Case study: The Libella Seat Varia, corrective anti-decubitus wheelchair seat, handles every diagnosis of wheelchair user
8. 3. 2023
Soňa Augustýnová has been diagnosed with cerebral palsy—spastic diaphoresis since she was born and underwent corrective surgery to prolong the tendons of her lower limbs. Until now, she used a combined foam seat with adjustments to correct the sitting in the form of padding and an increased wedge between the thighs. However, when choosing it, its setting was not verified by pressure mapping, it practically did not suit her, and that is why Soňa does not use the mentioned adjustments. To improve her posture, she helped herself with an Overball between her knees. However, due to excessive attention and stigmatization in public, she practised this option only at work.
The complicated diagnosis and the gradual deterioration of the posture due to improperly handled seat correction resulted in long-term pain in the hips, SI joints, knees, hips and feet, which significantly complicated Sonia's daily activities.
That's why Soňa booked the free seat measurement at Libella Ergolab. During the initial examination, occupational therapist Veronika Liďáková diagnosed a slightly slouched seat, head leaning forward, uneven shoulder height, bowed torso, oblique pelvis and unevenly spaced feet on the footboard. The examination using pressure mapping then showed a red map caused by heavy pressure under the left part of the pelvis. In addition to the pathological position of the spine and pelvis, Sona's biggest problem was spasticity, which twists the body mainly into torsion and adduction in the lower limbs.
Posture and results of the pressure mapping on the original wheelchair cushion
It was necessary for Soňa to underlay the left side of the 3D printed layer with the highest correction piece without contouring, thereby allowing the left lower limb to fall to the side. For the right lower limb a part with a lower contour was chosen and thus solved the rotation of the pelvis and the movement of the limb to the side. The individually adjusted middle part with increased contouring on the left side then provided relief for significant drawing (adduction) of the thighs together. The anti-decubitus latex layer has a standard height of 5 cm with different height inserts to relieve the left buttock. For the same reason — the substantial relief of pressure in the place of the left half of the pelvis, the client then used a carbon fibre platform with an outcut.
Design of individual layers assembly with modifications by the client needs
By the individual wheelchair cushion adjustment, there was an alignment of the oblique pelvis and a reduction of the scoliotic spine curvature on the left side and a comparison of the rotation of the pelvis and trunk on the right side. It was also possible to improve the position of lower limbs in the middle.
Sitting posture and pressure mapping results on the new Libella Seat Varia assembly
Since the appearance of the posture was very important to Sonia, she especially appreciated its comparison and the removal of the social stigma that resulted from uneven sitting posture. It was also possible to eliminate long-term pain, thus contributing to an increase in Sona's quality of life.
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