Individuals with neurologic disabilities deal with a number of challenges in completing activities of daily living. One of the most significant of those challenges is acquiring a mobility device that allows them to maximize their independence with both mobility and performance of their activities of daily living. For certain of these individuals the adaptive equipment that is often provided may be inadequate to achieve the potential for that participation and independence.

Course Description

Neurologic disabilities such as CP, ALS, MS, and SCI figure more prominently in discussions about the impact and importance of complex rehabilitation technology than CVA, yet more than 795,000 people in the United States suffer a CVA annually. Moreover, stroke reduces mobility in more than half of those over age 65. Medicare qualification requirements and reimbursement cuts have negatively influenced the caliber of wheeled mobility devices CVA survivors receive. Many obtain an upright, manual wheelchair that qualifies for Medicare rental reimbursement.

It is well documented that manual tilt-in-space wheelchairs provide seat angle adjustments that can facilitate pressure relief, postural control, and activity specific positioning, but these chairs are often not prescribed due to limitations related to independent propulsion, weight, and transport.

This presentation will explore the research supporting the use of tilt. Topics will include: how changes in seat angle affect posture and pressure distribution, seat height and angle characteristics that impact self-propulsion, the relationship between independent mobility and incidence of pressure ulcers, and how changes in seat angle can influence activities of daily living. The clinical justification and documentation requirements for Medicare reimbursement of the E1161 code will be outlined, and participants will be educated on options to achieve the clinical benefits of manual tilt while enabling self-propulsion and transport.

Course Objectives

Upon completion of this course participants will be able to:

• Cite 3 aspects of propulsion affected by seat height and changes in seat angle
• Cite 2 elements of the relationship between independent mobility and incidence of pressure ulcers
• Provide 2 examples of how changes in seat angle can impact pressure and affect posture
• Provide 2 examples of how changes in seat angle can affect participation in activity specific ADLs
• Produce documentation that clinically supports Medicare reimbursement of E1161 code

Course Instruction Details

• Course Audience: Dealers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Course Description

For many years, there were only a couple basic choices of primary supports for pediatric wheelchair users: custom configured or custom molded, with limited choices in between. The options available in seating technology for the pediatric client have expanded considerably over the years, and today there are a number of off-the-shelf, out-of-the-package products available. This greater range of available products requires professionals to be more discerning regarding the variety of choices before them, and recognize which product accomplishes the objective in a clinically appropriate way. We know that children are not just a smaller version of the adult client and that their needs can be different. What does the research say about what is important for the pediatric client regarding postural support and addressing postural asymmetries, maintaining tissue integrity, facilitating function, etc. This reworked presentation will explore the types of seating technology on the market and seek to inform clinical practice by discussing considerations and applications of the various types of technology for primary supports for the pediatric wheelchair user.

Course Objectives

At the completion of this course, attendees will be able to:

• Describe differentiating characteristics of three categories of primary supports for a pediatric wheelchair user.
• Identify two design objectives specific to a cushion for a pediatric wheelchair user and that will facilitate functional performance of activities of daily living.
• List 2 benefits of using the ICF Model as a framework for making appropriate clinical decisions about pediatric seating.

Course Instruction Details

• Course Audience: Suppliers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Minimum score on post-test for proficiency: 60% (3 out of 5 answers correct)

"iNRRTSCE is certifying the educational contact hours of the program and by doing so is in no way endorsing any specific content, company, or product. The information presented in this program may represent only a sample of appropriate interventions. As an IACET Accredited Provider, The interNational Registry of Rehabilitation Technology Suppliers offers CEUs for its programs that qualify under the ANSI/IACET Standard. This course is approved for .1 CEU."

Course Description

Children with disabilities may have many needs that differ from their typically developing peers. This may include adaptive equipment to maintain or improve health status, help them function, and meet developmental milestones. Refined assessment tools allow for early diagnoses, which then leads to early therapeutic intervention. As a result, we can anticipate what the functional impairments are going to be, and what type of equipment may be indicated.

The timing of interventions, including provision of adaptive equipment, can be a critical contributor to success in meeting therapeutic goals. Professionals involved in equipment prescription should recognize what types of equipment may be helpful, based on timing and diagnosis. This presentation will review childhood development and disability and encourage the learner to consider the scope of possible equipment needs for the child with a disability.

Course Objectives

At the completion of this course:

• Participants will be able to identify key developmental differences and equipment needs in children with disabilities compared to typically developing peers.
• Participants will be able to explain how early assessment and diagnosis inform and guide appropriate equipment selection.
• Participants will be able to explain the value of interdisciplinary collaboration in determining appropriate adaptive equipment for children with disabilities to help those children achieve developmental milestones and enhance occupational engagement and functional performance.

