more, this particular child had fractured herself when getting upset just by throwing herself around a little.

“I really didn’t want to take that risk to tell you the truth. I would’ve been really careful, but given all of the anxiety about it, I didn’t want to take a chance,” Kittelson-Aldred says. “Basically I had her mother move her in the ways that I wanted to see her move so that I could see what her range of motion was like and see what her head control and her trunk control were like. … And that’s not something that I would ever usually do, but that’s what I did in that situation.”

Monger, on the other hand, does handle children with OI, but says doing so is not without risk.

“I do handle them, and I’m very careful,” Monger says. “But again as a PT who’s been doing this for almost 30 years, I’ve had people break in my hands, whether they’re OI or someone with spinal cord injury who has extreme osteoporosis. It’s not a pleasant experience but also not always avoidable.”

Monger believes that’s a risk you have to take because you can’t build a system that will protect a patient if you don’t know what joints move or what limitations they have. But even Monger is especially careful when it comes to transferring.

“If they can transfer themselves, I’m going to fi nd a way to let them do that,” she says. “Or if they have someone who transfers them on a regular basis, I’m going to have that person transfer them for me.”

Barbara Crume, PT, ATP, a seating & mobility clinic specialist at CarePartners Health Services in Asheville, N.C., also does what she can to minimize the risk of fractures, and that means not giving a manual muscle test.

“I will look at them functionally, what they can do, but I won’t give resistance to their movement,” she says, because of the risk of fracture.

A Case for Manual or PowerChoosing manual or power chairs oft en depends on the type of OI and the goals for each client. Th e environment also plays a deciding role.

Crume cites a case of a 2-year-old with type 3 OI who was a prime candidate for a power chair because he already had fractures in his arms.

“I was very concerned for him to even push a manual chair,” Crume

Crumbling WallsThe part that we always encourage people to understand is that OI is so variable

– Mary Beth Huber, OI Foundation

Get to Know OI TypesIf you start looking at information online about the types

of osteogenesis imperfecta, you might fi nd yourself easily confused. Originally, OI had only four types, but recently that number has changed to somewhere between eight and 11. According to the National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center, these additional types account for the diff erent genes that might cause OI.

So what mobility challenges can you expect among the diff erent types of OI?

NIH reports that types 2, 3, 7 and 8 are usually severe. Furthermore, the OI Foundation says that people with type 2 OI rarely survive infancy. In contrast, those with types 4, 5 and 6 have more moderate symptoms. Type 1 is the mildest form of OI, and people with this type can generally walk.

However, don’t be fooled by the type listed on your client’s case fi le. Rarely are two clients, even with the same type of OI, exactly alike.

“It says in the literature that type 1 is the mildest form, but one of my younger patients… he’s had more fractures than one of my 14-year-olds with type 3. That may be because she has had the medication treatments, and he has not,” says Barbara Crume, PT, ATP, seating & mobility clinic specialist at CarePartners Health Services. “I think it’s not just the type but what interventions they receive, what medications they’re taking (and) if they get to a physician who’s familiar enough to provide that type of care.”

That has also been the experience of Jill Monger, who is currently a wheelchair seating & mobility clinic coordinator at Medical University of South Carolina.

OI is “not easy to predict,” Monger says. “You literally have to meet with the individual and see what their unique presentation is.” ●


says. In addition, the child had some discomfort in his pelvis.“I thought if we could do a little power chair with tilt he could stay

in the chair and tilt back off his bottom and be more comfortable throughout the day,” Crume says. “But I couldn’t do power because (the family) had no means to transport it, and in North Carolina, Medicaid will not cover the cost of a power chair if the family can’t transport the power chair.”

Instead, Crume recommended an ultralightweight, rigid manual chair.For Monger, the clients who have wanted manual chairs have been very

clear about their expectations.“Th ey don’t always want it to be very light because they don’t want it to

feel like it can turn or fl ip,” she says. “Th ey oft en actually want a little bit of a heavier chair.”

Even when prescribing power chairs, Crume asks very specifi c ques-tions about transferring. For example, she recommended a power base with a power seat elevator for a child with type 1 OI who was starting to get fractures in his upper extremities and clavicle. However, the family did not have him use this chair.

“Th ey weren’t able to transfer him the way they were used to trans-ferring him,” Crume says. “Th is was an unusual case — it turns out the way the dad had to pick him up from behind to support the child’s spine against his own trunk, he could not do it now in the power chair because the back came up too high.”

