Engage APOD Case Study
Briarwood Health Care Center, Denver, CO

Patient is an 81 year old male, with CHF, LE wounds, edema, cellulitis, severe kyphosis,
and increasing frequency of falls. He was treated by Matt Wittmann, DPT, Lisa Werner,
DPT, and Joanna Kochenower, OTD.
The patient was in a standard wheelchair with nursing and therapy both noting severe
positioning deficits, most significantly forward and L lateral leaning. At the onset of
treatment, he was described as “Leaning severely forward in the W/C, with his head
resting on a pillow placed between his knees, per his preference.” He had experienced a
gradual functional decline, and Physical Therapy had recently initiated treatment of LE
wounds with CPI (closed pulse irrigation). The patient had falls on 6/10/13, 7/13/13,
7/29/13, 7/30/13, 9/3/13, and 9/23/13.
The patient was placed on a low profile Engage APOD cushion on 9/15/13, and a Space
Saver Back Support was put in place on 9/16/13 from The PostureWorks. Physical
Therapy also swapped out his wheelchair for a lower profile one to allow his feet to still
make contact with the floor with the Engage APOD cushion in place. The patient’s
positioning, though still severely kyphotic, is more symmetrical and upright than before.
He spends almost 24/7 up in his wheelchair, declining to lay in bed at most times (this is
his baseline preference). He has had only 1 fall since the positioning interventions were
put in place – whereas, he was falling repeatedly beforehand. He expressed that he was
comfortable when the new cushion and back support were put in place. The patients LE
wounds, which were significant when Physical Therapy first intervened, were fully
healed by October 2013, and he was discharged onto a restorative program.
Altogether, in August the building had 26 falls, in Sept it decreased to 16, and by Oct and
Nov falls were averaging around 8-9. This decrease was in correlation with the 4 Engage
APOD cushions and the 4 Space Saver Backs purchased by the building, amongst several
other key factors.

Note: This is a representative example; actual user evaluations, and decisions regarding
the appropriateness of a particular product for a particular individual, should always be made by a
qualified healthcare professional.

Engage APOD Case Study
Rivergate Terrace, Riverview MI

Patient is a Female age 87 with primary dx of Alzheimer’s Disease, CHF, hx of falls, hx of
CVA with L side weakness and was treated by Carrie Bellomy MSOT, OTRL at Rivergate
Terrace.
The prior wheelchair seating system was a standard 18.16 wheelchair with posterior tilt,
pommel cushion, velcro seat belt, left half tray, elevating leg rests and foot buddy.
Positioning concerns included that the resident presented to therapy with frequent falls
from wheelchair, posterior pelvic position with hips slid forward in wheelchair and left
lateral lean. Resident was having difficulty with self feeding and interaction with the
environment for leisure activities.

The resident seating system was changed to include high back reclining wheelchair
18.16 with bilateral standard leg rests, PostureWorks Engage APOD low profile cushion,
slight posterior tilt to chair and flat left arm rest.

The outcome of the intervention is restraint reduction with removal of seat belt,
resident now able to maintain upright position with proper hip, knee and ankle
alignment. Resident presents with improved pelvic position, which allows greater trunk
control and increased ability to use upper extremities to interact within environment
and self feed. Resident has had no additional falls from wheelchair in past 5 months
(from the time that the intervention was completed until this was written).

Note: This is a representative example; actual user evaluations, and decisions regarding
the appropriateness of a particular product for a particular individual, should always be made by a
qualified healthcare professional.