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Desperately need help with wheelchair positioning

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    Desperately need help with wheelchair positioning

    First off hello everyone! Its been a long time since I?ve posted here. Hope everyone is doing well. I don?t even know where to begin. I?ve been paralyzed now over 10 years and I?ve never really had a chair that I felt was a good fit for me. I think this one is the worse. I feel like I sit on top of my chair instead of in it, if that makes sense. The first two photos are me sitting in the chair without the cushion. I wish i could sit that deep into the chair with the cushion. Is that even possible? I have no idea what adjustments to ask for and these DMEs never seem to know what they?re doing. I also have a hard time pushing and have calloused palms because of it. Any suggestions would be great. Thank you
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    #2
    Originally posted by SequinScandal View Post
    First off hello everyone! Its been a long time since I?ve posted here. Hope everyone is doing well. I don?t even know where to begin. I?ve been paralyzed now over 10 years and I?ve never really had a chair that I felt was a good fit for me. I think this one is the worse. I feel like I sit on top of my chair instead of in it, if that makes sense. The first two photos are me sitting in the chair without the cushion. I wish i could sit that deep into the chair with the cushion. Is that even possible? I have no idea what adjustments to ask for and these DMEs never seem to know what they?re doing. I also have a hard time pushing and have calloused palms because of it. Any suggestions would be great. Thank you
    I know EXACTLY what you?re talking. I LITERALLY feel the EXACT same way every time I sit in an unmodified Stimulite. I got pressure mapped and the genius OT suggested I cut out my cushion to match my natural sitting position. I highly suggest getting pressure mapped and have an OT that has some experience in modifying cushions.
    Never Give Up!

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      #3
      I’m trying to post pictures but it’s not working!
      Never Give Up!

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        #4
        there's plenty of room to drop the back which will get you in a better place for propulsion, but the more you do that, the more "dump" you'll have.
        Dump is how much lower the back of the seat is relative to the front.
        If you look at a side vies, you'll see a bracket that clamps the axle tube and extends to a vertical bracket which is clamped to the chair frame under the seat.
        The gap between the wheelchair frame and the axle bracket can be adjusted and you can see it could be a lot higher.
        If reset, you'll also have to loosen the caster fork hardware and reset the castor angle so the castor axis is 90* to the floor again.

        I'd start with that and see how much better it gets. You'll also probably want to adjust the seatback angle or not! It will depend on how it feels to you.
        Conventional wisdom is that if you drop your hand down as in your first picture, it should hang somewhere near the middle of the wheel.
        Your hand is awfully high!
        69yo male T12 complete since 1995
        NW NJ

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          #5
          Stimulite Contour XS with cushion
          https://photos.app.goo.gl/vw2zbRd3JtmFpCkTA


          Without Cover, business card for depth reference
          https://photos.app.goo.gl/uS3FASrQN4F4yfX56
          Never Give Up!

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            #6
            Originally posted by pfcs49 View Post
            there's plenty of room to drop the back which will get you in a better place for propulsion, but the more you do that, the more "dump" you'll have.
            Dump is how much lower the back of the seat is relative to the front.
            If you look at a side vies, you'll see a bracket that clamps the axle tube and extends to a vertical bracket which is clamped to the chair frame under the seat.
            The gap between the wheelchair frame and the axle bracket can be adjusted and you can see it could be a lot higher.
            If reset, you'll also have to loosen the caster fork hardware and reset the castor angle so the castor axis is 90* to the floor again.

            I'd start with that and see how much better it gets. You'll also probably want to adjust the seatback angle or not! It will depend on how it feels to you.
            Conventional wisdom is that if you drop your hand down as in your first picture, it should hang somewhere near the middle of the wheel.
            Your hand is awfully high!
            I agree with everything you wrote. I wasn’t looking at her cushion which is much thinner than mine.
            Never Give Up!

            Comment


              #7
              Originally posted by pfcs49 View Post
              there's plenty of room to drop the back which will get you in a better place for propulsion, but the more you do that, the more "dump" you'll have.
              Dump is how much lower the back of the seat is relative to the front.
              If you look at a side vies, you'll see a bracket that clamps the axle tube and extends to a vertical bracket which is clamped to the chair frame under the seat.
              The gap between the wheelchair frame and the axle bracket can be adjusted and you can see it could be a lot higher.
              If reset, you'll also have to loosen the caster fork hardware and reset the castor angle so the castor axis is 90* to the floor again.

              I'd start with that and see how much better it gets. You'll also probably want to adjust the seatback angle or not! It will depend on how it feels to you.
              Conventional wisdom is that if you drop your hand down as in your first picture, it should hang somewhere near the middle of the wheel.
              Your hand is awfully high!
              I agree. More dump will get you more into your chair. And by having a longer reach, pushing your chair should be easier. But it comes with the price of adjusting the caster fork angles and probably the back. I suspect you will want to adjust your balance point , cog, too. The good news is that you have an adjustable chair.
              I have had periodic paralysis all my life. I lost my ability to walk in 2011 beginning with a spinal block, which was used for a hip fracture caused by periodic paralysis.

