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/quantumrehabJoin the conversation.
mobilitymgmt.com4 2016-2017 Seating & Positioning HANDBOOK
Editor Laurie Watanabe (949) 265-1573
Contributing Editor Elisha Bury
Group Art Director Dudley Wakamatsu
Production Coordinator Charles Johnson
Director of Online Marlin Mowatt Product Development
Group Publisher Karen Cavallo (760) 610-0800
mobilitymgmt.com
2016-2017
REACHING THE STAFF
Staff may be reached via e-mail, telephone, fax, or mail. A list of editors and contact information is also available online at mobilitymgmt.com.
E-mail: To e-mail any member of the staff, please use the following form: [email protected]
Dallas Office (weekdays 8 a.m. - 5 p.m. CT) Telephone 972-687-6700; Fax 866-779-9095 14901 Quorum Drive, Suite 425, Dallas, TX 75254
Corporate Office (weekdays, 8:30 a.m.-5:30 p.m. PT) Telephone 818-814-5200; Fax 818-734-1522 9201 Oakdale Avenue, Suite 101, Chatsworth, CA 91311
Chief Executive Officer Rajeev Kapur
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INFRASTRUCTURE SOLUTIONS GROUP
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Mobility Management (ISSN 1558-6731) is published monthly by 1105 Media, Inc., 9201 Oakdale Avenue, Ste. 101, Chatsworth, CA 91311. Periodicals postage paid at Chatsworth, CA 91311-9998, and at additional mailing offices. Complimentary subscriptions are sent to qualifying subscribers. Annual subscription rates payable in U.S. funds for non-qualified subscribers are: U.S. $119.00, International $189.00. Subscription inquiries, back issue requests, and address changes: Mail to: Mobility Management, P.O. Box 2166, Skokie, IL 60076-7866, email [email protected] or call (847) 763-9688. POSTMASTER: Send address changes to Mobility Management, P.O. Box 2166, Skokie, IL 60076-7866. Canada Publications Mail Agreement No: 40612608. Return Undeliverable Canadian Addresses to Circulation Dept. or XPO Returns: P.O. Box 201, Richmond Hill, ON L4B 4R5, Canada.
© Copyright 2016-2017 by 1105 Media, Inc. All rights reserved. Printed in the U.S.A. Reproduc-tions in whole or part prohibited except by written permission. Mail requests to “Permissions Editor,” c/o Mobility Management, 14901 Quorum Dr., Ste. 425, Dallas, TX 75254
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Study: Cell Therapy Could Treat SCI Side EffectsResearchers at the University of California, San Francisco (UCSF), have successfully used cell therapy to treat multiple serious spinal cord injury side effects in mice.
Scientists transplanted immature human neurons into mice with spinal cord injuries and discovered the neurons were able to work with the damaged spinal cords to reduce neuropathic pain and to improve bladder control and function.
The study was published in the Sept. 22, 2016, edition of Cell Stem Cell.
Researchers said they focused on a way to reduce chronic pain and improve bladder function
because many people with spinal cord injuries noted that those side effects deeply impacted their lives. The scientists involved in the study are now working on moving toward clinical trials.
In a UCSF news announcement, co-senior author Arnold Kriegstein, M.D., Ph.D., professor of developmental and stem cell biology, said, “This is an important proof of principle for using cell therapy to repair damaged neural tissue. It brings us one step closer to using such transplants to bring much-needed relief to people with spinal cord injuries.”
Mice treated with neuron therapy showed fewer indications of chronic pain and also showed improved bladder function three and six months after the neuron transplants.
Researchers noted that chronic pain and lack of bladder control are significant issues for a number of people with spinal cord injuries.
Co-senior author Linda Noble-Haeusslein, Ph.D., chair of neurological surgery and professor of physical therapy and rehabilitation at UCSF, said, “The field has been very focused on restoring patients’ ability to walk, perhaps because that’s often their most visible impairment.” But she pointed out that a 2004 survey of people with spinal cord injuries showed that more people with SCI defined bladder control as their highest priority for treat-ment. Fewer survey respondents said walking was a higher priority.
“That study suggested that we had really missed the boat as a field,” said Noble-Haeusslein. She added, “It caused us to dramatically shift what we do in the lab.” l
On the cover: Photo by MizC/iStock.com.
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New Pressure Injury Staging Illustrations Now Available
Training segments of the spine can help children with cerebral palsy improve their trunk control, which can in turn improve their function in a number of activities.
