Custom Sooner = More Meaningful and Lasting Outcomes Thomas R. Hetzel, PT, ATP Ride Designs Introduction. Why, in the absence of a progressive neuromuscular or other disease, is the chronic deterioration of postural alignment and function so often regarded, even excused, as a normal result of long term sitting As medical and pharmacological care has evolved over the past decades, newborns are surviving events that a decade or two ago may have been deemed hopeless and fatal. Likewise, people are surviving and living long lives following traumatic events. The key word above is "events", not disease. Cerebral Palsy, Spina Bifida, Stroke, Spinal Cord Injury, Brain Injury, to name a few, are not diseases, but disabling events. The event itself does not result in a progressive condition, but the disability associated with the event can present with varying degrees of progression depending on numerous intrinsic and extrinsic factors. Seating is the art and science of managing the extrinsic factors in an effort to influence the intrinsic towards improved health and mobility. We are the first generation of wheelchair seating professionals to witness the effects of these events on and associated with aging. Clearly there are differences between aging with and without a disability. For the person aging with a disability the changes can be slow and insidious. Charlifue et al., recognized multiple system degeneration over time in the Spinal Cord Injured population, and stated that true decline is more likely to be detected when the aging process begins to interfere with function. What can be done earlier to delay or even prevent this decline so it does not reach the threshold level of functional impairment Are we too tolerant of or even missing early signs of age related changes that may respond to certain interventions if applied in a timely manner Aging With a Disability. Certain outcomes related to historical wheelchair prescription are becoming increasingly well documented. Additionally, current literature provides an increasingly comprehensive picture of aging with a disability. Though much of the published work does not directly implicate or measure seating and mobility prescriptions' effect on the aging process, the list of issues at the forefront of discovery parallels limitations and concerns often expressed in seating and mobility assessments. The trauma associated with long-term use of the upper extremities for manual wheelchair mobility is a prime exampl...
"Custom Sooner More Meaningful and Lasting Outcomes" by Tom Hetzel, PT, ATP web documents custom sooner paper