So when the child was eligible for a new chair, Crume recommended a folding cross-frame power chair. Th e back post had a hinge so that the

frame could fold down. “It looked like a manual chair but with motors,” she explains. “Th e dad

could release that hinge, fold it down and lift his son up that way.”Sometimes, however, the case of OI is so severe that a power chair is

really the only option.Kittelson-Aldred has a client who is classifi ed as either a severe type

3 or a type 2 who somehow survived. Th e girl has no head control and cannot sit up by herself.

“She has a power chair with everything: manual recline, tilt in space, a seat elevator. Her chair can do practically everything but talk because that’s what she needs,” Kittelson-Aldred says.

Making the Right Equipment ChoicesWhen it comes to making equipment choices, there are three important considerations: comfortable seating and positioning, safe transferring and good suspension.

In terms of seating, Monger says that generally people with OI have good core strength, including trunk and head control. So she focuses on client comfort when it comes to seating needs.

Adult seats usually start at 16" deep, and these guys might only need 14" deep

– Barbara Crume, CarePartners Health Services

http://www.asl-inc.com


Unfortunately, “Th ere’s this precarious balance between them being able to slide on and off the cushion independently and having a cushion that’s soft enough for them to feel comfortable and to have pressure relief,” Monger says.

Power tilt is a good option to bridge this gap by providing a safe trans-ferring surface as well as the comfort and pressure relief the client needs.

Wider and shorter seat depths are another variable for people with OI, Crume says. In one case, Crume positioned a boy with his legs fully out in front and the seat short with his knees bent.

“Th is gave him a lot more stability and balance to let him long sit in the seat,” she says.

Sometimes Crume even recommends a pediatric seating system on an adult power base because the depth is shorter.

“Adult seats usually start at 16" deep, and these guys might only need 14" deep,” she explains.

For children, the power seat-to-fl oor option, as found on chairs such as Permobil’s K450MX, are invaluable, especially for preschool-age kids.

“Th ey can get down to the fl oor, get out of the chair themselves, scoot around on the fl oor, (have) story time on the fl oor, whatever, and then get back in by themselves without a caregiver having to pick them up,” Crume says.

Th is option also raises the chair to help children transfer at varying heights, Monger says.

Because the simple act of touching can cause fractures, minimizing bumping and jarring in a chair is imperative when building a mobility system.

Crume always recommends pneumatic tires to reduce the risk of hair-line fractures.

“Most children and their families don’t really keep up with keeping air in the tires, so we usually recommend airless inserts and thus we really stress to these families that it’s very important that you keep the air in the tires. It gives them that suspension,” Crume says. “And we can oft en recommend Frog Legs [suspension components] on the casters also to help with going over thresholds and reducing impact there too to the front of the chair.”

Monger decides which shock-absorbing components to include by considering whether the chair is manual or power and if the client will self-propel or be pushed. She says shock-absorbing components are more necessary for manual chairs when someone else is pushing. In this situa-tion, the child might encounter more challenging terrain.

OI and Viking LoreHistorians believe that Viking Prince Ivan the Boneless might have had osteogenesis imperfecta. He was carried into battle on a shield because he had diffi culty walking on his soft legs, according to the OI Foundation Web site. ●

Pediatrics Series

Crumbling Walls

http://www.easystand.com


“But if they’re a limited self-propeller, they’re probably not going to be going over a lot of the lumps and bumps because they can’t usually do it,” Monger says.

Many of today’s power chairs have good suspension systems built in, so shock-absorbing components are less of an issue.

In addition, an air-fi lled seating system can help reduce the risk of frac-tures. Kittelson-Aldred actually designed such a system for her client with type 3 OI.

“We actually created a fairly wide backrest for her that has gentle curves, and we lined it with ROHO cells, air-fi lled cells that can be infl ated or defl ated by her parents if they deem necessary,” Kittelson-Aldred says.

Th is particular system enabled the parents to defl ate the air cells to give their daughter some freedom, yet have the option of fi lling the air cells to build in some protection or to support her when she was in pain or fractured.

Challenges AheadEven with the best mobility system, OI has one inherently unavoidable outcome: “Th ey’re going to fracture,” Monger says.

Th erefore, mobility equipment needs to help minimize the possibility of fractures and retain some fl exibility to accommodate fractures when they do happen, Monger concludes.

