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help...choosing first custom chair?

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    #16
    A big warning sign is when they add two inches to the width of your hips to get the seat width.

    Here's a great article about fitting a chair written by an OT (who is a frequent poster here on CCC) to other OTs. It's a bit technical, but full of great info.
    Chas
    TiLite TR3
    Dual-Axle TR3 with RioMobility DragonFly
    I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

    "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
    <
    UNKNOWN AUTHOR>

    Comment


      #17
      Originally posted by voxina View Post
      . . . If its OK to ask, why do you need such a low seat-floor height? Will the PT doing my measurements be able to help me determine things like that for me? . . .
      Sure it's OK to ask.

      Attached is a research paper about how to achieve the most efficient wheelchair push. For most people (including me) the goal simplified is to have your finger tips just touching your axles when you're sitting well with your arms hanging. For me that means a RSH of about 15", but I made my own ergo seat, which raises my butt a bit, so I need the low RSH to accommodate my homemade ergo seat (which cost me about $2).

      A good tech will know how to fit your RSH and much more.
      Attached Files
      Chas
      TiLite TR3
      Dual-Axle TR3 with RioMobility DragonFly
      I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

      "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
      <
      UNKNOWN AUTHOR>

      Comment


        #18
        Is your self-made seat comfy? Do you have sensation issues? There have been several periods that I've spent time in my chair daily, and I usually end up with the worst tailbone ache. For awhile I had just a basic chunk o foam seat cushion, and it was NOT cut out for comfort, or much of anything else! Pressure relieve was nonexistent and forawhile I had tihs big red spot on my rear where I could't take pressure off. (was totally nonambulatory then.) Lately even though I can walk on and off, when I use my standard chair it hurt my butt, even when I sit on a pillow. I still have the remains of blisters on my fingers from using my chair for a few days two weeks ago. I'm in a waning (think between flare-ups) period right now so I'm pretty much able bodied (temporarily!!!) but I rather want to get everything when ti comes to the new chair sorted out before the next flare up comes and I HAVE to use it then, no matter what kind of shape it's in. Are custom chairs better on your bottom than standard chairs, like for pressure relief, and do people with normal sensation really need anything special in the way of a cushion? My doctor thinks since my condition is so variable, I should just use it at school daily, and not worry about it. Last year the way I did things was 'walk until you literally fall over...then somebody will go get your chair for you'...but that sucked and I'm glad this year is looking like it won't be that way.
        Tourette's Syndrome - motor tics of the legs, feet and back, which can make it difficult or impossible to walk

        Comment


          #19
          Nother random thing...I've been using an 18 in standard...its width fits me exactly. Would an 18 in rigid work for me, or is there variability and would it be narrower? I don't want them to add *more* width to my seat for the new chair...yknow, narrower the better in terms of doors and finger-smashing against handrims.
          Tourette's Syndrome - motor tics of the legs, feet and back, which can make it difficult or impossible to walk

          Comment


            #20
            Originally posted by voxina View Post
            Is your self-made seat comfy?
            Yes

            Do you have sensation issues?
            No. I have full sensation, and I stand frequently. Even when I am using my chair to shop, I stand up to get things off shelves. My cushion is very comfortable; it is 4" thick and contoured; I don't even notice the plywood beneath it. (I also have a solid seat pan.)

            There have been several periods that I've spent time in my chair daily, and I usually end up with the worst tailbone ache.
            Tell your tech about that. The tech should know all about cushions, too.

            I still have the remains of blisters on my fingers from using my chair for a few days two weeks ago.
            Check out Natural Fit and Surge handrims. I love my Natural Fits, but some users hate them. Be sure to try before you buy. (I use gloves almost always. Many threads exist here about glove choices.)

            Are custom chairs better on your bottom than standard chairs, like for pressure relief, and do people with normal sensation really need anything special in the way of a cushion?
            The cushion is super important, more so than the chair for seating comfort. But well-fit custom chairs are like part of you - like prosthetic legs. Many users talk about sitting in their custom chairs versus sitting on poor fitting (e.g., standard) chairs. My wheelchair is the MOST comfortable chair I've ever sat in.

