Jan 202016
 

Case 525 – this lady with advanced MS  has very limited use of her hands . She is wheel chair bound and  lives alone . The remote controls for her TV, Digi box & DVD player  have a habit of dropping off  the small tray on her wheelchair when she has great difficulty in retrieving them from the ground. Mild steel washers were attached to both sides of all her remotes with superglue. Then a magnetic “wand” was constructed in wood with a pair of powerful magnets (salvaged from a damaged computer hard drive) attached to the  business end with a short length of flexible electrical cable – to give it flexibility.  She can now retrieve any of them easily from the ground in a single action.

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magnetic tipped pick up tool

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pick up tool in action

   The existing tray fitted to her electric wheelchair was too small and had no sides resulting objects especially her remotes falling to the floor(causing much angst) The next step was to re-site her existing perspex tray so that no longer protruded beyond her chair (which caused problems with moving around her bungalow) and to cover this a larger plywood tray with sides on. This should greatly facilitate the remaining use of her hands (by supporting her arms) and be able to hold more and drop less.

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Case 525 – a man with MND is a keen player of electronic games. He has very limited use of his hands due to profound upper limb weakness but has useful strength in his lower limbs. It was planned to optimise his residual use of his hands and provide future IT control with his feet.  A pedestal tray was constructed which rested on the arms of his riser chair and extended as far back as possible. This could also be swiveled round to allow him to leave the chair (without assistance) . His existing POSSUIM controls , positioned by his Left elbow were not disturbed.  By providing full support of both lower arms he could exert finer control with his hands resulting in improved usage of his hand mouse.

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pedestal table in position

table rotated out to allow access

table rotated out to allow access

 

The next step involved building a “foot operated” mouse . Instructions were downloaded from the internet . A surplus conventional mouse was mounted inverted on to a base plate of 9mm ply and two lever operated switches mounted alongside (to operate the Left & Right click operations). Wires were carefully soldered on to the circuit board (by a local computer shop) in place of the original click switches and joined to the new switches. It worked first time!

foot mouse sans feet

foot mouse sans feet

feet on- using the cursor control with right foot & Left switch with Left foot.

feet on- using the cursor control with right foot & Left switch with Left foot.

With a large wall mounted TV screen he was able to exert the necessary  degree of control of the cursor  from the outset with his Right foot and  no doubt will acquire a finer degree of control with further usage. Operating both Left & Right click switches was immediately successful with his Left foot . He now has both hand & foot operated mouse controls on his IT system and is well prepared for future clinical developments.#

Case 529 – a 6ft 6″ man requires a tripod walking aid following a CVE . This not extend high enough for a comfortable /stable posture.  This was dismantled and an extra 6″ length was added by means of nylon infill which enabled to him to stand upright for the first time since his CVE!

extended tripod walking aid

extended tripod walking aid

client using walking aid

client using walking aid

Case 530- a teenager in a wheelchair requires a portable changing table when attending a monthly “camp” in preparation for future independent living . The table had to be light weight & easy/quick to be assembled with adjustable legs for height . This was constructed in 25 x 50 x 3mm  aluminium box with tubular section for the legs -which telescoped with thinner section inside thicker outer section. These could be adjusted for height (to suit the working height of different carers) by means of  clips  fitting holes at 2″  intervals. The changing table was topped by a mat- 3″ high density foam on a plywood base covered with a waterproof material. The legs slotted into the table section so that the whole equipment could be flat packed & easily lifted for storing when not required.

bare frame

bare frame

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Case 535 – an elderly lady with  arthritis in her hands was finding the brakes on her 3 wheeled walker very stiff to apply. She lives on a slope & is worried that the walker might run away with her. On inspection the brake lever arm (activated by cable from the brake grip on the handlebars) was very stiff and could be slackened off to good effect. The return springs could now be replaced by softer ones. Finally small 1″ x 1″ brake pads were made in wood with a curved under surface covered  with coarse emery cloth (attached by glue) The pads were  angled to maximise the area in contact with tyre . The original design was a flat metal bar which only had contact with the centre of the tyre  due to its radiused shape . The new design increased the area of friction between the brake (pad) over a wider area on the tyre surface.

