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Clinical Justification for Tilt-In-Space Positioning Chair

 

Criteria for Individuals who present with one or more of the following conditions:

 

A. Decreased postural control
Justification:

Tilting a seating surface in a posterior direction can reduce the effects of gravity on one’s trunk/upper body, which facilitates a more functional and proper upright posture. Proper postural control also assists with higher and more practical use of the upper extremities. Posterior tilt efficiently opens the diaphragm allowing for more significant thoracic expansion resulting in improved oxygenation, blood flow, and organ function. The tilt-in-space feature facilitates positioning for comfort, pain management, and pain relief.

B. At risk of skin breakdown and/or decreased skin integrity
Justification:

Tilt seating systems maintain a constant seat to back angle allows for patient repositioning throughout the day without the risk of shear displacement. Tilting the seating surface provides repositioning for those who are unable to independently shift their weight. The posterior tilt of the seating surface moves the weight and pressure away from critical areas under the pelvis. Proper repositioning improves blood flow, oxygenation, and retention of the skin tissue which is vital for maintaining skin integrity. Posterior tilt facilitates position changes associated with pressure relief for individuals with limited range of motion.

C. Musculoskeletal deformities/conditions and other medical conditions which prevent proper positioning when seated in a non-tilting wheelchair (i.e., kyphosis or lordosis)
Justification:

Tilt-in-space chairs are commonly prescribed for individuals with musculoskeletal deformities or conditions. Posterior tilt reduces the effects of gravity on the trunk and upper body helping to eliminate postural deviations. Tilt-in-space best accommodates conditions such as but not limited to hypertonicity, hypotonicity, kyphosis, and lordosis. Posterior tilt helps decrease fatigue associated with hypertonicity and improves postural support and stability for individuals with hypotonicity.

 

D. Decreased head/neck control and/or unable to feed themselves or can be feed safely from a non-tilting wheelchair
Justification:

Clinicians use customized positioning to maximize breathing and speaking ability. This special positioning maintains vital organ capacity and also reduces the risk of aspiration. Posterior tilt provides stability and improved postural support for those who cannot keep an upright posture when seated. Tilting a patient can be used to realign posture and enhance function such as feeding, communication, and completion of activities of daily living. Postural deviations can be decreased with the use of posterior tilt, such as but not limited to; slumping, sliding, falling forward, lateral lean and head drop

E. Individuals who are at risk for falls or injuries from using a non-tilting wheelchair
Justification:

Tilt provides postural stability and support for those who cannot maintain an upright posture when seated. Tilting the seating surface in a posterior direction maximizes the body’s weight and gravity, allowing the patient to remain seated, perpendicular and engaged in functional activities. Tilting the patient in a posterior direction provides proper seating alignment, decreasing patient fatigue, and postural deviations. With the decrease in postural deviations and improvement of postural support and stability falls can be significantly reduced.

"The Broda Revive Tilt and Recline Shower Commode meets our patient's needs. He indicates he feels safe and his own care each morning. He is safe at all times while in the chair, and the caregivers are safe at all times while providing his care. All staff report being pleased with the commode and find it much easier to assist him."

Pam, Director of Nursing

“What a difference now that Mom is safe and comfortable. It gives me peace of mind to know that she is sitting in on of Broda's chairs. My only regret is that I did not get this chair sooner for her.”

Bill L., Family Member ; fmr. Executive Director of Canadian Assistive Devices Association |Toronto, ON

" My father, enlisted in the Air Force and trained as a machine gunner on B17’s during WWII. Photographs of the “Flying Fortress” grace the walls of his room in the Kansas Veterans' Home in Winfield, Kansas where he has been living for the past 6 years.

For the first 2 years in the Veterans’ Home, my father used a power wheelchair for mobility and independence. But at the age of 82, with advances in his Parkinson's and dementia, his power wheel chair was taken away for safety concerns. He was provided with a standard issue VA manual wheelchair with no tilt or recline. His posture in that chair was terrible ... he was very slumped over and leaning to the side. Even his breathing was limited as a result of his poor posture. All he could do was stare at the floor. It was so disheartening to see him this way. I would have to kneel on the floor to see him eye-to-eye due to his hunched posture from Parkinson's disease.

In a fortunate twist of fate, it was determined that my father was an ideal candidate for a chair from Broda. And as a vested veteran, he qualified for the VA to fund the chair. He has now had a Broda chair for over 4 years!

Since he's been in the chair from Broda we can now sit beside him on visits and look at each other face-to-face. Being able to tilt back in the chair and look upward, he can enjoy watching John Wayne westerns in the VA lounge. He can even use the Broda chair when he travels by transport for dental appointments. He can stay in his chair for the bus ride and in the office, since the chair can be tilted enough for the dentist to work on his teeth.

Broda's chair has been a blessing for my father, his caregivers and my family. The chair improves his quality of life and I can't imagine him not being in it over the past few years. We are fortunate that the VA will fund Broda chairs for Veterans like him who need them."

Kent P., Family Member

"My mother has osteoporosis and arthritis with muscle weakness and bone and joint discomfort- Since she received this new Latitude Pedal Rocker she has total comfort and less anxiety with increased mobility with the hopes of muscle and bone strengthening as she lost her ability to ambulate more than a few steps on her good days these last few months. She is legally blind seeing only light and dark these last 2 years. She just celebrated her 96th birthday and lived alone until age 93-This chair has met her very important needs of comfort, safety, strengthening, mobility."

Elaine R., Family Member |WI, USA

"Prior to using Broda's Elite Tilt Recliner, there were issues with safety for getting the resident out of the chair, safety for staff lifting her in, either manual/mechanical; comfort, keeping her in the chair, inability to get her body over the sides.

The chair sides raise to prevent her from throwing her legs/body over the sides; same with the extra padding along her leg area that is raised. The tilt puts her buttock in a comfortable position, but also makes it extremely difficult to push out. The chair sides also swing out to assist with ease of the mechanical tilt.

Broda's chair has given her a reason to want to get up and she enjoys her chair now. When we are using the mechanical lift she remains calm because she wants to get in it and will stay longer safely and comfortably! Staff can safely lift and position her without worrying about injuring themselves."

J. C., Unit Manager, RN |Campobello Island, NB