Case Study: Static Seating
by Ellie Burcher
Jane was involved in a road traffic accident in which she sustained significant orthopaedic injuries to her left leg and ankle. At the point of assessment, she had already undergone several reconstructive surgeries on her ankle but awaiting further surgery in the next few months.
At the point of assessment Jane was non-weight bearing on her left leg but struggling to manage the crutches provided by the hospital. She has experienced significant swelling in her ankle and had been advised by her consultant to keep her leg elevated for much of the day.
An OT assessment had been requested to review the equipment needs in Jane’s home to support her in managing transfers more independently. Jane was needing physical assistance to get on and off her bed, toilet and chair and was heavily reliant on her husband and teenage children to help her.
On assessment, these physical limitations were noted as having a significantly detrimental impact on Jane’s mood and levels of anxiety as she was struggling to adjust to requiring so much assistance. She was often reluctant to ask her family to help with transfers so stayed in bed for much of the day to ‘keep out of the way’.
When Jane did sit downstairs she found the sofa more comfortable but often sat along the length of the seat to elevate her leg. She demonstrated that as the sofa was low her husband would pull her to standing before she could use her crutches. Jane also reported increased spinal and neck pain after sitting on the sofa and it was considered that sitting in this position and transfer method was causing poor positioning. Jane was sat in a twisted position, putting additional strain on her core and neck muscles and then was being strained to manage the standing transfer.
It was identified that as well as equipment to manage the other transfers, a more suitable chair would be of significant benefit. A chair that had a rise function would enable Jane to manage an independent sit to stand transfer, reducing the dependency on her family and the risk of injury from the poor technique currently being used.
The leg rest elevation function of such a chair would also encourage and enable Jane to sit in an aligned position but with her legs elevated, reducing the twisted trunk and neck position.
Any chair could also be situated in the main lounge, reducing the isolation she was experiencing from spending her time in the bedroom.
Following the report and agreement recommending this and other items, a joint visit was planned with a local seating provider. This provider was able to offer products across several manufacturers to maximise choice and best value.
The chair trial enabled Jane to see the types of chairs available and try several chairs for comfort and transfer ability. It also allowed Jane to see the features such as back recline and water fell back that had been mentioned during the recommendation.
A suitable chair, meeting Jane’s clinical needs as well as her choices regarding fabrics and colours was quoted for and submitted for consideration to the case manager, agreed and ordered.
The delivery of the chair proved a significantly positive step for Jane in her feeling more able, independent and comfortable within her home.
As Jane progressed through her additional surgeries and rehabilitation programme the chair was a vital way of providing a safe area, transfer support and comfortable place for Jane to remain actively part of the family and came to be a normal piece of the family’s furniture, rather than a special or medical chair provided due to the injuries.