              Comment


                #8
                I recently had my DME remove all the dump because I thought that would help me sit up straighter but I was wrong and now I slide down even more. Everything just slides right off my lap. Like my legs are kind of going at a downwards angle now.

                Comment


                  #9
                  What level are you? Definitely looks like you need a couple inches of dump. Lower that rear a notch or 3 on the adjustable axle plate. In addition to the caster squaring mentioned earlier you'll need to adjust the back rest back to where you like it. More dump will add some tippiness too, so be ready for that (easily accommodated for by moving the axle back a bit or the backrest forward.) I bet just ~2" of dump will turn the situation around considerably. That chair is fully adjustable so if the seatpan size is good, then the rest should be fairly straight forward to setup to your liking. The owners manual has decent directions for lowering the rear seat height. If that cushion has been working for you, I'd hesitate to change it without a proper eval. The Stimulite Contour XS is a great cushion, but start with adding dump, and that Sport might be fine. It's a darn bit lighter, too. I'd use one if I had more meat on my butt.
                  "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


                    #10
                    Originally posted by SequinScandal View Post
                    I recently had my DME remove all the dump because I thought that would help me sit up straighter but I was wrong and now I slide down even more. Everything just slides right off my lap. Like my legs are kind of going at a downwards angle now.
                    Ahhhhh...yeah, that was probably the wrong direction. Add ~.5"-1" MORE than you had, but also try straightening that back up. I suspect the sliding feeling is made worse by the open backrest angle; that can often put some forward shearing pressure on your butt, causing some forward slip over time. A Contour XS could help keep you centered only if it's clinically sound for you. (If the Sport is, then the Contour or Classic would be too, in all likelihood, but get checked just to be sure.)
                    "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


                      #11
                      Originally posted by Oddity View Post
                      Ahhhhh...yeah, that was probably the wrong direction. Add ~.5"-1" MORE than you had, but also try straightening that back up. I suspect the sliding feeling is made worse by the open backrest angle; that can often put some forward shearing pressure on your butt, causing some forward slip over time. A Contour XS could help keep you centered only if it's clinically sound for you. (If the Sport is, then the Contour or Classic would be too, in all likelihood, but get checked just to be sure.)

                      I like to keep my cushion as low profile as possible. I was even just searching for one even lower than this one lol i told him to move my backrest forward a bit but it still looks looks like it’s at a 90 degree angle to me? Will definitely add the dump back plus a little more and I’m a T1

                      Comment


                        #12
                        Originally posted by SequinScandal View Post
                        I like to keep my cushion as low profile as possible. I was even just searching for one even lower than this one lol i told him to move my backrest forward a bit but it still looks looks like it?s at a 90 degree angle to me? Will definitely add the dump back plus a little more and I?m a T1
                        Backrest angle is measured relative to the floor, so you're definitely wider than 90deg. When you add dump, this angle will open even more, so you'll at least need to adjust it back to where it is now, relative to the floor, if it seems OK for you where it is.
                        "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


                          #13
                          Honest, I don't know a thing about manual chairs.
                          But, like posted by experts, it looks like some dump is needed. If you having things slide out of your lap then dump should help.
                          Backrest angle, think someone noted yours is adjustable. That be trial/error til you locate right spot.
                          Length of arm to wheel hub, as already noted looks like make pushing harder.

                          'Calloused palms' what gloves do you wear? Sounds like you might need a more padded inside of glove and harder/ridger outer covering of glove.
                          This more likely wrong. I use powerchair but have wear gloves due to loss of sensation, poor circulation, blood thinners and fragile skin. Thin lightweight synthetic gloves like shooting or running gloves I developed callus area between base of thumb and index finger where I control joystick. Went back to leather gloves and mostly mechanic gloves with padding in area.

                          Is there a Seating Clinic in your area? Did you have any seat mapping done before cushion was picked?
                          If there is a Seating Clinic or Rehab facility in your area I'd ask about getting checked, might require a Rx from your Primary but may help save your shoulders and possible sliding out of chair.

                          Comment


                            #14
                            The one REALLY BIG thing is to protect your butt!
                            I got arrogant about that and paid the price! (3 mos in bed from a stage 4/to the bone ischial ulcer)
                            After eight years in a chair, I dumped the heavy gel cushion for a Roho sport which only had pneumatic cells in the center with foam on the periphery.
                            Worked great-like bucket seal, very lightweight and pretty thin. And I stopped doing butt inspections. Works like a charm until 2012, 17 years post injury!
                            Don't take chances on your butt! Get a good cushion, get pressure mapped, and pay attention.
                            With any luck, you'll never appreciate my advice because you'll never have a breakdown, but I'm now a firm believer in getting mapped and having a good cushion-which may not be terribly fashionable.
                            69yo male T12 complete since 1995
                            NW NJ

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                              #15
                              I was never mapped, but will call my SCI doctor Monday to request for an order for the seating and positioning clinic at RIC aka Shirley Ryan ability center. I had a Roho most of my injury and hated it. Don’t kill me lol I’ve tried all kinds of cushions air, gel. Etc. i like the honeycomb material on the sport the best.

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