Wheelchair Seating / Positioning Case Study – CVA with left hemiplegia

Positioning Case Study:  Engage APOD

River Glen in Southbury, CT
Kate Ciancio, OTR/L



Patient: 76 yo female

Primary Diagnosis: CVA with left hemiplegia

Existing Wheelchair Seating
: Modified custom tilt-in-space wheelchair with gel/foam combo cushion

Positioning / clinical Issues: Within minutes of being positioned in her tilt-in-space chair, the patient presented with right lateral leaning, bilaterally rounded shoulders, and forward head posture. The patient reported discomfort in her chair and was only able to tolerate sitting up to an hour.   Her ADL performance was limited as a result of positioning and limited OOB time. Attendence to facility activites was also limited as a result of poor positioning and poor sitting tolerance.

The patients goal was to return home, however the barriers included transfer status and the inability to have a tilt in space chair in the home as a result of space constraints.

PostureWorks Intervention: Engage APOD™ Low Profile wheelchair cushion in a sling seat wheelchair

Outcome: The new seating and positioning intervention enabled the patient to tolerate sitting in wheelchair for 6 hours a day with upright and midline postural alignment. The patient demonstrated improvements with self feeding. She was previously dependent with self feeding tasks. Following new intervention, she was independent after set-up. Pt was also able to progress to stand pivot transfers using pivot disk. Discharge planning for home was initiated as a result of all barriers being addressed. While in the facility the patient increased attendence of activities which had a positive impact on her psycho-social well being.

Quality Outcome Measures Impacted by Intervention: QOL, ADLs

Feedback from therapist“Pt states she is significantly more comfortable with the Engage APOD™ cushion in place and enjoys being in wheelchair during the day. She reports an increase in quality of life as she is now able to participate in facility activities. She is excited to be able to return  home with family.”

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.

©2017 The PostureWorks LLC

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