The upgraded braking system was now much easier to apply & also more effective for less effort.

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note the less powerful return spring

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note the length of the new brake pad

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note the curved brake pad fits the shape of the tyre

 

case 550 – four clients in wheelchairs  2 in  semi recumbent & 2 in upright types with severe cerebral palsy needed detachable tables fitted to accommodate iPads. The tables were mounted on a metal arm, which swivels  so the table could easily be swung round out of the way (for transfers) but could be swung back & locked into position when required.

table in use with iPad

table in position for use with iPad

 

table in use with iPad

table swung out for access to transfer

Case 565 – an elderly,frail gentleman uses a commode in his bathroom and the bedpan needs to be lowered so that he does “catch himself” when the bedpan is withdrawn  from under him after use. The height must still high enough for the commode to fit over the existing toilet seat .

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note the high level of the plastic bedpan

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the bedpan has now been lowered.

 

 

 

Case 558 -a stroke client requires his 4WW walker to be fitted with  with unilateral brakes on his good Right side, whilst retaining parking facility (so he can turn round safely & sit down to rest when needed)  and gutter arm support  for his weak left side. Reverse – pull off  brakes needed to be fitted to achieve the parking facility.

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Case 568: a lady with long standing rheumatoid arthritis uses a mobility lift device in order to stand & transfer from her rising chair to wheelchair & also to transfer in/out of her car .  Her knees tend to buckle sideways due to lateral instability of her knee joints -resulting in two falls. Foam padded cushions were fitted to  the sides of her Mo-Lift central cushion in order to prevent this lateral movement.

Mo-lift device as original

Mo-lift device as original

Mo-Lift device with lateral support cushions fitted

Mo-Lift device with lateral support cushions fitted

Case 561 – a 60 year old with ataxia ( severe imbalance affecting his mobility)  following a CVE. He could only manage a few staggering steps on a frame with active support from two helpers. An Atlas frame was chosen as the most suitable to be adapted for his needs.

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basic Atlas walking frame- note: castors

Steps (1) -first the castors which allowed the client to swivel uncontrollably in all directions were replaced by conventional wheels from a standard walker -fixed in the rear  (with brakes) and swivelling in the front . The brakes were modified to be “pull off” type operated unilaterally from the right side only (for convenience)

DSCN0170Step 2 (a) protective shin pads were fitted over inside attachments of the rear wheels

(b) midline parallel bars fitted low down to prevent his feet from crossing the midline when walking. Padding was later added to minimise chafing when taking steps.

(c)  the main body support was extended rearwards by 9″ so as to enclose his body more within the frame and prevent him slipping out . This was constructed in sheet aluminium  with foam padding and covered with leatherette.

(d) lateral gutters were fitted to prevent his elbows from slipping out of the frame and improve control though his arms.Gutters constructed as per (b)

finishing touches

Step 3- practice, practice practice makes perfect

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This gentleman can now mange to walk reasonable distances under supervision (without physical support) . A credit to his determination and the skill of his physios!

 

Case 572 – this young woman was very short and could not reach the pedals for a foot cycle whilst in a Levochair .

Two adaptions were required (a) 4″  built up step attached to the foot rest of the Levochair  so that she was comfortable and her feet were supported

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(b) the foot cycle needed to be raised by 7″ off the ground  so that she could reach the pedals

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case 573 – a 62 year old man has severe curvature of his spine and has to sleep in a riser-recliner chair at night. However he  tends to lean over on his Right side and is danger of falling out over the Right arm rest.  His chair was fitted with a side panel on the Right side . This was constructed from 12mm plywood  and attached by 2 right angle steel brackets to  underneath the chair . 3″ thick dense foam -tapering down towards the arm rest was glued to the plywood by means of spray contact adhesive and covered with brown leatherette . This provides a soft  pillow for his head to rest on and should prevent further falls out of his chair at night.

side panel viewed from outside

side panel viewed from outside

 

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riser/recliner chair in normal upright position

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riser/recliner chair -in sleeping mode

 

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