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.

WHEELCHAIR SEATING CASE STUDY:
Improving Positioning & Decreasing Pain

150+ Bed Skilled Nursing Facility

Patient: 91 Year Old, Female, LTC Patient

Primary Diagnosis: Dementia, Repeated Falls, HTN, Hypothyroidism, Hx of
DVT, Hx of UTI

Existing Wheelchair Seating: Patient seated in standard sling seat wheelchair
with standard foam cushion.

Positioning / Clinical Issues: Patient presenting with sacral sitting and sliding,
forward head posture, and B rounded shoulders with L lateral lean. Pt was at risk
for skin breakdown given positional abnormalities. Pt reporting discomfort when
sitting for prolonged periods of time in chair.

PostureWorks Intervention: Engage APOD (Advanced Positioning Orthotic
Device), Low Profile

Outcome: Pt reported immediate elimination of discomfort when Engage APOD
intervention was placed into her chair. She is now able to sit in an upright and
midline trunk position and maintain this position. Pt no longer presents with
positional abnormalities, thus decreasing her risk of skin breakdown.

Quality Outcome Measures Impacted by Intervention: Pain , Skin Protetction,
QOL

Feedback from Patient: “I love this new cushion – it is more comfortable!”

Feedback from Treating Therapist: “My pt had an immediate improvement in
positional abnormalities and immediately reported being more comfortable when
transitioned from a foam cushion to the Engage APOD.”

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.