That’s what physical therapists (PTs) at the University of Hartford (Conn.) have discovered. They’re using a technique called Targeted Training to strengthen the
spines of children participating in the program.
Rather than treating the spine as a single entity, the Targeted Training program instead studies different sections of a child’s spine to determine where weakness exists. Once the weak areas are identi-
fied, the child is custom fit for a standing device that provides support where it is needed and helps the child to improve his control of weak areas.
Therapy using the standing device takes place at home, and the University of Hartford PTs reassess the
New illustrations of pressure injuries are now available for download from the National Pressure Ulcer Advisory Panel (NPUAP).
The collection of illustrations, free of charge for educa-tional use, includes images of stage 1, 2, 3 and 4 pres-sure injuries, plus images of deep tissue injuries, unstage-able pressure injuries, and healthy skin. Illustrations are of lightly or darkly pigmented skin.
Download the illustrations at http://www.npuap.org/resources/educational-and-clinical-resources/pressure-injury-staging-illustrations/.
The NPUAP announced in April 2016 that it was adopting the term pressure injury to replace pressure
Spinal Training Improves Trunk Control in Kids with CP
children every two months.Sandra Saavedra, assistant professor at the University
of Hartford’s College of Education, Nursing & Health Professions, leads the program.
“We assess the children’s control by holding them at their shoulders and determining if they can hold their heads,” Saavedra explained in a news announcement about the treatment program. “If they can, we move down under their arms to see if they have control of their upper spines and heads. We progress our hands down the body one region at a time to see exactly where they have trunk control.”
A 5-year-old boy with cerebral palsy who is one of the first program participants was able, after 18 months of training, to independently sit upright for several minutes. Before participating in the program, he was unable to sit independently for more than a few seconds.
The boy’s parents report that in addition to being able to sit up, the child is better able to make eye contact and to interact with family, friends and toys.
The treatment is currently unavailable in the United States, though it’s offered in the United Kingdom. Molly Maine, a colleague of Saavedra’s, added that the Targeted Training program has other applications, including helping patients who’ve had strokes. l
ulcer, noting, “The change in terminology more accu-rately describes pressure injuries to both intact and ulcer-ated skin.” The organization added that the new “pres-sure injury” language would eliminate the confusion that has sometimes resulted from Stage 1 injuries and deep tissue injuries also being referred to as pressure ulcers, though the skin is intact in those situations.
The NPUAP recognizes four pressure injury stages, ranging from non-blanchable erythema of intact skin (stage 1) to full-thickness skin and tissue loss (stage 4). The organization also includes unstageable pressure injuries and deep tissue pressure injuries in its official list of injury stages. l
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CChildren diagnosed with genetic conditions can have symp-toms as spiraling and unique as a double helix. Yet sometimes a malfunctioning gene results in the same developmental outcome: mobility impairment or delay. What can be done when the clock is running, but mobility development is slowed? Answering that question with the proper intervention can make all the difference for these children now and in the future.
Mobility Management looks at three genetic syndromes that can lead to full- or part-time mobility equipment use: Angelman, Rett and Down syndromes. Many of these children might even-tually walk. Here’s what you need to know to help them become independently mobile or to maximize their mobility potential.
A Look at Angelman SyndromeThe UBE3A gene, or Angelman gene, is located in chromosome 15. A deletion of a section of this chromosome is the most common cause of Angelman, which results in deficient expression of the gene in the brain, according to Angelman Syndrome Foundation.
By Elisha Bury
A Look at Genetic Conditions That Cause
Delays in Mobility Development
Children with Angelman are typically diagnosed between the ages of 2 and 5, although symptoms begin much earlier, according to the Angelman Syndrome Foundation. Characteristics usually include developmental delays, seizures, and diffi-culty with speech development, including lack of cooing and babbling. These children are unusually happy, with frequent bouts of laughing and smiling.
“Developmental delays are commonly seen between the three syndromes (Angelman, Rett and Down),” says Gabriel Romero, VP of sales and marketing at Stealth Products. However, with “Angelman, the inability to walk is more common.”
The reality is that “of the Angelman’s diagnosed customers, 12-15 percent will never be ambulatory,” says Ralph Booker, an ATP with National Seating & Mobility. These children “will need not only a mobility device, but positioning and pressure relief. Of the remainder, the use of a stroller base, manual wheelchair or companion chair will be needed.”
