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.

ENGAGE APOD TM

CASE STUDY

Improving Positioning, Reducing Pain, Reducing Falls

120 Bed Skilled Nursing Facility, Pennsylvania

Patient: Female (78) yrs / 195 lbs long term care patient

Primary Diagnosis: Toxic encephalopathy and dementia

Existing Wheelchair Seating: Patient had been issued multiple positioning
interventions without success. Most recently, patient was issued a pommel cushion
used with high-back reclining w/c and foot rests.

Positioning / clinical Issues: Patient presented with abnormal tone, specifically
increased hip extensor tone while in her wheelchair. The patient was demonstrating
pelvic thrusting that was so extreme that she tore the medial portion of the pommel
cushion from the base of the cushion. The combination of tone and decreased postural
control directly resulted in a history of falls while also placing the patient at risk for
pressure injuries and pain. The only position that prevented falls was a reclined position
where the patient was unable to engage with her environment. In addition, the patient
needed to be repositioned 2-4 times per day to ensure safety and comfort while in her
w/c.

PostureWorks Intervention: Engage APODTM Medium Profile 22×18

Outcome: Patient was issued an Engage Medium Profile cushion, which was
documented by therapy to eliminate forward sliding and promote upright, midline
posture. Utilizing the Engage APOD was an effective intervention that broke up the
abnormal tonal patterns and addressed the etiology of the positioning abnormality vs.
treating symptoms. The patient now presents with good posture 90% of time, and only
needs to be repositioned occasionally. The patient has not had any falls since the
Engage APOD has been in place and has also resulted in a decrease in time for nursing
interventions.

Quality Outcome Measures Impacted by Intervention: QOL, Pressure, Pain, Falls

Feedback from Dir of Rehab, COTA: “The cushion worked very well for the resident
and eliminated the forward slide (she presented with strong hip extension while in w/c,
and she actually pushed through a pommel cushion). She has been upright with no
sliding noted on the Engage APOD cushion.”

 

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.