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    Pics of Me in my ZR

    Please note my husband was impatient taking this pics because I interrupted him working (he works from home). Therefore, the pics do not show exactly what I wanted but...

    1. I have the JSP set so the top is pushed as far forward as possible and the bottom is as far back as possible (IE max forward angle). My back still does not contact the top of the JSP because of my anterior pelvic tilt. You can see this (to an extent) i pics 4 & 5. The chair is set at a back angle of 89 degrees. If I made this angle more acute to the seat do you think this could be helped without squishing me into a "V" or should I try adding more padding to the top of the JSP?

    2. I tend to lean to my left side (to the point where it takes close to nothing to push me completely sideways). This is particularly true without my leg on. For the past twenty years I have "solved" this issue by not using a cushion (yes, I used the WC upholstery only) and using the side guards as support. However, now I am having skin breakdown issues on the back of my legs and back side (as exampled on the lower front of my stump in pic 1) so I need a cushion. The one I am using is not going to work. What I really need in a cushion is:
    a) not more than ~2"
    b) some way to increase the stump side as it tends to ride lower than my full leg as twists my pelvis.
    c) something with lateral stability (I have great forward/backward stability and balance).
    d) weight is an issue

    3. My fingertips do not quite reach the hubs I am at ~115 degree angle bend while naturally sitting. One thing I notice is with the higher RSH my shoulders do not seem to move up as much. Whether because of this or a combo of all the changes, my left shoulder is not bothering me as much. Any thoughts?

    4. Not sure if I like the 5" casters. I know there are a ton of opinions here. The real question is should I spend the money to get the Al ones?

    5. Anything else you notice? I know normally this chair would be somewhat endo(y). Since they sawed off my leg I generally do not have endo issues.

    Thank you for taking the time to read this.

    Highlight points:
    back angle
    seat cushion

    E

    PS I am a full time roller; the amp was secondary.
    Last edited by Essie; 27 Mar 2013, 7:22 AM.
    There is no such thing as a stupid question but there sure are a lot of inquisitive idiots. -modified from despair.com

    #2
    Can you use anything like washers to push the back any further forward?

    You have regular upholstery seat, correct? And I see the cushion looks to be right up against the back of your knee. Since you're going to be getting a new cushion anyway, how about shortening the seat upholstry and cushion as opposed to trying to move the back even further forward? I've heard of people both cutting the upholstery and just removing it and folding it back to be shorter before putting it back on. You could also trim the cushion shorter since you're going to be replacing it.

    Since the back of your knees are all the way against the cushion I don't think angling the backrest is going to help, I think that might mess with your pelvic angle or push you back to the point where the cushion is irritating the back of your knees. Plus you mentioned starting to have skin issues. If I were you my first choice would be shortening the upholstery and cushion, second building up the back by placing additional foam.

    With the positioning issues, I'd look for a "deep" cushion with lateral supports. Air cushions with separate chambers would work well I think for building up the left but make your balance worse. So I would be looking for deeply contoured cushions with lateral supports. I'm not sure which ones would also meet your needs for low height though. But one thing to remember is the deep ones are going to be much higher at the high point than actual height for your ischials for example. If you go with a gel type cushion, there are ones you can buy extra gel packs for to raise up the left side, or purchase some extra gel packs separately from Jay to use to raise up the left side.

    I think the RIDE Forward cushion might be one to look into, the deep pelvic area might provide enough support and you can get foam wedges to help obliquity.

    Due to the balance and lateral support, I think you'll have to go with a foam or gel cushion, or foam/air combo and not all air or stimulite (don't know of how to get enough lateral support) in my layman's opinion.

    I think you currently have a comfort company curve cushion which is the one I started with, and its a pretty crappy cushion!
    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.

    Comment


      #3
      Originally posted by ~Lin View Post
      I think the RIDE Forward cushion might be one to look into, the deep pelvic area might provide enough support and you can get foam wedges to help obliquity.
      Yes. The Ride cushion can do everything you want. Correct or compensate for obliquity with a short profile and (some) lateral support.

      Comment


        #4
        Originally posted by ~Lin View Post
        Can you use anything like washers to push the back any further forward?

        You have regular upholstery seat, correct? And I see the cushion looks to be right up against the back of your knee. Since you're going to be getting a new cushion anyway, how about shortening the seat upholstry and cushion as opposed to trying to move the back even further forward? I've heard of people both cutting the upholstery and just removing it and folding it back to be shorter before putting it back on. You could also trim the cushion shorter since you're going to be replacing it.

