january 2016 • vol. 15 no. 1 serving the seating & wheeled...

January 2016 bull Vol 15 No 1

mobilitymgmtcom

Serving the Seating amp Wheeled Mobility Professional

0116mm_Cover1indd 1 12915 315 PM

adiridescom | stealthproductscomMark Zupan

S O L I D B A C K U PW H E N E V E RW H E R E V E R

ERGONOMICALLY DESIGNED for you and your lifestyle our seating system eases the strain on your lower back and is ideal for long days of great activityon the court and off

ADI Ad Finalindd 1 12815 905 AM

ldquoI am absolutely loving iLevel It is difficult to imagine how I lived

without this technology for so many years It has been life affirming Now

comments about my wheelchair have immediately turned from lsquoWhat

happenedrsquo to lsquoWhat a cool chairrsquo The progression of my SMA doesnrsquot feel

as inhibitory now as it did two weeks ago Although my chair is brand new

I feel like it is completely a part of my liferdquo

wwwilevelrehab bull (US) 866-800-2002 bull (CAN) 888-570-1113

quantumrehab quantum_rehab

4 mobilitymgmtcomjanuary 2016 | mobilitymanagement

january

Mobility Management (ISSN 1558-6731) is published monthly by 1105 Media Inc 9201 Oakdale Avenue Ste 101 Chatsworth CA 91311 Periodicals postage paid at Chatsworth CA 91311-9998 and at additional mailing offices Complimentary subscriptions are sent to qualifying subscribers Annual subscription rates payable in US funds for non-qualified subscribers are US $11900 International $18900 Subscription inquiries back issue requests and address changes Mail to Mobility Management PO Box 2166 Skokie IL 60076-7866 email MOBmag1105servicecom or call (847) 763-9688 POSTMASTER Send address changes to Mobility Management PO Box 2166 Skokie IL 60076-7866 Canada Publications Mail Agreement No 40612608 Return Undeliverable Canadian Addresses to Circulation Dept or XPO Returns PO Box 201 Richmond Hill ON L4B 4R5 Canada

copy Copyright 2016 by 1105 Media Inc All rights reserved Printed in the USA Reproductions in

whole or part prohibited except by written permission Mail requests to ldquoPermissions Editorrdquo co Mobility Management 14901 Quorum Dr Ste 425 Dallas TX 75254

The information in this magazine has not undergone any formal testing by 1105 Media Inc and is distributed without any warranty expressed or implied Implementation or use of any information contained herein is the readerrsquos sole responsibility While the information has been reviewed for accuracy there is no guarantee that the same or similar results may be achieved in all environments Technical inaccuracies may result from printing errors andor new developments in the industry

Corporate Headquarters 1105 Media9201 Oakdale Ave Ste 101 Chatsworth CA 91311www1105mediacom

Media Kits Direct your Media Kit requests to Lynda Brown 972-687-6781 (phone) 972-687-6769 (fax) lbrown1105mediacom

Reprints For single article reprints (in minimum quantities of 250-500) e-prints plaques and posters contactPARS InternationalPhone 212-221-9595E-mail 1105reprintsparsintlcomwwwmagreprintscomQuickQuoteasp

This publicationrsquos subscriber list as well as other lists from 1105 Media Inc is available for rental For more information please contact our list manager Jane Long Merit Direct Phone 913-685-1301 e-mail jlongmeritdirectcom Web wwwmeritdirectcom1105

On the CoverSo much about transverse myelitis remains unknown but new technology and education offer hope Cover by Dudley Wakamatsu

18 Transverse Myelitis A Unique Journey

While transverse myelitis can present with symptoms

similar to those of spinal cord injury and multiple

sclerosis its path and its prognosis are different

28 How We Roll Getting the Right Fit

An ultralightweight manual wheelchair case study thatrsquos

all about attention to details

volume 15 bull number 1

6 Editorrsquos Note

8 People amp Places

13 MMBeat

27 Marketplace Backrests

30 Ad Index


mobilitymgmtcom


contents

splin

e_x

istoc

kcom

Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen

splin

e_x

istoc

kcom

0116mm_Contents4indd 4 121015 1042 AM


Over the holidays my Aunty Sue visiting from Honolulu loaned me her library book called Adventures in Darkness by Tom Sullivan an American singer actor and

writer When he was born prematurely in 1947 Sullivan was given oxygen which saved his life but destroyed his eyesight Sullivanrsquos autobiography subtitled ldquoMemoirs of an Eleven-Year-Old Blind Boyrdquo describes a pivotal summer during which he was suspended from the Perkins School for the Blind after escaping campus in a most memorable way (Perkins is a few miles from Boston and the escape involved a rowboat and ahem the Coast Guard)

A boarding student at Perkins since age 5 Sullivan sought freedom not because Perkins was a terrible place but because of

the otherness of a school exclusively for children who were blind Banished for the summer Sullivan found himself separated again mdash this time by a protective fence around the family home and yard From the perspective of an active intelligent lonely child the fence didnrsquot keep the worldrsquos dangers out as much as it kept him in He spent the summer trying with the help of his colorful father to literally get outside the fence while also tearing down symbolic fences his mother and well-meaning others thought were for his own good

