[dustin87]

Hey everyone, I am a t9 paraplegic. I am wondering if anyone knows the recommended backrest height for a t9 level paraplegic. My backrest is low and seems to dig into my back. Also what kind of cushion does anyone recommend?

[Jax]

Everyone is different. What kind of backrest are you using (adjustable upholstery, rigid back, etc.)? What height, width, and angle setting? Is the height adjustable? Is the angle adjustable? These are all things that affect your comfort. I have been through 3 chairs and several backrest configurations, and am just now finding what works for me. (I had some really retarded OTs, and one retarded supplier) I just don't believe there's a "standard" height recommendation. In rehab, some OTs will say certain injury levels need higher or lower backrests, but in reality, it's all dependent upon what the person using the backrest is comfortable with. If you are using a short rigid backrest for example, then angle adjustment could be a big issue. If you are using something like the Quickie adjustable upholstery, it SUCKS, and will probably never be comfortable if you can feel any part of your back. Also, the angle of the backrest posts can change how you can adjust upholstery, which in turn affects how the backrest fits to your back. The best thing you can do is experiment. Adjust the backrest one way, and if it feels better, go a bit more. If that doesn't feel so good, go back. It's really trial and error, emphasis on the error. As for the cushion, that is something that can be recommended by a good rehab center with a pressure mapping system. I have 2 different cushions; 1 tempur-med(Tempur-Pedic) and 1 Support Pro. Others on here have all kinds of other cushions, from J2 to Roho, and everything between.

This post has been edited by Jax: 12 March 2009 - 08:21 AM

[twisted_ophelia]

As Jax said, everyone is different. I just switched to using a lower back, a Corbac by Ride Designs (see photos in Quickie Ti thread) that is about 7 inches high or so. I don't recall the actual measurement. I use a Jay Active cushion. Was previously using a J2, used that for years with very little issue. I'm good with shifting around in my chair a lot though. Some people swear by Rohos, others love Jays (me) and others use something else entirely. Whatever works for you. Always demo the gear you buy for your chair for at least a week, don't just go out and buy something super important like a cushion without trying it. Always go for a cushion that is designed for people at high risk for skin breakdown.

Edited to add that I measured the Corbac and it's 8 inches from my cushion.

This post has been edited by twisted_ophelia: 12 March 2009 - 03:32 PM

[Bagpuss-wheels]

dustin87, on Mar 12 2009, 06:27 AM, said:

Hey everyone, I am a t9 paraplegic. I am wondering if anyone knows the recommended backrest height for a t9 level paraplegic. My backrest is low and seems to dig into my back. Also what kind of cushion does anyone recommend?

Hi,

You don't say where in the world you are? If you are in the UK, the local 'Wheelchair Service' is responsible for sorting suitable cushion/backrest for you.

You may want to look at some previous threads about cushions, including some info I posted about having pressure mapping done - it can even be done with backrests!

"Wheelchair seating cusions"
http://www.apparelyzed.com/forums/index.ph...ic=3039&hl=

"New Power Chair And Pressure Areas"
http://www.apparelyzed.com/forums/index.ph...c=10084&hl= (Thread containing my post(s) about pressure mapping).

With regard to backrest height, as has already been said, what suits one person won't suit another. My spinal damage is in the lumbar region but I also have scoliosis - for me, a curve to the left which is also in the lumbar region. I am, however, curving back to the right in my thoracic region and this is causing more problems. I am in constant pain (despite strong painkillers) and I also have other conditions which cause pain as well as fatgue.

I cannot manage without a backrest of 19-20 inches high (though I sit on a 4 inch high Roho Quadtro for its positioning properties to try to counteract the scoliosis/pelvic obliquity). Shorter backrests mean that I am in more pain and more physically tired so I can sit for less time.

It's a case of 'trial and error' with things like cushions and backrests. I've never tried any of the specialist backrests - I just use the 'tension adjustable upholstery'. (It's not perfect but my scoliosis curves mean that a lot of the specialist backrests are not suitable for me.) With the tension adjustable upholstery, I had to ensure that the 'D' rings for the straps were on my right-hand side or I ended up with pressure problems because of my scoliosis and fragile skin.