Developmental delays in Angelman have considerable vari-ability, ranging from mild toe-walking to severe impairment. For some, sitting might occur after age 1, and for others walking can be delayed as late as 5 years, according to the Angelman Syndrome Foundation.
“Some children may exhibit hypertonicity, dystonia and/or spasticity early on in their development and not demonstrate any ability to move,” says Karen Kangas, OTR/L, who specializes in pediatrics. “Their own physical characteristics of movement can
resemble children who have been diagnosed with cerebral palsy.
“Other children may be ambulatory yet ataxic. Other children may be severely delayed in
motor development, spending months or years in an apparent single stage of motor
development [and] then change and gain more control,” she says.
Common issues associated with Angelman that impact mobility are seizures, ataxia, hypotonia and kyphotic posture:●● Ginny Paleg, DScPT, MPT, PT,
says that seizures can make unsup-ported walking unsafe in addition to preventing these children from
keeping up with peers. ●● Ataxia can be severe or mild. Mild
ataxia appears as forward lurching, TOY C
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balance issues or hyperkinetic movements, especially in the trunk and limbs. ●● Hypotonia is a common symptom, Paleg says. This low tone can severely delay development. ●● Another common issue is kyphotic posture, thanks to mobility equipment limitations, Romero says. In fact, scoliosis is quite common in as many as 80 percent of children with Angelman and might require bracing, according to the Angelman Syndrome Foundation.In addition, some children with Angelman also experience
feeding and speech problems, double vision caused by an inability to align the eyes properly, as well as a myriad of other mobility-related issues, such as uplifted fixed arms during ambulation and a wide-based gait with pronated feet.
Booker adds that those with deletion-positive Angelman are most at risk for hypotonia, feeding disorders and seizures.
Heat sensitivity can also interfere with mobility, says Booker, whose son has Angelman syndrome. As a result, mobility equip-ment might be needed for outings.
“In my son’s case, his seizures can be set off by heat [because he is] unable to regulate body temperature, [and] exertion fever [from] infection due to ears, wounds, UTI (urinary tract infec-tions),” Booker says.
Retrospective on Rett SyndromeUnlike Angelman syndrome, Rett syndrome develops after child-birth. The condition stems from a mutation of the MECP2 gene and seems to occur randomly, according to the Mayo Clinic. The mutations affect brain functioning in the areas of learning, speech, movement, breathing, heart function as well as chewing and swal-lowing, according to RettSyndrome.org. Because many different types of mutations can occur, Rett syndrome symptoms range from mild to severe. Rett syndrome affects girls almost exclusively.
With Rett syndrome, development proceeds typically at first. At around 6 months of age, infants begin to lose skills involving crawling, communicating or using their hands. Changes typically worsen around ages 12 to 18 months. Muscles can become weak or spastic.
“Children with Rett can be slow to walk independently or walk independently and then lose skills,” Paleg says. “New data show that as a teen, if walking is maintained, it can actually get better.”
Motor apraxia has a significant effect on mobility, although the results might be quite different among children with Rett syndrome.
“Motor apraxia prevents consistent sensory information to support motor control,” Kangas explains.
Like children with Angelman syndrome, children with Rett experience seizures, loss of muscle control and scoliosis. Unusual eye movements might also impact mobility functioning. Children with Rett are prone to fractures and can have trouble chewing and swallowing. Rett syndrome is also marked by life-threatening heart complications related to an irregular heartbeat.
One characteristic of Rett is the loss of communication skills. Children with this syndrome might stop speaking, making eye contact and communicating non-verbally. Loss of interest in people and surroundings might occur as well as periods of
sudden and prolonged agitation and crying. Communication skills can be regained later.
According to the Mayo Clinic, children with Rett experience a lot of pain. Unfortunately, these children might be unable to express this pain.
Although loss of communication skills might not seem tied to mobility, Booker says this symptom is the real key to mastering intervention.
“In all of these diagnoses, it took me too long to realize how much was understood by the customer I was working with,” he says. “The inability to express themselves is the limitation.”
Dealing with Down SyndromeDown syndrome, by far the most widely recognized among genetic pediatric conditions, occurs because of a full or partial extra chromosome 21. Individuals with Down syndrome present with the easily recognized small stature and upward-slanted eyes. In addition, these children have low muscle tone and cognitive delays, according to the National Down Syndrome Society.
What might not be widely recognized is that delayed mobility development in children with Down syndrome might be caused by cardiac conditions or low muscle tone, according to the National Association for Child Development.