I wonrsquot give away the ending but Sullivan later speaks about the Americans with Disabilities Act (ADA) and how hersquod thought it would tear down those symbolic fences He concluded that while the ADA helped in some ways such as improving accessibility a lot of mental fences remain among well-intentioned folks who believe people with disabilities need to be protected and separated

A day after finishing Adventures in Darkness I watched a short CNN film called All-American Family Twenty-year-old Kaleb is the only member of the Pedersen family who can hear His parents and siblings were born deaf and are well-loved members of the large Deaf community in their hometown of Pleasanton Calif Kaleb acknowledges that he wishes hersquod been born deaf too ldquoI feel like the odd one outrdquo he said He feels he can never fully be part of the Deaf community and culture His younger brother Zane once tried a hearing aid and loved being able to hear But he eventually gave it up saying he realized ldquoit wasnrsquot the most popular ideardquo in the Deaf community

The Pedersens do not consider deafness a disability and they donrsquot think there is anything ldquowrongrdquo with them Mother Jamie says she felt she had given Zane ldquothe greatest giftrdquo upon realizing he was deaf

Having just read Tom Sullivanrsquos book it was interesting to learn that at least some in the Deaf community are fine with some separation mdash at least enough to enable them to form nurture and love their own Deaf culture The two perspectives Tom Sullivanrsquos and the Pedersen familyrsquos seemed at such odds

Then I realized Isnrsquot this just called ldquobeing humanrdquo We make our own choices mdash to marry or not to have children or not to follow a faith or not to follow in our familyrsquos foot-steps or to forge our own paths or to adopt something in between

Why should our perceptions on disability be any less unique Why should we all have to think the same way or want the same thing And especially why should all people with disabilities want the same thing when theyrsquore all unique individuals

Thus begins another year of appreciating not just the individual nature of complex rehab technology but also the right of individual clients to be well individual However you personally choose to celebrate it with resolutions for improvement or by resolutely avoiding those traditions have a happy new year l

Laurie Watanabe Editorlwatanabe1105mediacom

CRTeditor

Editor Laurie Watanabe (949) 265-1573

Group Publisher Karen Cavallo (760) 610-0800

Group Art Director Dudley Wakamatsu

Director David Seymour Print amp Online Production

Production Coordinator Charles Johnson

Director of Online Marlin Mowatt Product Development

mobilitymgmtcom

Volume 15 No 1

January 2016

editorrsquos note

To Each Our Own

REACHING THE STAFF

Staff may be reached via e-mail telephone fax or mail A list of editors and contact information is also available online at mobilitymgmtcom

E-mail To e-mail any member of the staff please use the following form FirstinitialLastname1105mediacom

Dallas Office (weekdays 8 am - 5 pm CT) Telephone 972-687-6700 Fax 866-779-9095 14901 Quorum Drive Suite 425 Dallas TX 75254

Corporate Office (weekdays 830 am-530 pm PT) Telephone 818-814-5200 Fax 818-734-1522 9201 Oakdale Avenue Suite 101 Chatsworth CA 91311

Chief Executive Officer Rajeev Kapur

Chief Operating Officer Henry Allain

Vice President amp Michael Rafter Chief Financial Officer

Executive Vice President Michael J Valenti

Chief Technology Officer Erik A Lindgren

Vice President David F Myers Event Operations

Chairman of the Board Jeffrey S Klein

SECURITY SAFETY amp HEALTH GROUP

President amp Group Publisher Kevin OrsquoGrady

Group Publisher Karen Cavallo

Group Circulation Director Margaret Perry

Group Marketing Director Susan May

Group Social Media Editor Matt Holden

Photo

cour

tesy T

om Su

llivan

Tom Sullivan

0116mm_EditNote6indd 6 121015 119 PM

Put your clientsrsquo safety fi rst Find a QAP-accredited mobility dealer near you

Safety Confi dence DedicationThatrsquos what a QAP-accredited mobility dealer can do for you

The National Mobility Equipment Dealers Associationrsquos Quality

Assurance Programtrade ensures quality reliability and service when

modifying vehicles to be fully accessible for all This commitment

to driving independence is upheld by our members through

bull Individual in-person evaluations and custom

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bull Specialized training in adaptive technology

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bull 24-hour emergency roadside services nationwide

Call (866) 948-8341or visit NMEDAcom

15_NMEDA_0593_MobilityMgmtQAP_FullPgAd_R1V1indd 1 111115 1025 AM


Paul Bergantino amp Tim Burfield Launch Lifeway MobilityTwo complex rehab technology (CRT) veterans Timothy Burfield and Paul Bergantino recently announced their new venture the launch of Lifeway Mobility a southern New England providership of home accessibility products including ramps stairlifts vertical platform lifts patient lifts and bath safety items

Most recently the CEO of national complex rehab tech-nology (CRT) provider Numotion Bergantino sees an opportunity to import some CRT ideas into the world of accessibility while also respecting the fact that accessi-bility is a technology and business segment unto itself

A Completely Different Business ModelBergantino is Lifeway Mobilityrsquos president while Burfield is the new companyrsquos chairman Burfield and Bergantino are long-time business partners who launched Connecticut Rehab 25 years ago Eventually that company became ATG Rehab which merged with United Seating amp Mobility in 2013 to form Numotion

