I have come to the realisation that in clinical practice related to 24 hour postural care we are not asking WHY frequently enough.
For example:
The individual we are working with presents in their chair with a pelvic obliquity, pelvic rotation and legs sweeping to one side.
Their life box presents as a parallelogram, with one iliac crest and ASIS tucked up inside their ribs.
There is also a palpable posterior lateral rib shape deformation.
The individual is reported as having repeated chest infections, recurring GI challenges and occasional redness on one buttock, lateral trochanter. and posterior lateral occiput.
Alongside this, it is impossible for this person to keep their head in contact with their head support which is critical for their function. A travel pillow is often used to try help the situation.
Their feet are also reported to fall back behind the foot supports one side more than the other.
Quite a common tendency among the professionals who have the responsibility for identifying and prescribing appropriate Assistive Technology Solutions is to note the individuals presentation in their chair and from there begin to problem solve with technology thoughts.
In this Clinical presentation example, technology thought of may include pelvic obliquity buildups: 4 point pelvic positioning straps: perhaps a larger medial thigh support (aka ‘pommel’ and ‘abductor): a more adjustable head support, a custom contoured back support and a customised pressure reducing cushion.
But - Imagine if we were to identify and document the WHY behind this postural presentation?
Would there be a different outcome? Different solutions? Different interventions?
How would you go about doing this? And how do you communicate this to the team?
Share your thoughts below!