In all of these diagnoses, it took me too long to realize how much was understood by the customer I was working with. The inability to express themselves is the limitation
– Ralph Booker, ATP
“The most common issue for many children with Down syndrome is hypotonic or low motor tone,” Kangas says. “However, children with this diagnosis still exhibit great vari-ability in their range of tone. Most children with Down syndrome exhibit slower development when gaining independent mobility... What's critical early on is providing children with opportunities to move while engaged in activity.”
Paleg says, “We know treadmill and maybe gait trainer use will lead to sooner achievement of motor milestones and may improve language and cognition. Treadmill training later can improve walking as well.”
Like other genetic conditions, Down syndrome occurs on a spectrum, with mild to severe delays. Children with Down syndrome might eventually reach development milestones, including sitting, standing and walking, according to the American Academy of Orthopedic Surgeons.
Joint instability might impact the ability to walk, as hips, knees and other joints can become dislocated — resulting in falls.
“Protecting a child's skeletal health with Down syndrome is critical as we know many children may have some increased risk in their cervical vertebrae,” Kangas says.
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On the Clock
The Case for Early InterventionWhatever the diagnosis, early intervention could considerably improve outcomes.
“We've known for so many years that if independent mobility does not occur, all areas of development are lost,” Kangas says. She explains that research supports this idea.
Paleg agrees. “The best research says that the critical period for intraspinal neuron plasticity is before 12 months, and that the motor and sensory cortex plasticity peaks at 24 months. This is why you can’t wait until they walk at 15 to 24 months; it’s too late for spatial awareness, initiation [and more],” she says.
So what is the proper age for intervention?“That's the big question we all have,” Paleg says. “Dale Ulrich
has shown increased activity levels for children with Down syndrome who walked early due to treadmill training. We think it also improved spatial awareness, language and cognition. Cole Galloway and Sam Logan introduced power to a toddler who was a great driver, but never quite got the initiation part. Researchers are working hard to show that early mobility is essential, but it’s not so easy.”
Paleg begins at 9 months of age by introducing a stander and gait trainer, but she doesn’t stop there.
“I introduce a toy car or some form of power as well,” Paleg says. “The evidence is not strong but suggests that these interven-tions spur language and cognition.”
“In any pediatric case, the sooner a child can have access to independent mobility, the more experience they gain in impor-tant early development needs they may have,” Romero says.
However, the diagnosis significantly influences when and how mobility devices are introduced. This is especially true for Rett syndrome.
“Motor apraxia can prevent hands from holding on to a mobility device and/or prevent a child from reaching out to explore their environment,” Kangas says.
In fact, children with Rett have a hard time feeling where their bodies are in space, Kangas says. Supporting movement is critical
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Waiting means lost opportunity to make a better brain. If the CUNY team is right and the peak time for change has closed by 12 months, then watchful waiting is a lifetime sentence of lost potential
– Ginny Paleg, DScPT, MPT, PT
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to supporting a child’s development, but for children with Rett, going slowly and providing structure to mobility is key.
Certainly, waiting might be the worst thing for a child with a genetic condition.
“Waiting means lost opportunity to make a better brain. If the CUNY (City University of New York) team is right and the peak time for change has closed by 12 months, then watchful waiting is a lifetime sentence of lost potential,” Paleg says.
Equipment ConsiderationsWhile symptoms of Angelman, Rett and Down syndromes may vary, they all have one thing in common: “Loss of normal movement and coordination usually will require some form of mobility assistance,” Romero says.
Paleg describes children with Angelman and Rett syndromes as lean movers and those with Down syndrome as still, short and stout. But, “they all tend to have hypotonia [and] so will sink into any supports,” she says.
Dynamic components work best for these conditions. “I like the KidWalk and the Rifton dynamic activity chair,” Paleg says. “These children are at moderate risk for hip dysplasia. So I would get a stander that abducts 30° to 60°.”
For positioning, Romero says, “With Rett syndrome, the abnormal movements need to be considered in the type of seating and mobility that is prescribed. The kyphotic posture is commonly seen in the three syndromes; consider proper back
and seat surfaces and measurements.”Booker says the type of equipment, as with other conditions,
depends on the goals of the entire health team. Mobility providers
Showering, bathing or toileting, We have the products to help your clients get positioned for a safe and comfortable experience.
• Ocean shower and commode chairs• Aquatec powered bathlifts• Boris pediatric shower chairs• Roth portable grab bars.
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Learn more about genetic conditions that might impact mobility.