Their new company can perhaps be seen as taking over where seating amp wheeled mobility leaves off After optimal positioning has been achieved and once a wheelchair is providing dependent or indepen-dent motion how can an environment help to maximize the consum-errsquos and the caregiverrsquos safety and efficiency

Thatrsquos one of the important questions Bergantino hopes to answer via Lifeway Mobility

And while CRT and accessibility products have long been mentioned together mdash with accessibility products largely being consid-ered potential ldquoadd-onrdquo revenue for rehab providers mdash Bergantino suggested in an interview with Mobility Management that the two tech-nology segments are different in critical ways

ldquoItrsquos a different delivery system where you have installersrdquo he said of working with stairlifts and ramps for example ldquoReimbursement is very different So the whole transaction flow is different The delivery at the install and even in some cases the sale process is so different that it requires different skills setsrdquo

But Bergantino will still be applying some of his best CRT experi-ences to help set Lifeway Mobility apart

Identifying a Growing NeedAs long-time rehab providers Bergantino said he and Burfield have studied various funding models for years including a program called Money that Follows the Person (MFP)

ldquoThe basics of MFP are really helping people to stay home and espe-cially when theyrsquove been recently discharged [from a hospital setting] to help keep them homerdquo Bergantino said ldquoSo either help them stay

home or keep them home after discharge Therersquos some funding to support that and that funding is in lieu of institutions or skilled nursing facilities which would obvi-ously be more expensive

ldquoWe thought that because of our background in rehab and healthcare over the years that we would be able to apply [those experiences] because they are very similarrdquo Bergantino said ldquoVery similar referral sources some similar payors and funding in the mix and a similar customer base Because we understand that from our

previous industry focus wersquoll be able to apply it here as well as the aspects of applying technology systems and building teams Wersquoll be able to bring that and apply that to this industry and help fulfill that needrdquo

Lifeway Mobilityrsquos clientele Bergantino noted will include ldquoanyone that has limited mobility regardless of the particular need age or stage It could be the child who has cerebral palsy thatrsquos in a wheelchair and needs a lift or a ramp to the individual aging in place or looking to age in placerdquo

As part of his ldquodue diligence and workrdquo Bergantino added that he earned a Certified Environmental Access Consultant (CEAC) creden-tial from VGM Grouprsquos Accessible Home Improvement of America and a Certified Aging-in-Place Specialist (CAPS) credential from National Association of Home Builders which developed its program in conjunction with AARP and the American Occupational Therapy Association

He explained that the credentials ldquowere very helpful to be able to go in and assess a living environment a home as an example to iden-tify the needs Sometimes the needs are simple and there can be a low-tech solution such as removing the throw rug off of the polished hard-wood floor or simple bed risers to elevate the bed and to make transfers easier Or there can be much higher-tech needs

ldquoOur primary focus when I say accessibility products is ramps stairlifts wheelchair lifts bath safety solutions So when yoursquore thinking of the key areas of need when yoursquore thinking residential itrsquos how to get in the home how to get up to a different level or down to a different level or how to get into the bathroom into the bathtub into the shower Those are the different areas that we would focus on and it could be low tech or higher tech and thatrsquos where both of those certi-fication processes really help The application of bringing low-tech and high-tech solutions in to address those potential needsrdquo

CRT Best PracticesLifeway Mobility is very different than the rehab businesses Bergantino has launched in the past but he intends to carry over some best prac-

Paul Bergantino

0116mm_PeoplePlaces812indd 8 121015 1159 AM

Now Yoursquore Going Places

TM

COMING SOON

Hi-Low Base for TrekkerTM

convaidtrekker


I remember working Medtrades when my only reliable meal of the day was breakfast

There was no possibility of leaving the show floor at lunch to stand in mile-long lines for a convention center burger There might be a very late dinner after the expo hall closed after they turned off the lights and secu-rity shooed away those talking in darkened aisles But more likely it was a couple of hors drsquooeuvres grabbed at evening receptions and going to bed a little hungry because a few hours of sleep were worth more than a late-night sandwich

Thatrsquos why the prized ticket was an invitation to VGMrsquos Medtrade pancake breakfast

It was not really a pancake breakfast of course and certainly not one intended for famished reporters The event was for VGM members and its focus was an industry update on legislation and funding

But before the update there were pancakes Buttermilk banana blueberry chocolate chip light and hot off a smoking griddle flipped before your eyes like a dream come true Eggs bacon butter maple syrup No matter how dire the industry updates were those pancakes made everything go down a little easier

After one blissful breakfast I went to the VGM booth to thank VP of Communications Carolyn Cole She was happy I had attended and added ldquoVan is very serious about his pancakesrdquo

Van was VGM founderCEO Van G Miller an industry giant who

tices learned from the rehab segmentldquoWersquore applying in a sense the rehab lsquoteam evalrsquo concept to this

industryrdquo he said ldquoWersquore not just walking in and looking at the stairs Wersquore looking at the holistic accessibility needs

ldquoThis team may be different Wersquore not going to be in a clinic setting we may not be in a facility But the team may consist of a caregiver a clinician a home care nurse So the team may look a little different than a wheelchair evaluation in a clinic but the concept is exactly the samerdquo

Bergantino emphasized that while some accessibility businesses circumvent the detailed evaluation of the consumer and the environ-

ment in favor of just selling products quickly his teams will carry out assessments that include identifying a customerrsquos future needs partic-ularly if a diagnosis is progressive Lifeway Mobility consultants will be well versed in the types of conditions typically seen by ATPs and will approach potential solutions as members of a larger accessibility team