Th e system must allow a leg or arm to be in a diff erent position if it’s in a cast, and “Th at’s a tough one, especially for those who really, really want to use manual chairs,” Monger says.

Kittelson-Aldred says when someone is in a cast, power tilt can help adjust the client’s orientation, and an infl atable air cell seating system can provide support.

Another thing to consider is how treatment might aff ect physiological changes down the road. For example, Crume has one client whose long bones had all been rodded, but she later developed a pelvic obliquity and scoliosis.

“It’s a change of condition due to the OI over the years,” Crume says. “So we modifi ed her seating to accommodate and provide pressure distri-bution for her asymmetries.”

Growth, even though minor, might also aff ect the mobility system. Monger says for those using power chairs, building in growability is not as much of an issue because she typically puts these children in a bigger base for protection anyway. But it’s a diff erent story for children self-propelling manual chairs.

“If someone is using a performance manual chair that they have to push themselves, the last thing I’m going to do to anybody who is trying to get their arms up on a wheel to self-propel is build it too big because they won’t be able to use it until they grow to that size,” she says. “If it’s a true performance chair that they’re going to try to self-propel, it needs to fi t them now.”

Kittelson-Aldred says there is one important diff erence for building in growability for children with OI:

“I think the thing for kids who have OI is that they’re probably going to tend to not outgrow things as quickly because they’re not going to be as big,” she says.

Despite these challenges, an OI diagnosis is no diff erent from other mobility conditions.

“People overcomplicate things sometimes,” Monger says. “It’s really not that complicated. It’s really all about what everybody else in the world who experiences challenges with mobility needs; they want and need to be as independent as possible and as active as possible in their world.” ●

Elisha Bury is a freelance writer and editor who has worked in the mobility sector since 2005. She previously served as the editor of Th e Mobility Project and associate editor of Mobility Management.

Search for a CureAlthough OI currently has no cure, research to improve the

quality of life for people with this condition is ongoing. Mary Beth Huber, with the OI Foundation, points out the following areas of study:

● Uncovering details about genetic causes and bone formation. ● Identifying new targets for treatment, especially drugs. ● Testing bone-building drugs currently used to treat

osteoporosis. ● Researching stem cell therapies. ● Learning more about variables in how people with OI walk,

including gait analysis laboratories. ● Examining how OI changes during adulthood via longitudinal

natural history studies.“I think what we’re excited about is that there are initiatives

going on in all of these now. It’s not just looking at fracture preven-tion; it’s not just looking at the genetics,” Huber says. ●

http://www.opensesamedoor.com


Stealth P roducts’ new I-Drive head array enables ATPs to dial in unique performance features such as sensor engagement settings. But just as unique is the I-Drive’s star-spangled backstory of two companies that have more in common than it appears at fi rst glance.

One Good TurnI-Drive’s story has a family connection: Trident Research’s president, Mike Cardoza, is married to the sister of Stealth Products’ CEO (Lorenzo Romero) and director of sales & marketing (Gabriel Romero). But the story actually began with a problem: Trident Senior Software Engineer Andy Adamez was managing an Army project involving weapons scoring. “What I was in need of was some really good turnaround, good-quality manufacturing: mechan-ical assemblies for my sensors,” Adamez says. “I’d been using a couple of machine shops around town, and then Mike mentioned the possibility of using Stealth as a manufacturer for those parts.

“They have enormous capabilities over there, a lot more than I’d seen in other places, and they’re under a lot more scrutiny than some of the manu-facturers we deal with. When we’re talking about the medical industry, instantly what pops up in my head is standards: Everything’s got to be spot on. We started using Stealth, and I was really impressed with what they did for us.”

How impressed? Adamez says the folks at Trident began saying, “Let’s see if we can’t take some of our electronics expertise and solve a problem for Stealth.”

A Smart-Switch DesignDespite Trident’s interest, Gabe Romero still had to sell his idea.

“These guys are busy,” Romero says. “It’s not like they were looking for work. I’m humbled they had time to meet with me. They have a very important business, which is protecting our country and giving the mili-tary the best technology that it can have.”

Romero had in mind a new head array that could off er independent mobility to consumers who couldn’t otherwise drive a power chair. He described to Adamez and his team the kind of clients who use Stealth Products’ technology and why. He didn’t hold back when listing typical client challenges: cerebral palsy, ALS, muscle tone, tremors, fatigue.