Course Instruction Details

• Course Audience: Suppliers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Beginner
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEUs

Minimum score on post-test for proficiency: 60% (3 out of 5 answers correct)

"iNRRTSCE is certifying the educational contact hours of the program and by doing so is in no way endorsing any specific content, company, or product. The information presented in this program may represent only a sample of appropriate interventions. As an IACET Accredited Provider, The interNational Registry of Rehabilitation Technology Suppliers offers CEUs for its programs that qualify under the ANSI/IACET Standard. This course is approved for .1 CEU."

Course Description

It is well documented that there is a high rate of upper extremity repetitive strain injury (RSI) among manual wheelchair riders. In addition to the risk of RSI, physical ability and the environment of use can pose further challenges to mobility. These factors can affect accessibility, speed, distance, and duration of travel, potentially limiting an individual?s social participation. Even the act of propulsion itself can hinder tasks that require the use of one or both hands during movement. Power assist technology has provided a solution to these challenges for many wheelchair riders.

While power assist technology has been available for some time, its popularity is increasing as more professionals and users recognize the advantages it can provide. To assist users in making informed prescriptive decisions, professionals must understand this evolving technology and be aware of the increasing diversity of product choices available. This presentation will discuss the mobility and health-related challenges that come with propelling a manual wheelchair. We will consider alternatives to address these challenges and review the various types of power assist devices currently available.

Course Objectives

At the completion of this course, attendees will be able to

• Explain 3 aspects of mobility that can be limited by manual propulsion of a wheelchair
• Identify 4 aspects of daily life for a manual wheelchair user that can be impacted by repetitive strain injury (RSI) associated with propelling a manual wheelchair
• Explain 3 important considerations for a manual wheelchair user to manage the risks of repetitive strain injury (RSI) associated with propelling a manual wheelchair

Course Instruction Details

• Course Audience: Suppliers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEUs

Minimum score on post-test for proficiency: 60% (3 out of 5 correct responses)

iNRRTSCE is certifying the educational contact hours of the program and by doing so is in no way endorsing any specific content, company, or product. The information presented in this program may represent only a sample of appropriate interventions. As an IACET Accredited Provider, The interNational Registry of Rehabilitation Technology Suppliers offers CEUs for its programs that qualify under the ANSI/IACET Standard. This course is approved for .1 CEU.

Course Description

There are many firmly held opinions about what factors most dramatically affect manual wheelchair propulsion efficiency. Which factors have the greatest impact and are most important to consider? Is it the weight of the chair? Is it the component selection? Like an automobile, is it the way it is tuned or set up that optimizes efficiency?

Prescribing professionals must understand how people use their manual wheelchairs. They must also understand how wheelchairs actually work as a machine. Armed with this knowledge, the professional can make appropriate decisions to optimize efficiency while meeting the user's needs for support, stability, and function.

This presentation will discuss factors commonly considered to be predictors of manual wheelchair propulsion efficiency. We will compare these factors in light of what current research suggests as being predictive and then provide some applicable conclusions to inform clinical practice.

Course Objectives

Upon completion of this course participants will be able to:

• Cite 2 examples of how end users move about in wheelchairs during everyday life.
• List and explain 2 principles of physics that impact propulsion efficiency of a manual wheelchair.
• 3 characteristics of component selections that influence propulsion efficiency of a manual wheelchair.
• List 2 examples of propulsion maneuvers influenced by rotational inertia, and describe a strategy for each to lessen that influence.

Course Instruction Details

• Course Audience: Dealers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Course Description

Persons involved in recommending wheelchair cushions have relied on many factors in deciding which cushions to recommend, including word of mouth, self-perceived comfort and function, aesthetics, tribal knowledge, etc. While these can all be important factors, the science of design and materials should be a primary factor in driving the decision of cushion selection to allow for comfort and function, while optimally managing pressure.

It is important for those involved in recommending a wheelchair cushion to understand principles of design and characteristics of materials used in cushions in order to select an appropriate wheelchair cushion that will allow for comfort and function, while optimally managing pressure. Participants will receive a quick review of the forces that need to be understood when considering the selection of wheelchair cushions. They will be taught measurable characteristics of wheelchair cushions for tissue integrity and will be briefly introduced to a method of comparative testing. Participants will learn how to identify different materials used in the design of cushions and how those materials interact with the anatomy for pressure distribution. They will learn how to understand durability and stability of these materials in cushion construction, and they will also learn to identify and understand different design techniques used to improve cushion efficacy and their potential influence on functional outcomes.