But Bergantino said Lifeway Mobility consultants will focus on accessibility rather than get involved in suggesting or providing CRT

ldquoI think our team should walk in every morning and be the best at this one product linerdquo he said ldquoAnd wersquoll service our customer better that way rather than trying to be all to everyonerdquo l

mdash Laurie Watanabe

I learned that day was fanatical about good pancakes He insisted that the chefs cooking for his members be experts Carolyn encour-aged me to talk to Mr Miller directly though Irsquom generally not a talk-to-the-CEO kind of girl

But buoyed by maple syrup I ventured up to Mr Miller He faced me with a wide grin as I thanked him ldquoIrsquom glad you liked the pancakesrdquo he said ldquoGlad you could comerdquo

That was the only time I talked to Van Miller Still I thought I knew him by how

employees talked about him how much he cared about little details like pancakes and how he generous he was even to those who werenrsquot members of VGM

Just a week earlier Carolyn sent a letter to say shersquod be retiring at the end of October I called her to hear her voice and to once more rhapso-dize about those pancakes We laughed

Now inexplicably Irsquom writing about Van Millerrsquos passing on Sunday Oct 18 and his awards and how much he cared for his employees and his community

But Irsquom really thinking about pancakes and how a small gesture can feel like so much more to its recipient

Thank you Mr Miller for those pancakes and the heart behind them Your industry will miss you l

mdash L WatanabeThis story originally ran in the Oct 21 2015 edition of eMobility

Dear Mr Miller Thank You for the Pancakes

Van Miller 1948-2015

Van G Miller

Lifeway Mobility Continued


mobilitymgmtcom 11 mobilitymanagement | january 2016

Permobil Marketing VP Josh Anderson My Job Is to Be a Sounding BoardThe last two years have been a whirlwind for Permobil the complex rehab power wheelchair manufacturer based in Lebanon Tenn

In May 2014 Permobil acquired TiLite the custom ultralightweight wheelchair manufacturer in Pasco Wash

Less than a year later in March 2015 Permobil announced the acquisition of ROHO Inc a seating manufacturer based in Belleville Ill near St Louis

The swirl of activity made the industry wonder What would happen to the renowned TiLite and ROHO brands Would the companies lose their identities and be swallowed up by Permobil

Whether coincidentally or related to this sudden explosive growth some shaking out seemed to occur in the months after the ROHO acquisition Permobil saw personnel changes in divi-sions including sales and marketing

Then in November Permobil President Larry Jackson announced that Josh Anderson a VP with TiLite had been promoted to VP of marketing for Permobil The move was additionally significant because it meant an employee of one of the acquired companies had been added to Permobilrsquos senior management team

An Industry VeteranAnderson of course is not new to the industry Hersquos made his career in complex rehab first by working for a provider then moving into the marketing department for wheel manufacturer Spinergy Anderson then moved to TiLite to direct marketing and most recently product and brand development efforts

Despite that reacutesumeacute Anderson told Mobility Management that he sees his new role as a facilitator and wants to support his colleaguesrsquo efforts rather than to just come in and make changes as he sees fit

ldquoROHO being the newest member of the family is operating on their own in terms of their marketingrdquo Anderson said ldquoBut what we really hope to accomplish with this integration is to utilize the talent that we have across the three different organizations Wersquove got people in Nashville who are really good with print and we have people in St Louis who are great with the different social media Being able to utilize those talents across all three organizations is really huge It gives us a sounding board What do you think about this and vice versa Sharing a lot of those resources is the area I think that we stand to gain the most in the short termrdquo

As far as what ATPs and clinicians will see Anderson explained ldquoI think that theyrsquoll see because wersquore all part of the same family a more integrated high-end look across all of our ads even though wersquore func-tioning as different units Wersquoll have a breadth of talent that in every

way will improve the look of the ads whether itrsquos from photography to text to placement My focus is on TiLite and Permobil We are hiring within both departments so we have the right people to do the things we want to do We have a really aggressive schedule for what we want to commit to in terms of developing campaigns around our existing products online and Web site development pretty much every facet of marketing We want to improve and change the look give everything a fresh new look and I think thatrsquos a bold statement to do that in many different arenas in a pretty short time period We would like to do that in 2016rdquo

From a Consumerrsquos PerspectiveIn addition to his marketing expertise Anderson brings the consumer perspective to his new position A wheelchair user since his teens Anderson has developed high expectations for the seating amp wheeled mobility equipment he uses every day and for the equipment he wants Permobil TiLite and ROHO to offer his peers

ldquoI think wheelchair users are just like any consumersrdquo Anderson said ldquoTheyrsquore looking at the aesthetics of the chair saying lsquoCan I see myself using that product Does that make me feel more enabled or do I feel disabledrsquo If Irsquom sitting a hospital chair and I look in the mirror I feel pretty disabled If Irsquom sitting in a TiLite or in a Permobil I feel more enabled because theyrsquore sleek theyrsquore modern they have this design element that makes them less medical And I think thatrsquos really coolrdquo