            My doctor thinks since my condition is so variable, I should just use it at school daily, and not worry about it. Last year the way I did things was 'walk until you literally fall over...then somebody will go get your chair for you'...but that sucked and I'm glad this year is looking like it won't be that way.
            I do what your doc says. I always use my chair away from home no matter how I may feel at the moment. If I don't, I become helpless. A good chair can actually be fun (wheelies, spins, dancing, rolling easily down ramps - use caution and antitippers).

            Nother random thing...I've been using an 18 in standard...its width fits me exactly. Would an 18 in rigid work for me, or is there variability and would it be narrower? I don't want them to add *more* width to my seat for the new chair...
            Different manufacturers measure differently; check the order form out for your favorite chairs when you get that far (they're all available on line). I actually had mine all filled in when I visited the seating clinic - all the tech did was confirm/tweak what I had already entered.

            yknow, narrower the better in terms of doors and finger-smashing against handrims.
            I have 4-degrees camber to help protect my knuckles.
            Last edited by chasmengr; 18 Aug 2012, 12:32 AM.
            Chas
            TiLite TR3
            Dual-Axle TR3 with RioMobility DragonFly
            I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

            "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
            <
            UNKNOWN AUTHOR>

            Comment


              #21
              Oh, also pay very close attention to learning proper pushing techniques. Bad pushing habits will permanently damage your shoulders.
              Chas
              TiLite TR3
              Dual-Axle TR3 with RioMobility DragonFly
              I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

              "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
              <
              UNKNOWN AUTHOR>

              Comment


                #22
                And regarding my 14.5" RSH, my cushion is thick, too, so that requires a lower RSH. RSH is measured from the frame.
                Chas
                TiLite TR3
                Dual-Axle TR3 with RioMobility DragonFly
                I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

                "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
                <
                UNKNOWN AUTHOR>

                Comment


                  #23
                  Ahah!!!! I KNEW there had to be a way to keep from smashing fingers....camber!! Like, you have NO IDEA how exciting that is, cuz I have like, zero spatial-body awareness, spasms or no! I'll be going along, hohum...and BAM!!! Right on the fingers... When I'm walking, I will walk right into doorframes or shut a door *on top of* my toes. It's part of the neuro thing I have, dyspraxia+tourettes. The chair width, I broke out my ownt ape measure and measured the seat rail to rail.

                  Do the DMEs really give you loaner chairs to try for like, several days at home?! I demod a couple in the shop, when I tried the Quickie no-name light spoke wheel's quick release I had this little gushy moment over how smooth the release was...my Invacare Patriot rental that got returned was hell to take the wheels off of (so called quick release!!!) I've heard camber helps with side-slopes...one afternoon I was off-roading in my no-camber standard and just about did a sideways face-plant (but I put my feet down...)I want at least a few degrees of camber based on my research.

                  Yeah, I love it when I can do *more* stuff in a chair than out, I stop feelign disabled and feel...free. Which my family doesnt seem to 'get' they seem to think...walk walk walk is better..and I'm going...uh, when we go to Biglots and i have to sit down on their for-sale furniture just to catch my breath, I don't call that 'better.' I call that needing a chair.
                  exercise, heat, stress of any sort, loud noises, trigger my tics, and I go from AB to convulsing in a couple minutes flat. I think the chair will help me with that...being able to do things again. How do you deal when acquantainces ask things Like 'not feelin better yet?' and crap like that? Yknow, based on your being a chair user, and they think its weird or something?
                  Tourette's Syndrome - motor tics of the legs, feet and back, which can make it difficult or impossible to walk

                  Comment


                    #24
                    Originally posted by voxina View Post
                    Ahah!!!! I KNEW there had to be a way to keep from smashing fingers....camber!! Like, you have NO IDEA how exciting that is
                    Freedom is very exciting isn't it!!

                    The chair width, I broke out my ownt ape measure and measured the seat rail to rail.
                    Good. Glad to hear you taking initiative

                    Do the DMEs really give you loaner chairs to try for like, several days at home?!
                    Some do, some don't. Push for a several-day, home trial - it's valuable, especially for your first ultralight. (caution: you'll hate turning it in and having to wait months for your own to arrive, but it'll be worth it!!)