Course Objectives

Upon completion of this course participants will be able to:

• Describe the basic biomechanics of seated posture as it relates to wheelchair cushions
• List the material science of wheelchair cushion components
• Name the different means by which cushions redistribute load

Course Instruction Details

• Course Audience: Dealers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate to Advanced
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Course Description

This course reviews updates on current guidelines of transporting children with special needs per the 2019 American Academy of Pediatric Policy Statement. Various child restraint options including infant car beds, vests, car seats, and booster seats will be presented as options for infants and children with special needs including those with risk of airway obstruction, tracheostomy, muscle tone abnormalities, gastrointestinal issues, casts, and challenging behavior. Case studies will be presented to reinforce clinical application of various restraints. Additionally, the importance and necessary components of hospital-based multi-disciplinary child passenger safety programs will also be discussed as a means to increase child safety and prevent delays in hospital discharges.

For children with disabilities who are unable to transfer from their wheelchair when traveling in motor vehicles, and the wheelchair serves as the vehicle seating system, a thorough review of ANSI/RESNA and ISO safety standards and transit compliance will be presented. This includes selection of appropriate transit options for wheelchairs (WC19) and seating systems (WC20), as well as securing the wheelchair in the vehicle (WC18) using Wheelchair Tie-down and Occupant Restraint Systems (WTORS).

Course Objectives

Upon completion of this course participants will be able to:

• Identify at least four common medical and development needs of infants and children who will benefit from utilizing adaptive equipment for transportation
• Choose the most appropriate specialized restraint system for a clinical scenario and identify resources for configuration, positioning, and installation of systems for optimal comfort and safety
• Recognize at least three elements of a multi-disciplinary child passenger safety program
• Identify the required transit options for pediatric wheelchairs that meet RESNA WC18, WC19, WC20 and ISO safety standards

Course Instruction Details

• Course Audience: Dealers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Beginner
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Course Description

Many consider adjustable wheelchair cushions to be the ultimate solution for clients at high risk of pressure injuries. However, they may not be fully aware of what defines an adjustable wheelchair cushion, how the technology works, and what it should accomplish when properly constructed, adjusted and used.

Every interaction between an individual and a different cushion is a unique result of those two specific variables at that point in time. Can you know whether a specific adjustable cushion can be properly adjusted for any individual's seating needs without trialing it first?

Further, can you determine the proper adjustment prior to trial? Over time, will the adjustable characteristics of the cushion be able to accommodate changes in clients' needs? Should a good adjustable cushion offer the adjustment needed to properly fit at initial issue, as well as the ability to adjust as an individual's needs change?

Course Objectives

Upon completion of this course participants will be able to:

• Explain the various methods of pressure redistribution in wheelchair cushions and how they could affect pressure values at specific points.
• Explain how viscosity in wheelchair cushions may affect stability.
• Explain the importance of being able to adjust the fluid volume of a wheelchair cushion 'in the field' during an initial fitting or a follow-up with a user.

Course Instruction Details

• Course Audience: Dealers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Course Description

Imagine a meticulously configured ultralightweight rigid manual wheelchair, set-up for the user's anatomic measurements, postural support needs, and skill level. The wheelchair has an aggressive axle position and is stripped down of secondary components, such as anti-tippers, armrests or even wheel locks. The end user is expecting a highly efficient, high-performance wheelchair.

Now, imagine the chair being issued equipped with mag wheels and pneumatic tires with flat-free inserts. Research is giving us new insights into the impact of wheel and tire selection as a critical influencer of performance. Are we considering the right factors and context when it comes to wheel and tire selection?

Wheel and tire selection on manual wheelchairs often comes down to choosing the standard, no-additional-cost option, or may be based on an assumption that a user is not able or willing to maintain wheels and tires that require it. Are we providing end users an explanation of what to consider, and giving them the options to determine how much maintenance they are willing to accept? An understanding of materials, and the physical and performance characteristics of wheels and tires, can contribute to improved decision making regarding the selection of a critical aspect of wheeled mobility: the wheeled part.

This presentation will address the science of wheels and tires and review current research findings on the impact of selection and setup on wheelchair performance and propulsion efficiency. Attendees will be provided practical considerations to equip them to make appropriate wheel and tire selection when configuring manual wheelchairs.