“What was amazing,” Romero says now, “is I never got ‘That can’t be done.’ I think they understood the importance of why it needed to be done. So instead, they said, ‘We’ll need to spend time to fi gure that out.’”

Though complex rehab was new to Trident, Romero says, “They deal with a lot of motor controls in their industry, so they know what it is for motors not to be balanced, or when you’re dealing with proportional devices, how they react diff erently. They understood that already. So they cleaned up a lot of problems people complained about in our industry

when it came to alternative drive controls.”When Romero tested the prototype, “I could

feel the diff erence. It almost felt intuitive, that it knew what I was about to do.” With other head arrays, Romero says, “I would tilt my head to left and hear the motors engage. But with this one, when it felt my head going that way, it knew it needed to prepare for that type of signal. It felt a lot smoother in turns.”

Adamez says, “We’ve been able to start from a blank piece of paper and say, ‘Let’s design a mech-anism for controlling the chair that does it in a smooth fashion, that does gross oversampling with some fi ltering that will allow it to smooth out the reactions. When you have a standard switch, it’s going to come on at full strength. But the way we’ve set up the device, it’s a smart switch — several smart switches — and you’ve got one brain in there that’s interpreting what the user’s trying to do and making the decision that corresponds to that. That smooth feel is a product of that, the fi rm-ware inside the device.”

He adds, “Like any other system we make at Trident, we’re going to try to make it expand-able and have more capability than it needs today because technology turnover is so rapid now. You don’t want to put the lowest-denominator chip in a device, because you may be writing fi rmware for it for the next three or four years. You want the design to have a little life to it and not be obsolete the moment you ship it.”

Hope in Dark TimesDespite the challenge of the head array project, Romero says Trident staff ers were eager to work on it and are asking when the next collabora-tion will begin.

“The opportunity to work together was really mutually benefi cial,” Mike Cardoza says. “For us, it was an opportunity to diversify, but more important than that, to actually get into a market where the work that we do can have meaning, can have an impact.”

Trident employees share photos and videos of I-Drive successes, including a woman at an event in Russia who has athetoid CP, but was able to drive for the fi rst time in her life thanks to the new head array.

Adamez’s son survived cancer as a toddler, and Adamez recalls the many people who helped his young family through the crisis. Working on the I-Drive is a way “to be that person for someone else. I’m on the other end of it now. I’m helping make devices that will give someone else hope when it seems really dark.”

“It’s been extremely rewarding, and it’s brought a sense of satisfac-tion that we don’t tend to get all the time in our defense work,” Cardoza agrees. “Every once in awhile, Gabe will shoot me a video of somebody using the head array, and you see this big smile on their face and the challenges that this in some small way has helped them overcome.” ●

Case Study: I-Drive Head Array A Defense Contractor Pays It Forward

new discoveries

A company (top) that helps U.S. armed forces be all that they can be collaborated with Stealth Products to create the I-Drive (above).

By Laurie Watanabe

Produced by: Nielsen Expositions, a part of the N ielsen Company

October 8-10, 2013Orange County Convention Center Orlando, FL

The HME industry is being pushed down a path not of its own choosing. But the question is, are you

evaluating and renewing business models to move forward in a way that is best for your business?

Or are you allowing yourself to be pushed forward and eventually out by others reckless decisions?

You need three things to succeed.

Products – the newest or the ones you have yet to consider await as opportunities to diversify your product line.

Information – an incomparable educational circuit of HME hot-topics and need-to-knows.

Networking – thousands of providers with ideas, success stories and mutual concerns .

medtrade.com

Register at Medtrade.com.

http://www.Medtrade.com


Bellavita Bath Lift erWeighing just 20.5 lbs., the Bel-lavita can be separately reclined (up to 50°) and lowered. The hand control unit is water-tight and fl oats for easier retrieval. The unit will not lower the consumer into the tub unless there is suffi cient power to lift the user back out. In-cludes padded seat and backrest with washable covers.

Drive Medical(516) 998-4600drivemedical.com

Serta Perfect-Lift Pride’s new lift chair features the Serta name and individu-ally wrapped coil springs for a balanced seating experience and enhanced durability versus traditional foam bases. Includes 2" of Cool Action Gel Infused Foam that conforms to any body shape and relieves pressure points. The Serta Perfect-Lift chair is available in fi ve color options.

