Case study: Comfort and easier life thanks to the right wheelchair seat configuration

Mrs Libuše Niemkiewiczová has been living in a wheelchair since 2018 with paraparesis, scoliosis and significant spasticity. For a long time, she used a combined foam + gel wheelchair seat with padding under the left part of the pelvis. Although it was verified by pressure mapping when it was purchased, it did not suit her due to poor stability on the wheelchair, as she had to hold on to the wheelchair with her hands while performing normal daily activities. At the same time, she was bothered by the burning of the sitting areas, and therefore every 2-3 hours she had to relieve herself in bed. All of this limited her self-sufficiency, which is why she ordered the seat measurement in Ergolab Libella design to try to solve these problems with the help of the Libella Seat Varia, a customized anti-decubitus cushion.

During the initial examination, occupational therapist Bára Rusínová diagnosed retroversion, tilting and rotation of the pelvis on the left side, scoliosis of the spine and rotation of the trunk to the left, uneven distribution of the legs on the footboard and internal rotation in the hip of the left lower limb. Pressure mapping on the original seat showed significant pressure in the area of the left buttock.

When assembling the customized testing version of Libella Seat Varia, the occupational therapist, therefore, choose a rotating part to correct the position of the pelvis, a short part to relieve the coccyx due to retroversion, parts with significant contouring due to the tilted pelvis and front parts with contouring for better guidance of the lower limbs. Inserts were also used — with their correct placement, it was possible to raise the right and lower the left ischial hump, thus achieving a better correction of the pelvis.

With the testing assembly of Libella Seat Varia, Mrs Niemkiewicz went home for two weeks of testing, which allows the client to try the self-sufficient during all daily activities, thus avoiding possible discomfort later. After the first week of testing, Mrs Niemkiewicz came back enthusiastic and decided to order a custom version without further adjustments and control measurements.

Pressure mapping on the final Libella Seat Varia set-up showed a significant reduction in pressure in the area of the left buttock. By comparing the oblique pelvis, the stability in the wheelchair has also improved, so that both upper limbs are free and can be used in individual daily activities. The subsequent selection of the peloton for the backrest, which Mrs Niemkiewicz carried out, also contributed to this.

According to the client's subjective evaluation, the burning sensations in the buttocks area also disappeared. Thanks to this new anti-decubitus cushion, she did not have to stay at home for regular relief anymore, she could also move outside the home and improve her social life.