arm placement in pwc

[Kristina1]

I have a permobil m3 with roho bottom and back cushion. the back wraps around my torso to keep me secure. These wrap around wings are great, but present an issue for me as far as arm placement. I can keep my arms on the outside of the wings, forearms laying across armrests-- this is very comfortable but leaves my shoulders stiff and painful over time. Alternately I can lay arms inside the side 'wings' laying in my lap, but this slightly hunches shoulders and leaves me stiff in the opposite way. It seems the 'wings' prevent that perfect middle ground where shoulders are neither too spread or too hunched. Has anyone else had this issue? For now I alternate between the two positions and have my cals manually roll my shoulders every so often.

 

[lgelb]

When your CALS manipulates your shoulders, make sure that they're gently reconstituted toward the spine before anything else, to avoid subluxation.

We used rectangular foam blocks to bridge the gap between the "wings" and the armrests, to position the arms how we wanted them to be, after first achieving everything we could by repositioning the arm rests, which would be my first move.

Note: the foam part is not necessary for most people, but Larry had the "flail arm" variant with subluxation of both shoulders, and pre-existing spine deformity.

But also, I should have mentioned that the arm rest "trays" can be lined with gel, beyond the padding they come with, and the geometry of the tray (depth) can be changed in either way to further offload the shoulders. Check out the Gel Ovations line, which your DME should be able to order.

 

[Kristina1]

I had no idea the armrests could be moved/adjusted. is this something i call numotion for?

 

[blitzc]

Kristina, the representative who completed my pwc assessment, ordering, and delivery made it clear that he would come help make any adjustments that were necessary either early on or later down the road as my needs changed. Try calling and asking for someone to come out.

 

[KarenNWendyn]

I had NuMotion come out and adjust my arm rests. I use my right hand to control the joystick. My right arm was stretched out too far in order to reach the joystick. This threw my shoulder too far forward and caused pain on a long ride. I showed this to my PT from the clinic and she advised me to call NuMotion. They moved the armrest back, and my shoulder is happier now.

They could probably advise on your seatback wing issue too.

Another question for all you wheelchair users out there (sorry Kristina if I’m hijacking a bit) concerns headrest position. The NuMotion guys have insisted to me that my head should not be contacting the headrest when I am sitting upright to drive the wheelchair; that the purpose of the headrest is only to support the head when fully reclined.
My PT disagrees. She says that might be true for a spinal cord injury patient but not for a PALS with weak neck muscles needing support when upright. The PT’s opinion makes more sense to me. What do you all think?

 

[Kristina1]

I was never told that. I use it most the time even upright. For pals with neck weakness it's necessary. I definitely would go with what your pt said.

 

[lgelb]

Your PT is correct. Your head should be supported vertically and laterally as much as needed to compensate for the weak muscles.

 

[nona]

I can't imagine trying to keep my head off the headrest. As it is now, I'm having a hard time with my head controls and the small block of a headrest that comes with it. There is no neck support whatsoever.

I'm also trying to figure out the arms. Mine sit in my lap, shoulders forward. I can't get my elbows on the armrests.

 

[KarenNWendyn]

I think that as our posture, body mechanics, and functionality changes over time with this this disease, that multiple wheelchair adjustments are probably pretty typical throughout the duration.

 

[MarieLaure]

Hello
Barging in on that post to ask a question :
How about neck weakness in bed ? We tried adjusting pillows, different sorts of travel pillows and still haven’t found a satisfactory position. How do you guys manage with that situation ?

 

[Nikki J]

Do be careful MarieLaure. My sister’s neck was broken while being repositioned in bed because the muscles were weak. She had to have emergency surgery

 

[MarieLaure]

Oh!!! Thanks for the warning! I am seeing the physiotherapist tomorrow. Will mention this.
His head drops on one side.

 

[MarieLaure]

Sorry for your sister it must have been painful and scary

 

[lgelb]

In addition to elevating the bed head and feet, we put rectangular Comfort Bags (herbal or unscented, microwaveable heating pads) on the pillow on both sides to keep the neck from going out of alignment laterally. That has the additional benefit of providing warmth when needed.

 

[MarieLaure]

Thanks. We ll look up for that. It bothers him a lot and worries me