In the first of the threads above, I go through my own personal thoughts on the cushions I've tried. (see: http://www.apparelyzed.com/forums/index.ph...amp;#entry83629 firt post, my second post is on the second page.) These are just my own experiences. You may well find that something that doesn't suit me, would suit you.

Some people swear by Jay2 cushions. I hated it - it was too heavy, the gel kept squishing out of the back of the 'well' and I 'bottomed out'. I also couldn't 'kneed' the gel because of my hand/wrist problems.

On the other hand, I love my Roho Quadtro! I wouldn't sit on anything else. I'm even in the process of buying another one so that I have two. (I.e. the one from the NHS wheelchair services and one I would own myself). This way, I can have one to use in the car without having to manhandle the one out from under my backside. (I currently use the remains of the 'foam-gel' thing which is well past its use-by but is better than nothing. Even on short car journeys, my rear is not comfortable so I can't wait until next month when I collect my new Roho Quadtro!) The 'difficulty' with Roho cushions is that you need to know how much air is 'just right'. Too much air in the cushion and you are at risk of pressure sores, too little air and you are 'bottoming out' and at risk of pressure sores! However, if you get it 'right', you will be sat 'in' a very comfortable cushion which is one of the best for reducing the risk of pressure sores. This is assuming it suits you. I find that it is more stable sitting 'in' a Roho than perched on top of a foam cushion. Transferring off a Roho is less stable though and this is why some people don't like them. I find that the pay-off is well worth it though.

Try as many different things as you can and ask them to do a pressure mapping with each cushion - this will show you what you may not be able to feel - whether a particular cushion/backrest is causing increased pressure anywhere which could lead to pressure sores.

Hope this helps!

Best wishes,
Cat
>v,,^<

[Unbreakable]

Quote

I cannot manage without a backrest of 19-20 inches high (though I sit on a 4 inch high Roho Quadtro for its positioning properties to try to counteract the scoliosis/pelvic obliquity). Shorter backrests mean that I am in more pain and more physically tired so I can sit for less time.

This is an excellent point you've brought up. When I first got my chair, I saw so many other paras with sporty, short backrests. I too, thought I wanted one of these. My doctor firmly advised against it. He said that while they may save a little weight on the chair, they contribute to scoliosis and other back problems. Also, he brought up a good point when he asked me, "Before you got injured, would you have found it comfortable to sit for long periods in a chair with such a low back on it? Say an office chair or dining room chair? No. That is why these chairs have full backs on them and that is why I recommend a taller height backrest." That low backrest offers NO support for your back. And I can't speak for anyone else, but at my injury level, most of the musculature along the lower and middle spine isn't working in my case so there is nothing to stabilize my spine all day EXCEPT my back rest. Sure feels good to know I've got my backrest BACKING me up. Don't know what I'd do without it.

This post has been edited by Unbreakable: 15 March 2009 - 05:51 AM

[Jax]

Unbreakable, on Mar 14 2009, 03:38 PM, said:

Quote

I cannot manage without a backrest of 19-20 inches high (though I sit on a 4 inch high Roho Quadtro for its positioning properties to try to counteract the scoliosis/pelvic obliquity). Shorter backrests mean that I am in more pain and more physically tired so I can sit for less time.

This is an excellent point you've brought up. When I first got my chair, I saw so many other paras with sporty, short backrests. I too, thought I wanted one of these. My doctor firmly advised against it. He said that while they may save a little weight on the chair, they contribute to scoliosis and other back problems. Also, he brought up a good point when he asked me, "Before you got injured, would you have found it comfortable to sit for long periods in a chair with such a low back on it? Say an office chair or dining room chair? No. That is why these chairs have full backs on them and that is why I recommend a taller height backrest." That low backrest offers NO support for your back. And I can't speak for anyone else, but at my injury level, most of the musculature along the lower and middle spine isn't working in my case so there is nothing to stabilize my spine all day EXCEPT my back rest. Sure feels good to know I've got my backrest BACKING me up. Don't know what I'd do without it.

Good point. I have the J3 back in 8", but set up so the top is about 11". My situation is somewhat unique, as I don't know many who have spinal reinforcement from T10 all the way through the pelvis. With all this hardware, I don't really need as much support from the backrest. It's more for keeping my butt from sliding out the back of the chair. The first chair I had did have a higher backrest, but a couple months after my second spine surgery, I shortened it a good bit. I found that it worked better that way because it was supportive in the lumbar area for pushing, but it didn't put pressure on the upper parts of the hardware.