Pride Mobility Products(800) 800-8586pridemobility.com

Giudi Tilt-in-SpaceWith a compact design for smaller spaces, the Ormesa Giudi wheel-chair is built to be easy to handle indoors or outdoors. It features swing-away side supports and a low seat for easy transfers. A spe-cial covering limits unwanted slid-ing forward. The Giudi comes in two sizes and is built to be durable for use by multiple consumers.

Innovation In Motion(800) 327-0681mobility-usa.com

CorbacThe adjustable, contoured back support is designed to provide control, comfort and protection superior to adjustable-tension upholstery. Adjustment straps and pelvic wedges provide accurate adjustment to a wide range of spinal shapes and alignments — especially the kyphotic posture common in older clients. Features layered spacer mesh overlay to promote air circulation.

Ride Designs(866) 781-1633ridedesigns.com

Lynx ScootersA compact size and simple assembly/disassembly help to make the Lynx three-wheeled (pictured) and four-wheeled scooters easy and convenient for consumers. Features foam-fi lled, fl at-free tires, a 360° rotating chair, a three-position adjustable tiller, on- or off board charging, and an estimated seven-mile range.

Invacare Corp.(800) 333-6900invacare.com

JAY Basic ProThis high-performance general-use cushion is for consumers with very low risk of skin breakdown. It incorporates a soft foam base with moderate contours to encour-age proper positioning of thighs and pelvis. Includes a stretch top cover surface and water-resistant Dartex coating for easy cleaning. The cushion is available in 14-21" widths (300-lb. weight capacity) and 22-24" widths (500-lb. weight capacity).


Natural-Fit HandrimThis ergonomic handrim can enhance comfort and propulsion effi ciency, and can also ease pain in users’ hands and wrists while providing greater control during braking. It also helps to eliminate pushing on the tires. The Natural-Fit retrofi ts to all types and sizes of wheels, from 20" to 26".

Out-Front(480) 833-1829out-front.com

Transfer BoardsTherafi n Corp.’s many transfer board off erings include models ranging from standard to bar-iatric weight capacities; made of splinter-free birch wood or high-density plastic; and with or without hand holes, notches and non-skid pads. Wheelhold and off set boards are also available.

Therafi n Corp.(800) 843-7234therafi n.com

senior mobility marketplace


http://www.mobility-usa.com

http://www.invacare.com

http://www.out-front.com

http://www.pridemobility.com

http://www.ridedesigns.com

http://www.sunrisemedical.com

http://www.therafin.com


ZRATiLite’s lightest fully adjustable chair, the ZRA is built to be easier to propel or push, and easier to move in and out of cars for consumers, caregivers and family members. Features a titanium monotube frame that is ultralight-weight and extra durable, as well as attractive. The ZRA is designed to adjust to the changing needs of its users.

TiLite(800) 545-2266tilite.com

Refl ex CushionA non-adjustable cushion created for clients with moderate risk of skin breakdown, the Refl ex delivers air-foam fl otation and never needs adjustment. A built-in air-release device lets out a por-tion of air when the client sits on the cushion, and automatically reinfl ates when the client moves off the cushion. The fi xed amount of immersion prevents bottoming out while conforming to the body.

VARILITE(800) 827-4548varilite.com

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Abilities Expo . . . . . . . . . . . . . . . . . . . 13