                    I demod a couple in the shop, when I tried the Quickie no-name light spoke wheel's quick release I had this little gushy moment over how smooth the release was...my Invacare Patriot rental that got returned was hell to take the wheels off of (so called quick release!!!)
                    A terminology lesson: Medicare has a coding system (HCPCS pronounced hic-pics)for everything medical. Coding for wheelchair related equipment starts with the letter "K". The Invacare Patriot is coded K0004:

                    Ultralight chairs are coded K0005 and K0009. For example, TiLite chairs:


                    Here's the whole list for manual chairs with Medicare's terminology:
                    Click image for larger version

Name:	HCPCS K1-K9.JPG
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ID:	2657173

                    Here is the explanation for codes 1-7. (in case you're interested ) K0009 is used mainly for custom, custom chairs (including titanium frames).
                    Click image for larger version

Name:	HCPCS K0001-K0009 explained.JPG
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ID:	2657174

                    I've heard camber helps with side-slopes...one afternoon I was off-roading in my no-camber standard and just about did a sideways face-plant (but I put my feet down...)I want at least a few degrees of camber based on my research.
                    It does help with side slopes. I'd feel really wierd/uncomfortable without some camber.

                    Yeah, I love it when I can do *more* stuff in a chair than out, I stop feelign disabled and feel...free.

                    Which my family doesnt seem to 'get' they seem to think...walk walk walk is better..and I'm going...uh, when we go to Biglots and i have to sit down on their for-sale furniture just to catch my breath, I don't call that 'better.' I call that needing a chair.
                    I hate waiting in lines without my chair. Standing still without support is difficult for me. I used a rollator for a year, but walking is difficult/fatiguing, too. Having a chair is perfect. One of CCC's members uses the signature "Walking is overrated.." I love it.

                    But do have some kind of regular exercise routine so you don't atrophy. Losing abilities because of our medical conditions is unavoidable; losing abilities because of deconditioning is tragic.

                    exercise, heat, stress of any sort, loud noises, trigger my tics, and I go from AB to convulsing in a couple minutes flat. I think the chair will help me with that...being able to do things again.


                    How do you deal when acquantainces ask things Like 'not feelin better yet?' and crap like that? Yknow, based on your being a chair user, and they think its weird or something?
                    It's difficult, challenging, and time consuming. I'm a member of PatientsLikeMe.com. They have forums devoted to many different chronic conditions. For example, I have Multiple Sclerosis. The MS forum is full of MSers from all over the world. I learn a lot there about dealing with this sort of thing.
                    Chas
                    TiLite TR3
                    Dual-Axle TR3 with RioMobility DragonFly
                    I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

                    "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
                    <
                    UNKNOWN AUTHOR>

                    Comment


                      #25
                      For example here's a PLM screen shot of some public members with Tourette's (more members probably exist in the private/logged-in area):
                      Chas
                      TiLite TR3
                      Dual-Axle TR3 with RioMobility DragonFly
                      I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

                      "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
                      <
                      UNKNOWN AUTHOR>

                      Comment


                        #26
                        Thank you Chas!!!! You're awesome.
                        Tourette's Syndrome - motor tics of the legs, feet and back, which can make it difficult or impossible to walk

                        Comment


                          #27
                          Yeah, in terms of atrophy, I'm at very low risk...good days, that come in periods of waning, like an MS person might have during a remission, I'm totally fine...and then the waxing, the worsening, strikes. So like, I've had 2 great weeks last 2 weeks unltess I"m tired or overstimulated I'm not really in need of equipment or help. At home I'm gonna be walking, except doing things in the yard/exercising my dog, since that will trigger spazzes. My life's just crazy cuz of my crazy yoyo btw able-body/not able body. And the movemetns I have, anyways, keep my lower body looking like an athlete...seriously people have asked what sports I play cuz they're like, youve got awesome muscles...and im like...uh...none??? Strange body I live in! I think living with involuntary movements should be considered a sport! lol.... Nah not really but it is exhausting.