        Since the back of your knees are all the way against the cushion I don't think angling the backrest is going to help, I think that might mess with your pelvic angle or push you back to the point where the cushion is irritating the back of your knees. Plus you mentioned starting to have skin issues. If I were you my first choice would be shortening the upholstery and cushion, second building up the back by placing additional foam.
        My knee is against the upholstery in the pics. When dynamically wheeling I find I have about a fingers width distance. I have 14" length strap-on upholstery (hehe she said "14" strap on") that I replaced the current upholstery with but I found my amp leg "fell" too much and twisted my pelvis forward. I am wondering if I should try for a solid seat with two different lengths in the front????

        My back issue is caused by my anterior pelvic tilt and not from being "pulled" forward by the upholstery.

        Thanks for your thoughts.

        E
        There is no such thing as a stupid question but there sure are a lot of inquisitive idiots. -modified from despair.com

        Comment


          #5
          Link to the Ride Forward cushion. You might also consider a deep contour ADI back.
          Played with bombs- No SCI, Brain Damage enough that I require a chair and a caregiver.

          Comment


            #6
            My advice is to a) gently remind your husband you're far more important than work and b) try flipping the clamps on the JSP (the tear drop part) to face the opposite direction. This will allow greater forward adjustability of the back, and might help you get it to reach your back properly, along the top.

            Good luck!



            Originally posted by Essie View Post
            Please note my husband was impatient taking this pics because I interrupted him working (he works from home). Therefore, the pics do not show exactly what I wanted but...

            1. I have the JSP set so the top is pushed as far forward as possible and the bottom is as far back as possible (IE max forward angle). My back still does not contact the top of the JSP because of my anterior pelvic tilt. You can see this (to an extent) i pics 4 & 5. The chair is set at a back angle of 89 degrees. If I made this angle more acute to the seat do you think this could be helped without squishing me into a "V" or should I try adding more padding to the top of the JSP?

            2. I tend to lean to my left side (to the point where it takes close to nothing to push me completely sideways). This is particularly true without my leg on. For the past twenty years I have "solved" this issue by not using a cushion (yes, I used the WC upholstery only) and using the side guards as support. However, now I am having skin breakdown issues on the back of my legs and back side (as exampled on the lower front of my stump in pic 1) so I need a cushion. The one I am using is not going to work. What I really need in a cushion is:
            a) not more than ~2"
            b) some way to increase the stump side as it tends to ride lower than my full leg as twists my pelvis.
            c) something with lateral stability (I have great forward/backward stability and balance).
            d) weight is an issue

            3. My fingertips do not quite reach the hubs I am at ~115 degree angle bend while naturally sitting. One thing I notice is with the higher RSH my shoulders do not seem to move up as much. Whether because of this or a combo of all the changes, my left shoulder is not bothering me as much. Any thoughts?

            4. Not sure if I like the 5" casters. I know there are a ton of opinions here. The real question is should I spend the money to get the Al ones?

            5. Anything else you notice? I know normally this chair would be somewhat endo(y). Since they sawed off my leg I generally do not have endo issues.

            Thank you for taking the time to read this.

            Highlight points:
            back angle
            seat cushion

            E

            PS I am a full time roller; the amp was secondary.
            "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

            "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

            Comment


              #7
              To me it looks like you are sitting on your chair and not in your chair. Being that it is a ZR and from the looks of the picture you have adjusted the COG as far forward as it can go there is not much you can do about it. One suggestion is a Hybrid Elite cushion that is slightly under-inflated. If you rode around with no cushion your butt can obviously take it and the front of the cushion would protect your legs from skin breakdown.

              Comment


                #8
                Originally posted by ismaisin View Post
                link to the ride forward cushion. You might also consider a deep contour adi back.
                thanks!!
                There is no such thing as a stupid question but there sure are a lot of inquisitive idiots. -modified from despair.com

                Comment


                  #9
                  Originally posted by DaleB View Post
                  My advice is to a) gently remind your husband you're far more important than work and b) try flipping the clamps on the JSP (the tear drop part) to face the opposite direction. This will allow greater forward adjustability of the back, and might help you get it to reach your back properly, along the top.

                  Good luck!
                  a) Yes. Since he started his own (successful) business he seems to always be working. It's only been a year and I am hoping he will find balance soon. With that said, I could not ask for a better husband!!

                  b) Thanks! I thought of that but was worried it would push both the bottom and top forward hence, not changing the actual angle. I wonder if it is possible to just flip the top ones???