When Anderson discusses wheelchairs and their components he sounds like the educated consumer he is mdash and hersquos convinced that other chair users assess their mobility choices the same way

ldquoWhen you talk about what does a consumer see and look for they look for a comfort levelrdquo he noted ldquoI donrsquot mean just a physical comfort level but reassurance When yoursquore talking about seating amp posi-tioning with a backrest you have a lot of real estate and yoursquore looking for something clean and elegant that integrates into your chair At the same time and equally as important for all of these products is a func-tional level Looking at that product does it meet my functional needs Is it going to have the performance that Irsquom looking for Is that going to make my quality of life better than any other product on the market If yoursquore talking about a power chair that has a standing function and that you can weight shift and weight bear all at the same time and itrsquos in this sleek package that nobody even notices mdash thatrsquos hugerdquo

What the Industry Will SeePermobil and TiLite shared booths at such events as the International Seating Symposium in 2015 expect all three manufacturers to share

Josh Anderson



exhibit space going forward Anderson saidMore significantly expect the three to share intellectual resources

such as the expertise of their respective clinicians And look for research efforts to continue

ldquoROHO has a fantastic group of researchers led by Kara Kopplinrdquo Anderson said ldquoSo wersquore already looking at different products and types of research that we can work on together There is no one in the industry that has done nearly as good a job in terms of their research and developing usable data Thatrsquos definitely going to continuerdquo

Anderson also looks forward to technology collaborations when designers and engineers from all three companies are able to get together and let ideas fly

ldquoThat integrationrsquos already happening and itrsquos funrdquo he said ldquoAgain what makes it easy for us all to work together is the same fundamental philosophy If you asked anybody at ROHO they would say absolutely we are consumer centered and develop the best possible products for our customers If you asked somebody at Permobil theyrsquod say the same thing If you asked somebody at TiLite theyrsquod say the same thing

ldquoGoing into a project wersquore not designing around a code or devel-oping around a code or creating a marketing around lsquoHey we offer free armrestsrsquo or something like that Wersquore looking at lsquoWhat can we do to enhance our usersrsquo livesrsquo When you start from that basic point and move forward from there it makes it so easy to do all these things and these integrationsrdquo

And as for the latest acquisition mdash Patricia Industries a division of Permobilrsquos parent company Investor AB purchased adaptive auto-motive manufacturer BraunAbility in September mdash Anderson canrsquot contain his excitement His father made his career in the automotive industry so cars are in Andersonrsquos blood

ldquoI havenrsquot had any conversations with [BraunAbility] yet as far

as collaborations but that certainly would be a dream of minerdquo he said ldquoJust from the standpoint that if therersquos an area where Irsquove seen a disconnect itrsquos the wheelchair manufacturers and the adaptive vehicle manufacturers never really did communicate I feel therersquos this void in the way our products can be integrated to work together and be seam-less and much better looking and again offer better quality of life As soon as I heard [about the acquisition] my mind started racing What could we do to develop this next level of product togetherrdquo

ldquoSome of the Best People in the IndustryrdquoAnderson was adamant that his responsibilities include supporting the efforts of all of his colleagues ldquoThis family I think represents some of the best people in the industryrdquo he said

And he is not worried about either TiLite or ROHO being strong-armed or absorbed into Permobil

ldquoI donrsquot think anything will be forcibly changedrdquo he said ldquoEveryone whether theyrsquore working in Pasco or St Louis or in Nashville therersquos such a great deal of respect for the people who have built these brands and these companies that nothing would forcibly changed If therersquos a strong feeling about things those people are heard Therersquos always middle ground that can be reachedrdquo

He noted that speaking with his Permobil hat on ldquoWe would never forcibly change something at TiLite just from the standpoint that if we were getting pushback on it therersquos a reason We need to take a better look at that and maybe come up with a better solution The same holds true for ROHO

ldquoMy job here right now is to facilitate those projects we all want to move forward on and be a sounding board and the type of person that anyone can go to with questions and concernsrdquo l

mdash L Watanabe

brieflyhellipMobility Ventures has announced it is expanding its government and commer-cial fleet sales division and the manufacturer of the wheelchair-accessible MV-1 automotive vehicle has

hired Bill Gibson to serve as its VP of Government amp Commercial Fleet Sales Gibson is a veteran of automotive fleet management operations Mobility Ventures said and he has more than 40 years of sales and marketing experience Previous tenures include VP of fleet sales for VNGCO and VP of sales and marketing for SCT Performance Gibson also served for 38 years at General Motors He worked in GMrsquos fleet amp commercial operations segment for 21 years Howard Glaser president of AM Generalrsquos commercial division said of the hire ldquoI am pleased to have someone of Bill Gibsonrsquos caliber and business acumen join the Mobility Ventures team His depth and breadth of managing automo-

tive fleet operations and customer relations will significantly further Mobility Venturesrsquo progress in expanding accessible transportation alternatives to fleet operators in the local state federal and international market spacerdquo AM General is the parent company of Mobility Ventureshellip Kevin Hayes is the new executive VP of operations for BraunAbility in Winamac Inc Hayesrsquo reacutesumeacute includes 12 years as plant manager at four different Fiat-Chrysler manufacturing and vehicle assembly plants in the United States and Canada BraunAbility CEO Nick Gutwein said of the new appointment ldquoThis represents yet another step forward in our strategic plan to accelerate our rate of innovation and reach world-class manufacturing quality and safety benchmarksrdquo Hayes will oversee all BraunAbility operations groups including the manufacturing amp assembly purchasing amp supply chain and quality departmentshellip Claudia Zacharias presidentCEO of the Board of CertificationAccreditation (BOC) is the new board chair for the Institute for Credentialing Excellence Zacharias has served as the organizationrsquos

secretarytreasurer for the last two years l

Mobility Venturesrsquo MV-1

Permobil Marketing VP Continued



mm beat

AEL Debuts Upgraded Web SiteLocation location location So goes the old real estate mantra But it could also apply to the many business environments for todayrsquos ATPs and clinicians who evaluate clients in multiple clinic settings visit clientsrsquo homes and schools make deliveries and spend as much time in their cars as they do at their desks