                          Do you have to pay for the demo use of chairs or is it free?? Oh, and are rigids usually lower sh than standards? I've seen folks out in rigids and they had low seat heights, and the thing is, I'm used to being tall in a like, 18 in height standard. I don't think I want to be that short in my chair! Although I do stand up even when I'm using it to get things like off shelves, etc. People sure look at ya funny though when you do! Sometimes I use my current chair as a walker... at one point ti was suggested I could probably benefit from like a rollator but I refused. There's something about an actual walker that makes me think nursing home and I can't stand that. Wheelchairs at least you see active people in yknow? Like, the wlakers, ugh. I'd much sooner go for forearm crutches except with my nonexistent coordination and arm movements I'd probly take somebody out with em...or faceplant frequently.
                          Tourette's Syndrome - motor tics of the legs, feet and back, which can make it difficult or impossible to walk

                          Comment


                            #28
                            Originally posted by voxina View Post
                            Thank you Chas!!!! You're awesome.
                            You're most welcome Thanks. MS has left me unemployable so I find purpose in offering what I can. You're helping me, too.

                            Originally posted by voxina View Post
                            Do you have to pay for the demo use of chairs or is it free?? Oh, and are rigids usually lower sh than standards?
                            Not usually; depends on your DME.
                            Yes, by definition ultralights have a lower SH than standards. This to save your shoulders. Chairs K4 and below are for short-term users (recovery from surgery, etc). K5-K9 chairs are for long-term use, thus they are customized to fit, can be very adjustable, and are configured to save shoulders (when fitted correctly).

                            This is the rollator I used. It's not so nursing homish.
                            Last edited by chasmengr; 18 Aug 2012, 4:02 PM.
                            Chas
                            TiLite TR3
                            Dual-Axle TR3 with RioMobility DragonFly
                            I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

                            "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
                            <
                            UNKNOWN AUTHOR>

                            Comment


                              #29
                              Ha! Not bad. It's pretty epic in terms of rollators. : )

                              In terms of SH I've read different things like, how it interacts with the seat to footrest height....I've measured myself to get an idea and I'm 17.5 knees to heel....like, how does one end up with an SH so much lower than your seat to footrest and still maintain ground clearance with the footrest?

                              Also, I've heard about having to true spoked wheels and it does not sound pretty...do you really have to true em? And, like, what's the deal with all the wheel sizes? I've read the larger your wheel the more efficient your pushin terms of ground covered per rotation, but I get the feeling the bigger ones must be heavier and just...cumbersome getting em in and out of the car.
                              Tourette's Syndrome - motor tics of the legs, feet and back, which can make it difficult or impossible to walk

                              Comment


                                #30
                                Originally posted by voxina View Post
                                Ha! Not bad. It's pretty epic in terms of rollators. : )

                                In terms of SH I've read different things like, how it interacts with the seat to footrest height....I've measured myself to get an idea and I'm 17.5 knees to heel....like, how does one end up with an SH so much lower than your seat to footrest and still maintain ground clearance with the footrest?

                                Also, I've heard about having to true spoked wheels and it does not sound pretty...do you really have to true em? And, like, what's the deal with all the wheel sizes? I've read the larger your wheel the more efficient your pushin terms of ground covered per rotation, but I get the feeling the bigger ones must be heavier and just...cumbersome getting em in and out of the car.
                                Dump, whichis the difference between the front and rear seat heights.*
                                Some people like taller chairs, some lower chairs. Like Chas has his set up to be able to stand easily, while others may prefer a taller chair with more ground clearance. It's about what's right for you and what's functional for your environment. Like getting under tables.

                                Spoke wheels can need to be trued. I don't think you have to worry about it unless a spoke breaks, or a now and then maintenace thing. You would just need to take the wheels to any bike shop.

                                The wheel size depends on what works best for you. What's functional with your chair measurements, as well as works with your arm length. Like Chas mentioned earlier the rule of thumb is your fingertips should be around the middle of your wheel hub when hanging down relaxed. Most adults use 24" wheels and up. Some smaller adults might use 22" wheels. You're probably not getting any taller so I'm considering you an adult that way. Bigger wheels cover more ground but are more difficult to start moving. And what matters more is the best fit to maximize your push.
                                Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

                                I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

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