Another point is the amount of time per day you actually spend in the wheelchair. I don't mean how long you are up. I mean do you transfer to couch or recliner in the living room, or office chair at the computer? I sit on the couch a lot in the living room. My wheelchair is my legs now, and I wouldn't have been on my feet 24/7 prior to my accident, so I do things as closely as possible to how I did before. Plus, the couch my wife had when we married is WAY comfy. If you don't sit on couches/recliners, but stay in the wheelchair mostly, then the higher back would probably be beneficial and more comfortable on your back.

[Unbreakable]

Jax, on Mar 17 2009, 04:24 AM, said:

Unbreakable, on Mar 14 2009, 03:38 PM, said:

Quote

I cannot manage without a backrest of 19-20 inches high (though I sit on a 4 inch high Roho Quadtro for its positioning properties to try to counteract the scoliosis/pelvic obliquity). Shorter backrests mean that I am in more pain and more physically tired so I can sit for less time.

This is an excellent point you've brought up. When I first got my chair, I saw so many other paras with sporty, short backrests. I too, thought I wanted one of these. My doctor firmly advised against it. He said that while they may save a little weight on the chair, they contribute to scoliosis and other back problems. Also, he brought up a good point when he asked me, "Before you got injured, would you have found it comfortable to sit for long periods in a chair with such a low back on it? Say an office chair or dining room chair? No. That is why these chairs have full backs on them and that is why I recommend a taller height backrest." That low backrest offers NO support for your back. And I can't speak for anyone else, but at my injury level, most of the musculature along the lower and middle spine isn't working in my case so there is nothing to stabilize my spine all day EXCEPT my back rest. Sure feels good to know I've got my backrest BACKING me up. Don't know what I'd do without it.

Good point. I have the J3 back in 8", but set up so the top is about 11". My situation is somewhat unique, as I don't know many who have spinal reinforcement from T10 all the way through the pelvis. With all this hardware, I don't really need as much support from the backrest. It's more for keeping my butt from sliding out the back of the chair. The first chair I had did have a higher backrest, but a couple months after my second spine surgery, I shortened it a good bit. I found that it worked better that way because it was supportive in the lumbar area for pushing, but it didn't put pressure on the upper parts of the hardware.

Another point is the amount of time per day you actually spend in the wheelchair. I don't mean how long you are up. I mean do you transfer to couch or recliner in the living room, or office chair at the computer? I sit on the couch a lot in the living room. My wheelchair is my legs now, and I wouldn't have been on my feet 24/7 prior to my accident, so I do things as closely as possible to how I did before. Plus, the couch my wife had when we married is WAY comfy. If you don't sit on couches/recliners, but stay in the wheelchair mostly, then the higher back would probably be beneficial and more comfortable on your back.

Well, I pretty much stay in my chair because I tried transferring to the couch and all that but found it was too much trouble to get back in and get situated if I wanted to go get a drink from the fridge, etc. Not only that, I just felt....like a big-ass couch potato! haha! Besides, I have to stay mobile, agile, and hostile at all times to be ready to intercept my son from his latest hijinx!

[Jax]

Unbreakable, on Mar 17 2009, 10:16 AM, said:

Besides, I have to stay mobile, agile, and hostile at all times to be ready to intercept my son from his latest hijinx!

I can only imagine! We don't have kids, but we watched my little cousin for a few days. That was insane! The kid steals and hides EVERYTHING!! LOL!

[Unbreakable]

Jax, on Mar 17 2009, 10:43 AM, said:

Unbreakable, on Mar 17 2009, 10:16 AM, said:

Besides, I have to stay mobile, agile, and hostile at all times to be ready to intercept my son from his latest hijinx!

I can only imagine! We don't have kids, but we watched my little cousin for a few days. That was insane! The kid steals and hides EVERYTHING!! LOL!

That, and you have to keep them from killing themselves it seems like every 30 seconds. Choking on food, climbing up on back of couch and getting ready to swan dive onto the wood floor, trying to stick things in electrical sockets, investigating all the poison cleaners under the sink, etc.

It's a full time job.
But then he climbs up in my lap and says, "I luv voo" and that makes up for it.