Active C6-7 Quad needs better back than fabric for T6 Crossfire. Help?

[mthomson]

I'm an active guy, and recently the fabric back which I've always used (29 years now) isn't cutting it for support. I'm all over trying to push around, and my back is killing me. I probably have mild scoliosis from being so right side dominant. I'm thinking I need a rigid style back to contain and support me better. I'd still like the freedom of movement to hook my canes and bend over to retrieve stuff from the floor. Any suggestions/real life experiences? Any help would be greatly appreciated.

[Mystery]

I have Cerebral Palsy, tilt to the left side, and up until almost now, did very well in a basic Comfort Company Curve (16 x 16) cushion and an Invacare Matrx Elite (mild side contour) back, 16w x 18h.

Recently had a seating re-evaluation pre-meeting as they are still determining whether or not insurance covers things....but they gave me some thoughts on cushions/backs that would work for me. So far however, I haven't been formally evaluated as insurance is dragging their feet. I reckon it's time to call the DME and just check in on the progress and how I best get evaluated.

First of all, while trying not to stray too far off topic: are you sure your cushion is supporting you well? I ask because at the appointment, the PT & DME actually realized I have a pelvic tilt going on (in addition to scoliosis in my back). They recommended trading out the cushion for a Comfort Company Acta-Embrace Cushion (with Zero-Thrust option), and I'm able to trial it now. (Full disclosure: in talking with Comfort Company, odds are good that they'll let me keep it). Wow! What a difference just one small change made...I'm almost thinking I don't need to trial a different back, but I'm going to try a different back just so I know what else is out there. I have (had) huge issues with my pelvis sliding forward due to the CP, and a ton of scoliosis/tilt issues due to CP, but this new cushion has allowed me to be stable in my chair *without* armrests and I'm not sliding as often. I didn't think it was possible. I'm also fitting much better against the back of my chair, which is probably also improving my time in the chair.

As far as the back...I have done well with the Invacare Matrx Elite, especially now that I am positioned against it the majority of the time! I like it because I can still access my push handles (on the chair that has them), and my shoulders have full movement to push the chair 100%. If I want to I could certainly "hook my canes" as you say, although I think my push handles are about an inch short for that (I have height adjustable push handles, so could pick the canes up an inch and maintain the back position, if it was important to me). And my back does so much better in it than a sling back (although it is basic foam).

The Quick Release hardware on the Invacare is pretty easy to use for me, but you'd probably want to try it out. Note of warning, if you have friends with large hands (I'm a tiny gal), some large handed guys hauled my chair for me and it ended up they hit the QR's on the back without knowing it and we had to click that back together! No problem because I wasn't in the chair at the time thankfully. The QR's are designed to do that to dismantle for transport, but if the guys can do it with their thumbs, perhaps it would be possible with limited hand function?

Before I got the Comfort Company cushion to trial, I did a lot of research (mostly on Comfort Company backs). The DME at the PT meeting had recommended a Ride Designs Java Back (deep contour to hold me up and probably a low back, which I questioned - I prefer mid rise backs), which I did some research on but couldn't fathom the price and I wasn't sure if I need that much support or even if the back would be considered comfortable to me. I also had some questions as to whether insurance would go for a custom Ride Designs immediately, and it weighs in at a frightening 5.7 lbs (I believe). For someone who pushes an ultralight chair (with initial insurance ideas for me to push a lightweight chair with non-adjustable COG, so I picked up the ultralights privately/out of pocket), and admittedly has to carry a lot of stuff (while out) in case of medical conditions deciding to flare...adding 5.7 lbs as a back on a chair is a frightening proposition. Even in my house it's a very frightening proposition, just to have the back weigh 5.7 lbs.

So, I started looking at other choices. Sunrise Medical / Jay Seating tends not to work well for me. Something about it just sends my body into "oh no you don't!" mode for the stuff I've tried (I have partial feeling). I don't know why. It apparently works very well for other people - just not for me.

I looked at Invacare stuff next although didn't call them - didn't come up with anything promising that could accommodate both for the pelvic tilt & the scoliosis, at least browsing through their website. Weights of the backs that looked like ones my PT/DME would recommend also started climbing.

I checked out Comfort Company stuff next, specifically for backs that would accommodate for a pelvic tilt & scoliosis. That looked very promising, and they have a cool little selector widget that helped me get into the right categories. The only thing about it? They didn't publish the weights of the backs on the website. Odd! I called them and spoke with an awesome person, who called Engineering and actually got back to me same-day! I was impressed!

The backs I was looking at were about 4.7 lbs, which is still much heavier than my tiny Invacare Matrx, but probably dealable. If I recall my research correctly, most (if not all) of the Comfort Company backs have a couple of Quick Release options. They can be mounted anywhere on the back canes and still allow access to the push handles for hooking (or, in my case, of removing the push handles entirely while keeping the canes, ).

They recommended the Acta lineup, either with their metal stays that can be adjusted or with their newer "Boa" tension adjustment system which can accommodate for all kinds of scoliosis tilts, supposedly. The "Boa" system can also be adjusted pretty easily any time you want to...the metal stays have to be pulled out and re-inserted. I was interested in easy adjustment because my needs may continue to change over time and if I'm going to pay out of pocket I want it to be able to last a long time. I also find myself with fluctuating back pain levels and if I could just have a co-conspirator (family member/friend) lift up the Velcro and twist a knob, that would be easier on them.

Comfort Company also told me a place in my area that should be receiving a couple of demo / trial backs soon, so I'll call that DME and ask if they are available to sit with. With my back and the idea of an out of pocket purchase (and/or insurance co-payment), I want to be sure something can be adjusted to fit me comfortably before I commit to it.

I hope that helps; feel free to PM or post back if you have other questions.
Take care,
Mystery

[russianboss]

Solid back is a huge pain relief for my back, lower and mid back pain level went from 10 to 2. I looked on ebay for wheelchair back and found one that can work for my chair(TiLite aero z s2) for $70 was worth a try. Three years later still use and love it. Find something inexpensive and try it.

[RollingInParadise]

its tough for us and hard backs. im c6 and have tried them all and have not found one that does it for me. good luck. as far as backs go adi makes about the best hard backs. I use the supracor back, much better than regular stock tension adj.
http://www.supracor.com/products/medical/

[Brianm]

I switched to a hard back a few years ago and could never go back. I jumped into my back-up chair about a year ago that still has fabric, tension strap adjustable to boot, and I couldn't believe how bad the support was; I couldn't get out fast enough. There are numerous companies that make good backs, you can go to sites like Bike-on.com and SportAid.com to see various brands and what they offer.

It took some time for me to get mine dialed in. My body is very finicky to the slightest adjustments. It may be very desirous to get the lightest and most streamline model with minimal adjustments, but that will limit you on making it work for you. I'd love to have a lighter option, that said, I never noticed any added weight. You may want to consider working with a local company that can get you samples to try. It will cost you more as you will probably pay retail, but it will be worth it to have access to some sample backs.

I am using a back from Varilite.

[baldfatdad]

Try getting hold of Brain at Ideamobility.com. I think he has the same chair and makes his own back. It fabric, but laces, so you can adjust it.

[Tman9513]

See if you can get a demo Jay3, ADI, or Jetstream back from local DME. Your posture will immensely improve.

[mthomson]

Thank you guys immensely for the advice and direction. Especially you Mystery

It looks like I'll be checking into a prescription for a seating eval to try a variety of backs.