CASE STUDY – Pain and Positioning
Engage APOD® Cushion and Float™ Positioner
Life Care Center Of Gwinett, Lawrenceville, GA
Melody Brown, PT
Patient: 79 year old LTC male pt 120 lbs
Primary Diagnosis: CVA with L hypertonicity, L AKA, L elbow contracture, chronic
pain, acute kidney failure, HTN, severe PVD, Hx DVT, A-fib, CAD, Stage 2 pressure
injury to L heel.
Existing Wheelchair Seating: Patient seated in a standard sling seat wheelchair
with standard foam cushion.
Positioning / clinical Issues: Patient was reporting constant pain when in the chair,
however was unable to rate the pain. Pt was in sacral sitting and would get into
sacral sliding to avoid pain. Pt would fatigue as he was up in the chair and would
present with increased sacral sliding. He presented with R lateral leaning as a result
of increased extensor tone on L side and was unable to sit and maintain pelvic
neutral without pain. He would demonstrate forward head posture as his sacral
sitting increased and would struggle to make eye contact with peers. His sitting
tolerance was limited by pain, fatigue and positional abnormalities.
PostureWorks Intervention: Pt was transitioned into a high back, sling seat,
reclining wheelchair with elevating R leg rest and an Engage APOD Medium Profile
cushion. A large Tube Float Positioner was also placed behind the pt in the lumbar
section of the sling back chair and the ends would rest on either side of lateral thigh
just distal to the greater trochanter.
Outcome: Pt is now sitting in an upright and mid-line trunk position with no sacral
sitting or sliding. He is reporting comfort when up in the chair. He is engaging with
his peers and is able to make eye contact. His sitting tolerance has increased by 2
Quality Outcome Measures Impacted by Intervention: Pain, QOL
Feedback from therapist: “The Engage APOD and Float Positioner have been
life changing for my pt. His quality of life has increased significantly.”
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.