Adaptive Engineering Lab (AEL) understands the challenge of being effi-cient even on the road In fact thatrsquos the reasoning behind the launch of AELrsquos new Web site at AELseatingcom

On the MoveAlexis Kopca marketing manager for AEL says the work landscape has evolved tremendously for seating amp wheeled mobility clinicians and ATPs in a very short time

ldquoMaybe even five years ago everyone was still using desktops for everything for 90 percent of their workrdquo she noted to Mobility Management ldquoJust over five years a big change has happened where theyrsquore shifting to laptops and mobile devices and tablets So we had to accommodate for thatrdquo

In fact Kopca added AEL received those sorts of comments in rela-tion to the manufacturerrsquos former Web site

ldquoWe got a lot of feedback from our previous site a demand for apps or ways they could be able to do quotes and orders and look at prod-ucts from their phones or their tabletsrdquo she said of what ATPs wanted Ultimately AEL opted not to create an app since users would have to download it onto an appropriate device ldquoIt was just another steprdquo Kopca explained

Instead AEL developed a more robust Web site that was user friendly regardless of the type of device accessing it And AEL wanted a site that wasnrsquot just a static list of product photos and part numbers but rather an interactive system that could help ATPs and clinicians be more efficient at their desks or in the field

Interactivity in Real TimeThe most immediately noticeable feature of the new AELseatingcomis its visual adjustability View the site on a laptop or desktop computer and pages are laid out the way yoursquod normally expect of a Web site But when a visitor accesses the site via smartphone or tablet the pages auto-matically adjust so scrolling remains easy to perform

ldquoWe wanted to create a site that could be used on your mobile devicerdquo she said ldquoItrsquos compatible whether you use it on your phone tablet or computer Yoursquore able to minimize your screen and you can still see everything without having to scroll left or right You donrsquot lose the features it just comes in a view thatrsquos easy to see and navigate whether yoursquore on your phone or

whatnotrdquoAELrsquos old site was Kopca said focused on pediatrics But the seating

amp positioning manufacturer actually offers components for clients of all sizes mdash so the new site features a cleaner look with plenty of white space and product photos

ldquoItrsquos very product centric you see a lot of product photos everywhererdquo Kopca said

The photos do more than just create an elegant look At a glance they help visitors to define or refine their searches Product photos also are used in the sitersquos shopping cart ldquoso you can

easily see that you have your abductor pad and your bracket but you can identify if yoursquore missing something because you can see all the photosrdquo Kopca said ldquoLike Oh Irsquom missing the hardware or whatever it may berdquo

ldquoReductive navigationrdquo features and smart-search capabilities in navigation bars also help visitors drill down to what theyrsquore looking for Type Air into the navigation bar on the homepage and all products starting with those letters including AELrsquos well-known AirLogic line will appear in a drop-down list Type in 14 and all part numbers begin-ning with those digits will appear

ldquoIf you know the part number starts with 14 you can type that in and it starts narrowing down what falls into that categoryrdquo Kopca noted ldquoIt helps with problem solvingrdquo

Got a few AEL parts that you order regularly The new sitersquos Quick Order feature on the homepage allows you to enter the part number add it to your shopping cart and get a quote without having to toggle through a bunch of other pages

And the site remembers your past actions to further streamline the ordering process Quotes and orders are automatically saved so ATPs can pick up where they left off if they get interrupted during the ordering process

ldquoSupport personnel can access the quotes and orders of the ATPs within their company under their own loginrdquo Kopca said ldquoThey donrsquot need to log in under the ATP All users within a company share a Quote amp Order Archive so they can all access each otherrsquos work without needing to log into their coworkersrsquo accounts It makes it easy for purchasers to convert the ATPsrsquo quotes mdash all under one loginrdquo

The Web site can even help to determine correct part numbers For instance choose a Planar Seating product and the site will automatically amend the part number for you as you select specifica-tions such as sizing and color

All of those abilities make the new site much more of an interactive tool for todays busy and mobile ATP or clinician

ldquoThisrdquo Kopca said ldquois just a better fit for their lifestyle l

The view on the left shows an AEL product page as it would be seen on a desktop computer On the right the modified view as seen on a smartphone or tablet

0116mm_MMBeat1317indd 13 121015 1257 PM


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Study Wheelchair Users More Likely to Die in Car-Pedestrian Accidents A Georgetown University study determined that in car-pedestrian crashes wheelchair users are one-third more likely to die than pedestrians who were not using wheelchairs

And more than half of those fatal-ities for wheelchair users happen at intersections

