Wound & Positioning Case Study – Wheelchair Seating


Brian Center of Southpoint, Durham NC
Julie Applewhite, PT, DPT

Patient: 50 year old male admitted to rehab in this SNF following B AKA; patient previously lived at home.


Primary Diagnosis: Cerebral Palsy, history of chronic Stage 1 and Stage 2 wounds on sacrum.  Patient has been wheelchair bound since 10 years of age.

Existing Wheelchair Seating: Custom manual wheelchair with foam pressure relief cushion with sacral cut out.

Positioning / clinical Issues: Following acute bilateral AKA, pt demonstrated difficulties with transfers from foam cushion with sacral cut out.  Pt also demonstrated difficulty with self care for hygiene and dressing as he was unable to effectively weight shift on the foam cushion with the cut out to perform ADLs.

Pt has extensor tone with weak abdominals resulting in fixed positional abnormalities.  Pt is in a posterior pelvic tilt, increased thoracic kyphosis, with bilaterally rounded shoulders, forward head posture, and sacral sliding.

Acute Stage 2 wound 2cm by 1cm

PostureWorks Intervention:  Matrix medium profile cushion and Position Pro Insert

Outcome: Use of Matrix Medium profile cushion with Position Pro Insert resulted in increased independence with self care in the wheelchair and improved quality and independence with transfers in and out of the chair.

The pt is now able to maintain upright posture without sliding anteriorly in the chair.  

The patient’s sacral wound closed after using the Matrix Medium Profile and Position Pro Insert for 3 weeks.

Quality Outcome Measures Impacted by Intervention: Quality of life, pressure reduction and redistribution, functional mobility with transfers and wound healing

Feedback from therapist:
“I really like the Matrix cushion with the Position Pro Insert.  I believe this was especially helpful for my patient with bilateral above knee amputations as he is at less risk for skin breakdown at his incision site, and it resulted in increased independence with functional transfers.”
Julie Applewhite, PT, DPT

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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