                  E
                  There is no such thing as a stupid question but there sure are a lot of inquisitive idiots. -modified from despair.com

                  Comment


                    #10
                    Originally posted by t8burst View Post
                    To me it looks like you are sitting on your chair and not in your chair. Being that it is a ZR and from the looks of the picture you have adjusted the COG as far forward as it can go there is not much you can do about it. One suggestion is a Hybrid Elite cushion that is slightly under-inflated. If you rode around with no cushion your butt can obviously take it and the front of the cushion would protect your legs from skin breakdown.
                    Hi T8!
                    I have heard people say that to others in various posts but I do not know what it exactly means. Is it a function of dump or having the RSH and FSH lower? I do have more forward COG adjustablity (by moving the camber bar forward and/or flipping it). However, I am confused as to how this will make me sit in the chair more. Please explain (if you don't mind).
                    E
                    There is no such thing as a stupid question but there sure are a lot of inquisitive idiots. -modified from despair.com

                    Comment


                      #11
                      Originally posted by Essie View Post
                      Hi T8!
                      I have heard people say that to others in various posts but I do not know what it exactly means. Is it a function of dump or having the RSH and FSH lower? I do have more forward COG adjustablity (by moving the camber bar forward and/or flipping it). However, I am confused as to how this will make me sit in the chair more. Please explain (if you don't mind).
                      E
                      Dump is the difference between the FSH and RSH, I have a 4 inch dump in my chair. How much dump you need depends on a lot of things but in general if you don't have a lot of trunk stability (because of my injury level I have no ab muscles) having a lot of dump puts you more "in" the chair. If I had no dump I would not be able to control the lateral movement of my body and be unstable. The main way to change this is course by making the posts that attach your camber tube to your chair shorter, which you can't do with a ZR. Moving you COG forward will do this as well if your chair has dump already (it wont if you have none) but will make your chair more tippy. Typically if you want to change your dump you adjust both.

                      The reason I suggested a roho hybrid elite is I have one and I can adjust my dump somewhat by changing how much the air cushion is inflated. I made the comment about you looking like you are "on" your chair and not "in" your chair by looking at the pictures you posted. I would not be able to sit in a chair with that little dump without holding on to something, I would wobble like a weeble. If you could get your butt lower, putting your body in more of a V shape you may be more laterally stable. As with all wheelchair fitting the devil is in trying what works for you. I have no idea how not having the weight of one leg would affect this, not sure how much trunk control you have but it seems like something to try at least.

                      Comment


                        #12
                        Originally posted by t8burst View Post
                        Dump is the difference between the FSH and RSH, I have a 4 inch dump in my chair. How much dump you need depends on a lot of things but in general if you don't have a lot of trunk stability (because of my injury level I have no ab muscles) having a lot of dump puts you more "in" the chair.
                        Thanks for explaining.

                        I have tried various dump amounts with past chairs and find much more than 2" and I get increased leg spasms. I have fairly good fore and aft (?? correct word choice) stability so the lack of dump does not cause too many problems (except maybe with lateral stability).

                        E
                        There is no such thing as a stupid question but there sure are a lot of inquisitive idiots. -modified from despair.com

                        Comment


                          #13
                          Originally posted by t8burst View Post

                          roho hybrid elite
                          I was really stuck on getting a Stimulite because I hate, hate, hate sweaty bum. However, I am not sure if they have a good option for me. PLUS (and this is humongous in my mind) Tom Borcherding, of ROHO, has impressed me with his quick and helpful responses.

                          I am looking at the Quadtro Select Low as I think it may help with keeping my amp leg knee even with my other leg (by adding more air to the amp leg quadrant).

                          E
                          There is no such thing as a stupid question but there sure are a lot of inquisitive idiots. -modified from despair.com

                          Comment


                            #14
                            For help fighting sweaty bum, I use "Anti Monkey Butt Powder." It works pretty well. Construction workers and farmers use it. I've read that a medical-grade sheepskin cushion cover works well, too.
                            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


                              #15
                              With your lateral stability issue, I'd try out a full air cushion like the quadtro before purchasing one. The different chambers would be perfect for your obliquity, but I've heard lots of complaints about feeling or being unstable on air cushions. This might not affect you though, if I remember correctly you have CP and not paraplegic? So with the proper immersion you may feel more stable. But I'd try it out first. Just from what you'd said, I'd think a foam/air combo like T8's suggestion of roho hybrid elite would fit your needs better. But theres no way to really know without trying.

                              Ok, I understand the issue with the back a bit more now. I thought the problem was due to the seat depth you had the back angled further forward in the bottom than top to shorten depth and as a result the top was too far away. So I thought shortening the depth more would solve the problem.

                              With the current back, you don't have much angle adjustment? Is that correct? If so, a different back may fit your needs better but of course will be costly. I also have an anterior pelvic tilt, but together with excessive curve in my lower back so higher up on my back is not more forward. So understanding better, I would first see what you can do with adjusting the hardware (know nothing about your back or how to adjust it like people suggested) and possibly build up the foam. If that doesn't work, you may need a different back. In my Jay 3 I have foam wedges to build up the lumbar support area of the back to fill in my excessive curve and provide enough support. You could get some firm upholstery foam from a shop or sewing store and experiment with cutting it into shapes with an electric carving knife. You can use velcro in the shell of the back and on the foam pieces to secure them under the main foam.
                              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.

                              Comment

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