Angelman: Angelman Syndrome Foundation angelman.org/
Foundation for Angelman Syndrome TherapeuticsCureangelman.org
Rett:RettSyndrome.orgrettsyndrome.org
Mayo Clinicmayoclinic.org/diseases-conditions/rett-syndrome/basics/definition/con-20028086
Down:National Down Syndrome Societyndss.org
American Academy of Orthopedic Surgeonsorthoinfo.aaos.org/topic.cfm?topic=A00045
Resources
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On the Clockalso must consider the home and school environments as well as transportation.
If the child cannot walk, then Booker might recommend a manual tilt-in-space wheelchair, a positioning back with lateral supports, as well as pressure-relieving devices. Booker also says to account for individual health conditions, including seizures, scoliosis, incontinence and heat dissipation, as well as communi-cation and orthotic devices.
But Kangas warns that children with these diagnoses do not simply need a scaled-down version of adult equipment.
“Mobility devices do not always allow a child to participate in the act of entry and exit. Instead an adult is required to lift and/or place the child in the system,” Kangas says. “For the child with motor apraxia, this can be confusing or anxiety producing. Mobility equipment needs to be readily controlled by a child's body and be very maneuverable.”
For example, Kangas usually recommends powered mobility for children with Rett syndrome, but often this equipment is rejected. Again, Kangas says that assessment for power should be different from an adult assessment.
Usually, “a chair with a joystick or single hand switches is tried in a large gym or big space,” Kangas explains. “This is incredibly confusing for a child with motor apraxia. First of all, eye-hand coordination is the most compromised of all motor processing with apraxia. Then a large space gives no clues as to how the device is to work or a path to follow. However, using electronic
switches (zero force) within a headrest within a very structured familiar pathway, working in short routines and in singular directions first has proved successful when the seating and powered chair fit and have been adequately programmed.”
Funding ConundrumFunding for these conditions doesn’t have to be as tricky as it might sound.
For children with Angelman syndrome, “about 70 percent are prescribed mobility devices in the school setting, and funding in Pennsylvania is good,” Booker says.
He attributes the ability to get funding to the involvement of the school therapist, physical medicine and rehabilitation physi-cians, and neurologists.
Paleg agrees. “I have never had any issues. In early interven-tion as well as at school, it is the responsibility for the provider agency to purchase loaner equipment, as per IDEA (Individuals with Disabilities Education Act). We loan out equipment for the family to try and then purchase it after they know what they want or need.”
Paleg says to do what you know. “Start with a full assessment, [and you] must include two or
more ICF [International Classification of Functioning] areas. Use a valid reliable tool, like GMFM-88 (Gross Motor Function Measure). It's all about medical necessity. Make sure you cite real primary research that shows medical need. Leave out all extra-
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Meet Sandra. Sandra was born with Angelman syndrome. She didn’t start walking until she was 4. At that time, she used a gait trainer and a walker with help. However, frequent seizures put Sandra at risk for falling. Intensive therapy helped Sandra walk independently, but only for a few months.
Then Sandra tried a KidWalk with a soft trunk wrap for fall prevention. Adding a vagal nerve stimulator helped reduce seizures, and Sandra finally was able to maintain independent mobility. Sandra requires dynamic systems because of low tone. She uses a ThevoTwist seating system with a rocking option and a Thomashilfen bed, which helps her sleep comfortably through the night.
Case Study: Angelman Syndrome
Sandra is now 25. She has low bone mineral density from years of anti-seizure medicine. However, Sandra still stays active and is involved in
her community. She enjoys cycling, swinging and playing with her switch toys. ●
Case study provided by Ginny Paleg, DScPT, MPT, PT.
neous information. Stick to the point,” she advises.Sometimes getting funding might require a little coaching
of the medical team. Booker explains, “We have a good rela-tionship with our son’s (primary care physician) and neurolo-gist who will write ‘whatever you need,’ but don’t know what to write to satisfy insurance scrutiny. So we need to find a therapist who is not threatened that we know more about our son than
they ever will.”Funding can be a bit tricky as children with genetic conditions
grow up.“It is when they transition out of the school setting when
funding becomes difficult,” Booker says. “Therapists in the adult market are unfamiliar with all the issues involved with these diagnoses.” ●
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product revue
Axion Rotary InterfaceThe Axion enables headrest pads and head positioning devices to rotate with the user’s head, thus transforming static headrests into dynamic positioning devices. Combined with the user’s head support, the Axion allows the head support to rotate to reduce shear forces and improve peripheral vision. The result: Head support that also enables the head to move horizontally.