Adaptive Switch Laboratories . . . . . . 23

Altimate Medical . . . . . . . . . . . . . . . . 24

Aqua Creek Products. . . . . . . . . . . . . . 29

Comfort Company/PVI. . . . . . . . . . . . . .9

Convaid. . . . . . . . . . . . . . . . . . . . . . . . . . .5

Diestco Manufacturing Corp.. . . . . . . 29

Freedom Designs. . . . . . . . . . . . . . . . . .11

Invacare Corp.. . . . . . . . . . . . . . . . . . . . .3

Max Mobility . . . . . . . . . . . . . . . . . . . . 31

Medtrade. . . . . . . . . . . . . . . . . . . . . . . 27

Motion Concepts. . . . . . . . . . . . . . . . . . .7

Numotion. . . . . . . . . . . . . . . . . . . . . . . 19

Open Sesame. . . . . . . . . . . . . . . . . . . . 25

Ottobock. . . . . . . . . . . . . . . . . . . . . . . . . .2

Permobil. . . . . . . . . . . . . . . . . . . . . . . . 32

SKYLINK Group.. . . . . . . . . . . . . . . . . . 29

Sunrise Medical. . . . . . . . . . . . . . . . . . 17

Wenzelite Re/hab. . . . . . . . . . . . . . . . 21

advertisers’ index Company Name Page #

http://www.aquacreek.com

http://www.diestco.com

http://www.otodor.com

http://www.tilite.com

http://www.varilite.com


Velocity Xpress Remote OptionThe new Velocity Xpress mechanical remote release option for Q’Straint’s q’Pod seeks to make operations more convenient for drivers while improving securement for passengers. The new system enables drivers to unlock rear restraints for 15 seconds to facilitate quicker wheelchair securement and minimize the bending that driv-ers experience — which could reduce back injuries. Q’Straint says installing the Velocity Xpress is simple and quick either as a retrofi t or new installation.

Q’Straint(800) 987-9987 qstraint.com

Zippie VoyageAesthetics are critical to new parents with a special needs child. That truth is the heart of the new Zippie Voyage, an early-intervention chair with a Baby Jogger stroller base. The Voyage combines functions important to caregivers — telescoping push handles, a canopy with a rear window, and Baby Jogger’s Quick-Fold Technology — with clinical features such as 45° rearward tilt, optional 45° recline, and seating options for head, hip, thigh and trunk supports. The Voyage, WC19-approved up to 60 lbs., has a reversible seat and off ers accessories including vent trays, IV poles and oxygen tank holders.

Sunrise Medical (800) 333-4000 sunrisemedical.com

Wallaby Pediatric ChairThis new pediatric folding chair is available in 12" or 14" seat widths (with 12" seat depth for both sizes) and is WC19-approved up to 80 lbs. when used with Wenzelite’s headrest extension and H-style harness. The Wallaby — priced as a retail sales opportunity — has a powdercoated steel frame, nylon upholstery, height-adjustable push handles and 22" rear/6" front swivel solid rubber tires. Its weight capacity is 150 lbs.

Wenzelite Re/hab (877) 224-0946 drivemedical.com

PivotFit Shoulder HarnessThe pad shape of the new PivotFit increases surface area and provides 25 percent greater pressure distribution compared to a traditional H-style harness. The durable fabric is easy to clean and prevents stretching, making PivotFit suitable even for severe positioning needs. A new high-strength swivel buckle allows easier adjustments for clothing and provides precise pad place-ment for an individualized fi t. And a body-contouring shape results in a stylish fi t…even in new size XXS for 2- to 4-year-old consumers.

Bodypoint (800) 547-5716 bodypoint.com

product revue

Comfort Company’s booth was packed at National Seating & Mobil-ity’s symposium, and this was the main draw: the new Flexion Foot-box. The Flexion has a lightweight aluminum shell with all surfaces and edges foam padded. It’s angle adjustable from 90° to 160° with a single screw: Drill mounting holes in the footbox and bolt it onto the chair for permanent placement. The Flexion — covered in Comfort-Tek fl uid-proof, multi-directional-stretch fabric — is available in single

sizes (5.25", 6.25", 7.25", 8.25" wide) and double sizes (for 14", 16", 18", 20" chair widths). And yes, Comfort Company has already heard the clamor for pediatric sizing in the future.

— Laurie WatanabeComfort Company (800) 564-9248comfortcompany.com

Flexion Footboxphoto by Laurie Watanabe

http://www.comfortcompany.com

http://www.qstraint.com

http://www.bodypoint.com

http://www.sunrisemedical.com


Power Your Life >>

w w w. M a x - M o b i l i t y. c o m

A Revolutionary new power assist device that gives greater Freedom and Power to chair users.

Push to go, brake to stop, it’s that simple.

http://www.Max-Mobility.com

The C500 Corpus® 3G is designed for the collage of life… busy streets, meetings, lunches, entertainment and nightlife. With its independent suspension, the powerful C500 provides a smooth ride over a variety of terrains from sidewalks to grassy parks, while the Corpus 3G seating system offers the ultimate in comfort for your exciting lifestyle.

Permobil.com

http://www.permobil.com

Documents

July 2013 † Vol. 12 No. 7 Serving the Seating & Mobility ...pdf.101com.com/MMmag/2013/701920527/MM_1307DG.pdf · With the NEW OBSS Ortho-Shape low-profile custom cushion or the