Course Objectives

Upon completion of this course participants will be able to:

• List two characteristics each of drive wheels and of caster wheels and explain how they influence manual wheelchair propulsion efficiency.
• Explain the importance of drive wheel diameter as it relates to rolling resistance.
• List two examples of manual wheelchair propulsion maneuvers where rotational inertia has a significant influence, and describe a strategy for each to lessen that influence.

Course Instruction Details

• Course Audience: Suppliers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate to Advanced
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Course Description

Professionals involved in manual wheelchair prescription must work with end-users to create a configuration that achieves optimum results for comfort, postural stability, function, and propulsion efficiency. As professionals involved in manual wheelchair prescription and fitting, the value we bring to the process is directly related to our knowledge.

This knowledge should always be evolving with integration of new research evidence. Without this requisite knowledge, we are ill-equipped to contribute to the quality of life of manual wheelchair users. This presentation will dive into the details of wheelchair set-up factors that must be considered to optimize postural stability and propulsion efficiency for end users. Factors include horizontal axle position, vertical axle position, seat height, seat angle, back height, back angle, and front frame angle.

Consideration will be given to the relationship between these factors and the current research supporting optimization of each factor. We will address how to make prescriptive decisions while providing for potential changes in clinical need and the value of implementing follow-up to reoptimize the wheelchair over time.

Course Objectives

Upon completion of this course participants will be able to:

• Describe the influence of weight distribution on manual wheelchair rolling efficiency.
• Describe the relationship of upper extremity position to force application during manual wheelchair propulsion.
• List 3 aspects of manual wheelchair set up to assess during follow-up visits.

Course Instruction Details

• Course Audience: Suppliers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate to Advanced
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU

Course Description

Every wheelchair fitting starts with a good eval, from client history to equipment trials, to careful measurements (and let?s not forget to get the rider?s and caregivers? thoughts on what matters to them). Once we have funding, we do our delivery and fitting and we?re done with that rider for the next 5 years, right? We know that?s not the case at all. Riders change. Whether it?s growth, weight changes, changes in the rider?s condition, or evolution of wheelchair skills, riders change. Can the chair you prescribed change with them?

In this session, we are going to look at a variety of the decisions that you often face when configuring a chair and help navigate some of options that will allow you to build future adjustments into the chair. We will discuss some of the more critical adjustments to consider, and what their impact can be on present and future performance. We will also discuss some of the set-up factors you need to consider when fitting and adjusting your chair and will offer some tips on how to avoid some of the mistakes that can rob a chair of its efficiency and performance.

Course Objectives

At the completion of this course, attendees will be able to

• List 2 common set-up errors that can have a negative impact on propulsion efficiency and thus influence functional performance of mobility related activities of daily living
• Discuss how body type and wheeling skills can impact the decisions around COG set-up
• Explain the difference between Y and V taper on a rigid wheelchair

Course Instruction Details

• Course Audience: Suppliers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEUs

Minimum score on post-test for proficiency: 60% (3 out of 5 answers correct)

iNRRTSCE is certifying the educational contact hours of the program and by doing so is in no way endorsing any specific content, company, or product. The information presented in this program may represent only a sample of appropriate interventions. As an IACET Accredited Provider, The interNational Registry of Rehabilitation Technology Suppliers offers CEUs for its programs that qualify under the ANSI/IACET Standard. This course is approved for .1 CEU.

Course Description

Every manual wheelchair user would like their chair to be a high-performance machine. Performance is impacted by principles involved in translating human movement into movement of a wheelchair and factors that contribute to energy loss. In order to help end users achieve maximum performance, persons involved in the wheelchair selection process need to have a fundamental understanding of how people use their wheelchairs, and how those wheelchairs function.

This presentation will examine the real-world behaviors of manual wheelchair users and discuss the mechanical principles and factors that affect propulsion efficiency. In addition to explaining some details of the science involved, we hope to inspire participants to think critically about their current understandings and beliefs on this topic.

Course Objectives

Upon completion of this course participants will be able to:

• Cite 2 examples of how end users move about in wheelchairs during everyday life.
• Describe 3 physical principles that impact propulsion efficiency of a manual wheelchair. List 3 locations or components on a manual wheelchair where manufacturers have attempted to reduce the transmission of WBV to the user.
• Describe 3 component selections that impact propulsion efficiency of a manual wheelchair.

Course Instruction Details

• Course Audience: Suppliers, ATPs, Clinicians (OT, PT, COTA, PTA)
• Course Level: Intermediate
• Course Length: 1 Contact Hour
• CEU's Offered: .1 CEU