Symmetric Designs(800) 537-1724symmetric-designs.com
Custom-Molded Seats & BacksThis infinitely adjustable custom-molded wheelchair seating can be grown to accommodate weight gain and evolving positioning requirements. The design of the seating system provides optimal pressure distribution and supe-rior ventilation to reduce buildups of heat and moisture. And because this system can flex with the wheel-chair’s movements, it maximizes shock absorption to reduce shear and pressure.
Matrix Seating USA(800) 986-9319matrixseatingusa.com
ADI CF Series Back SupportsFor the consumer demanding the highest-quality back support with the greatest combination of weight reduction, clean aesthetics and functionality, the Accessible Designs Inc. series of carbon fiber backrests combines a light weight with adjustability (1.25" depth adjustment, 1"+/- width adjustment, 20° angle adjustment with applicable hardware). Hardware options such as fixed, quick-release and 2- or 4-point mounting ensure just the right choice regardless of application.
Stealth Products LLC/ADI(512) 715-9995stealthproducts.com
Tarta OriginalModularity enables the Tarta backrest system to provide functional, dynamic movement and support exactly where it’s needed. Harmonic steel central plates construct the spine, while composite vertebrae use high-resiliency foam in all pads. The components come together in a highly adjustable (width and height) configura-tion, with different widths possible in different areas of the back. The vertebrae design also facilitates the breathability especially important to active users.
Stealth Products LLC(512) 715-9995stealthproducts.com
AGILITY CarbonWith a compression-molded, lightweight carbon fiber construction, the AGILITY Carbon combines high-strength performance with a streamlined design. With single clamps on each side, hardware is smaller, lighter and stronger than typical fixed-back hardware. Discs lock into the carbon fiber to create a solid backrest; when loosened, the discs allow the shell to rotate independently to provide 15° forward/rearward angle adjustment in 5° increments.
ROHO Inc.(800) 851-3449roho.com
Little Wave FlipThis pediatric tilt-in-space chair has fewer parts, making it easier to change seat height, depth and width. A modular tube-in-tube seat rail design makes changes possible without replacing parts, and a raised pivot point on the folding back creates the possibility of leaving more seating on the Little Wave Flip when it’s folded. More than 500 color combinations are available at no charge, ensuring that kids can pick the aesthetics just perfect for them.
Ki Mobility(800) 981-1540kimobility.com
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TRU-Balance 3 with iLevelComplex clinical positioning or optimal indepen-dence? TRU-Balance 3 with iLevel technology combines these two goals to improve the consumer’s over all quality of life. Available with power tilt, recline and an articulating foot platform, TRU-Balance 3 accepts a wide range of positioning components and accesso-ries. iLevel with Extra Stability Technology to mechanically stabilize the base lifts the seat 10" in just 16 seconds, with driving speeds up to 3.5 mph for real-time success while performing activities of daily living.
Quantum Rehab(866) 800-2002quantumrehab.com
OmnilinkThe Omnilink swing-away lateral bracket includes a unique telescoping feature that allows its pad to be locked at varying depths, without requiring extra links. The telescoping feature provides additional lateral pad pressure prevention. Non-adjustable lateral pads frequently increase pres-sure between the consumer’s trunk and the lateral pad, but Omnilink allows slight pad adjustments to be made on a routine basis.
Adaptive Engineering Lab (AEL)(866) 656-1486AELseating.com
EaSyS AdvantageWith 180° recline, face-to-face viewing direction, a central release lever for tilt in space, and a seat release for easy folding, the new EaSyS Advantage is designed to provide maximum comfort for both child and caregiver. A new brake assembly optimizes safe handling, and the soft suspension absorbs vibrations for an extra-smooth ride. An extra-thick cushion enhances comfort, and the seat/back are fully adjustable without requiring tools.
Thomashilfen North America(866) 870-2122thomashilfen.com
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November 2016 • Vol. 15 No. 11 Serving the Seating and Wheeled Mobility Professional
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They’re both True!
AmyseatAmysystems’ aftermarket powered positioning options include complex seating for standard or custom-built systems. Backed by a comprehensive warranty, the systems are built at a local facility to ensure no discrepancies exist in the final product. A dedicated customer service and technical support staff can help configure solutions for even the most highly involved clients. Custom work is available.
Amysystems(888) 453-0311amysystems.com
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