The referral from the Occupational Therapist said:
“This child has SMA type I/II. She has really reduced active movement and is dependent on adults for all changes of position. She uses a specialist wheelchair and requires a high level of postural support to be able to maintain a seating position. She has no head control and wears a corset.
She has a new hygiene shower chair: The Rifton shower chair. (The previous one was not providing sufficient postural support). She will use this in the shower and over the toilet. The chair provides overall good postural support but head support remains a problem. She has severe scoliosis and headrests are always fitted to the middle of the backrest. She needs it off-set to the side. No specialist headrests which can accommodate her requirements, and that are suitable for a shower environment were found.
A vacuum headrest has been ordered as well, but it normally fits in a bath, therefore cannot be fitted on the chair easily.
Option 1: For Remap to fit the vacuum headrest on the backrest of the shower chair so that it can be used with the chair. (Not implemented)
Option 2: For Remap to adapt the current headrest so that it can be moved laterally and provide additional support. If this solution is chosen, we need to be able to adjust the position of the headrest in all directions for when she moves and grows etc. (This option was implemented.)
The existing shower chair had a headrest that was only adjustable vertically and in tilt, but only on the centre-line of the chair. Because her spine is curved, the headrest needs to be about 200mm to the left side of the centre-line (i.e. to the child’s left), and slightly swivelled towards the centre-line. This adjustment was not possible with the standard headrest.
The solution was to add a pair of arms with diving ball-joints on each end between the headrest and its normal centre mounting. This allowed enough movement and adjustment to position the headrest in the right place for her, providing a waterproof solution suitable for use in the shower. The photos show the diving ball joints and arms, and the positioning on the shower chair from different angles.
The client is now able to sit comfortably, and well supported in her shower chair.