Results of the study were published in November in BMJ Open a medical journal for all disciplines and thera-peutic areas

Researchers used accident data from the National Highway Traffic Safety Administration as well as news stories that reported fatal car accidents In a news announcement about the studyrsquos publication researchers said about 528 pedestrians using wheelchairs were killed in car crashes that occurred in the United States between 2006 and 2012

ldquoThis equates to a pedestrian wheelchair userrsquos risk of death being about 36 percent higher than non-wheelchair usersrdquo the study said

Five times as many men using wheelchairs were killed versus the number of women using wheelchairs who died the report added Fatalities among male wheelchair users were highest for those aged 50 to 64 years

The fatal accidents happened at intersections 475 percent of the

time and ldquoin 39 percent of these cases traffic flow was not controlledrdquo the study said

That lack of traffic control was a major factor said John Kraemer JD MPH assistant professor of health systems administration at Georgetownrsquos School of Nursing amp Health Studies The studyrsquos co-author was Connor Benton MD MedStar Georgetown University Hospital

ldquoA high proportion of crashes occurred at locations without traffic controls or crosswalksrdquo Kraemer noted ldquoWhen there is poor pedestrian infrastructure or itrsquos poorly adapted to people with mobility impairments people who use wheelchairs often are

forced to use the streets or are otherwise exposed to greater risk It also may be telling that in three-quarters of crashes there was no evidence that the driver sought to avoid the crashrdquo

Kraemer said other previous research suggested that ldquowheelchair users may be less conspicuous to drivers (because of speed location and height) and this is a topic that needs to be explored more It is important to make sure that communities are designed to meet the requirements of the Americans with Disabilities Act so that people with disabilities can use them fully and safelyrdquo l

A new research study has determined that the muscle weakness found in children who have spinal muscular atrophy (SMA) type 1 may be due to decreases in muscle thickness over time

Researchers at Washington University School of Medicine in St Louis used ultrasound technology to measure the muscle thicknesses in the arms and legs of three young children with SMA type 1 They discovered that the children were losing muscle thickness as time progressed

The study called ldquoQuantitative Muscle Ultrasound Measures Rapid Declines Over Time in Children with SMA Type 1rdquo was published in October in Journal of the Neurological Sciences

Researchers noted that muscle changes do not occur in children who have SMA type 2 or 3 but wanted to determine if muscles changed in children who have the most severe form of the condition The research team led by Dr Kay W Ng tested infants who were 1 month 6 months and 11 months old then repeated the tests two or four months later

According to a news announcement about the study ldquoAlthough at baseline the children showed normal muscle thickness except for the quadriceps (thigh) muscle in the oldest child at the later time point muscle thickness decreased All three children showed lower than normal quadriceps muscle thickness Negative changes were also noted in the biceps of two children and the anterior forearm of one child but the tibialis anterior (shin) muscles were unchanged in all three This indicates that not all muscles are affected equally throughout time by SMA type 1 mdash muscles closer to the body were more affected than those further from the bodyrdquo

Researchers chose to use ultrasound technology they added because it ldquois a relatively simple and less painful technique to measure muscle thickness and function in childrenrdquo Other studies have used magnetic resonance imaging (MRI) technology which the researchers noted can require higher levels of training for personnel and can be painful for the children involved l

Ultrasound Study Says Muscle Thickness Decreases In SMA Type 1

Jon B

ilous

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brieflyhellip

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On Nov 20 Invacare Corp declared a cash dividend of $0125 per share on common shares and $011364 per share on Class B common shares Those dividends will be payable Jan 13 to shareholders on record as of Jan 4 according to an Invacare news announcementhellip Purdue University has announced that one of its innovations that helps people with Parkinsonrsquos disease to communicate better is now an award winner RampD magazine presented SpeechVive devel-oped by Jessica Huber professor in Purduersquos department of speech

language amp hearing sciences with an RampD 100 Award In an announcement about the award Purdue University said SpeechVive ldquoreduces the speech impairments associated with Parkinsonrsquos disease which causes people with the disease to speak in a hushed whispery voice have mumbled speech and commonly impacts their ability

to communicate effectivelyrdquo Other winners in the ITElectrical segment included Adelphi Technology IBM and Qualcomm Technologies ldquoTo be recognized alongside those highly innovative businesses and organizations makes my colleagues and me proudrdquo Huber said ldquoOur resolve to improve the lives of people affected by Parkinsonrsquos has been strengthenedrdquo Huber added that data from the last four years indicates 90 percent of people using the device have found it to be effectivehellipThe Office of the Inspector General (OIG) says Hoveround Corp ldquoclaimed at least $27 million in federal reimbursement for power mobility devices that did not meet Medicare requirementsrdquo In its December

