Modular Seating

For a Customised Fit

Seating is challenging

Basic Requirements of

SeatingTo accurately accommodate the correct amount of required seat width and depth

To facilitate the required level of backrest angle, height and position

To accommodate asymmetry or provide asymmetrical support

To Provide a medically and physically safeenvironment

To assess likely changes in needs, based on prognosis of condition in relationship to diagnosis – 3-5 years

Clinical Decision Making

How much positioning is required?

◦ How, where, why?

◦ Ingress/Egress

◦ Complexity

Accommodation versus Correction

How much stability required for function?

◦ Is there hidden function in current movements and position?

Clinical Decision Making What changes are predicted to occur?

What are the lifestyle considerations?

◦ Transferring and transporting

Client-Caregiver training

◦ Compliance with prescription, pressure relief and maintenance?

Closed Kinematic Chain

Standard Seating

Asymmetries

Posterior Pelvic Tilt

What happens to the spine?

Common causes of PPT

• Weak core strength

• Tight hamstrings

• Seat depth too long

• Backrest doesn’t support

posterior pelvis

• Base of support not solid

(sling upholstery)

Pelvic Obliquity

Named for the side that is LOW

(LEFT or RIGHT)

Where is there pressure?

What happens to the spine?

Obliquity- Scoliosis ~Common

causesTrunk Asymmetries

Structural Scoliosis

No solid base of support

Wheelchair too wide

Back does not provide enough

lateral support

Seat cushion does not provide

pelvic stability

Pelvic Rotation

Named for the side that is back

(LEFT or RIGHT)

Where is there pressure?

What happens to the spine and lower

extremities?

Rotation ~ Common causes

Pelvic obliquity

Leg length discrepancy

Unilateral foot propeller

Back support does not support posterior pelvis

Seat and/or backrest contours too narrow

Pelvic & Trunk Deformities

Possible Implications

Posture/Instability

Pain/Discomfort

Self propulsion

Forward reach reduced

Safety

Digestion

Respiration

So how do we solve these

seating problems in the field?

Start with the Pelvis

The position of the pelvis dictates one’s alignment and ability to function in the seated position.

(c) 1996 Dorling Kindersley Multimedia /Times Mirror International Publishers

A Solid Foundation is KEY

Recognise the differences

Male vs Female Pelvis

Maximise Pelvic Control

Pelvic Total Support

Balance the relationship of the

femurs/pelvis/spine ~ coccyx/sacrum/lumbar

and contain the anatomic shape

to prevent slipping; even asymmetrical

So how do we do it?

TECHNOLOGY

Starting from a flat base we build a modular

system that is always modifiable, composed of

independent pre-moulded inserts which adapt to

any shape and size and morphology

Set Cushion to fit your Client

Cushion & Modular Pieces

can be Cut or Ground

Lets look at some

Customisations

Wind Sweeping

DOMINO MEDIANO

Abduction

DOMINOTANTO

Adduction

DOMINO

PUCCO

Pelvic Rotation

DOMINO

TANTO

Asymmetry due to Pelvic

Rotation

DOMINO

PUCCO

Fixed Pelvic Obliquity

MEDIANO

Hip Dislocation Prevention

PUCCO

Moving further up the

Spine….

Total Trunk Support

Differences are welcomed

Totally Modular Solution

Fixed Pelvic Obliquity

Wind Sweeping

Comfort able & Supportive

Thoracic Support

Head Support

Ermes Seating System

Multifunctional postural solution for kids

Fits on a range of bases

Inserto Seat & Back

Technology

Seating that will grow with your

client

Without a solid foundation,

you’ll have trouble creating

anything of value