report the OIG noted that it is Medicare policy to pay for power mobility devices (PMD) for beneficiaries to use in the home and that Medicare ldquodoes not pay for PMDs for use solely outside the homerdquo The OIG added that Medicare-reimbursed PMD ldquomust be deemed medically necessary on the basis of a number of factors including whether the PMD would help the beneficiary perform mobility-related activities of daily living and whether a different type of equipment such as a cane walker or manual wheelchair would meet the beneficiaryrsquos medical needsrdquo The OIG examined documentation for a sampling of 200 benefi-ciaries who received Hoveround power chairs that were paid for by Medicare ldquoHoveround often did not claim Medicare reimbursement for PMDs in accordance with Medicare requirementsrdquo the OIG report said ldquoHoveround complied with Medicare requirements for 46 of the sampled beneficiaries However for the remaining 154 sampled benefi-ciaries Hoveround received payments for claims that did not comply with Medicare require-ments Specifically for 144 sampled beneficia-ries Hoveround did not support the medical necessity of PMDs For 10 sampled benefi-ciaries Hoveround provided incomplete documentation to support the PMD claims On the basis of our sample results we estimated that Medicare paid Hoveround at least $27027579 for PMDs that did not meet Medicare requirements during 2010rdquo The report said Hoveround didnrsquot agree with the findings and that the manufacturer was unaware of the nature of the OIG review

and therefore didnrsquot supply all of the relevant documentation l

Momentum keeps building for WHILL the Japanese manufacturer whose eponymous Model A device is being campaigned as a personal mobility vehicle rather than as a power wheelchair

WHILL with American headquarters in San Carlos Calif recently announced it had won grand prize in the Good Design Award contest hosted by the Japan Institute for Design Promotion In its news announcement the manufac-turer said the presiding jury noted ldquoWith its futuristic look WHILL reinterprets the classical mobility devicerdquo

The company received an Honorable Mention in 2014rsquos Red Dot Award design contest

WHILL has been demonstrating and showing its mobility vehicles for years at consumer and industry events and its Model A is currently available for consumers The device was not submitted to the US Food

amp Drug Administration for consider-ation as a wheelchair and therefore is not considered a medical device

Among WHILLs features are a 4-wheel-drive configuration and all-directional wheels mdash each made up of 24 individual rollers mdash that enable the vehicle to essentially turn within its own footprint and navigate nimbly indoors as well as outdoors over gravel dirt grass and snow The Model A is operated via controls on a handrest that can be configured for right- or left-handed users

The vehicles are currently being sold via DME mobility and accessibility providers

While WHILLs Model A is not being marketed as a wheelchair WHILL executives previously indicated interest in creating a second model that would target power chair users l

WHILL Wins Japanese ldquoGood Designrdquo Award

WHILLrsquos Model A has ldquoall-directionalrdquo wheels that create a tight turning radius to improve maneuverability

Imag

es co

urtes

y WHI

LL

Purdue University professor Jessica Huber works with a patient who has Parkinsonrsquos disease and is trying out the SpeechVive system to improve communications

Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


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Sunrise Medical Launches User-Friendly Web Site DesignCRT manufacturers are accustomed to beginning work on their next latest-and-greatest technology as soon as a new product launcheshellipand maybe even before that

But today manufacturers also find themselves needing to keep up with the ever-evolving ways that ATPs and clini-cians search for and retrieve informa-tion on topics ranging from product part numbers to continuing education

SunriseMedicalcom for instance was by no means an older Web site Still recognizing the change to electronic media and always seeking new ways to interact with its customers Sunrise Medical in November launched what itrsquos calling a ldquofresh new look and user-friendly designrdquo

Teresa Adkins VP of marketing for Sunrise said in a news announce-ment ldquoWe are delighted to launch this new Web site which provides an easy way to locate information and relevant content and engaging experience and is mobile friendlyrdquo

The new site focuses on a holistically successful and intuitive experience for visitors and it starts by asking whether the visitor is a Consumer Dealer or Clinician

That input enables the site to then provide ldquocustomized homepagesrdquo Sunrise says with resources

tailored to each visitorrsquos particular interests That would include for example offering a Dealer Locator for consumers connecting to a Technician Support Center or Sunrise Training amp Education Programs for providers and showing an Education in Motion blog to clinicians

The newly revamped site is also designed to be more easily and conve-niently viewable and usable via smaller electronics devices such as tablets and smartphones Content on the pages scales and reconfigures per the size of the devicersquos screen while eliminating the need for the visitor to scroll left and right to see all the content

Sunrisersquos commitment to communi-cating via another important method mdash social media mdash is also demonstrated on the new site Visitors can access Sunrisersquos pages on Facebook Twitter Pinterest Instagram and more via the Community page and can also keep up with Sunrise Medicalrsquos commu-nity activities clinician blog posts and media mentions

ldquoWe believerdquo Adkins said ldquoour new Web site will improve visitorsrsquo online experience encourage visitors to connect with their peers and make learning about mobility products and

services more convenientrdquo l

On the heels of launching a second-generation power-assist system in 2015 MAX Mobility has announced itrsquos added industry veteran Devon Doebele to its staff

Doebele whose reacutesumeacute includes managing the Florida territory for MSL Associates is MAX Mobilityrsquos new SmartDrive Educator and will also be a member of the manufacturerrsquos executive team

MAX Mobility President Mark Richter said in the news announce-ment ldquoI am thrilled that Devon will be joining our team He shares our values and our focus on innovation and he places the same strong emphasis as we do on the user experience He has shown

Devon Doebele Is New SmartDrive Educatorhimself to be extraordinary throughout his career and has a proven track recordrdquo

Doebelersquos new responsibilities will include ldquooversight of the strategic direction expansion and education of SmartDrive which has rede-fined the mobility experience for thousands of users around the worldrdquo the company said

ldquoI am very excited to join MAX Mobility in this newly created position this year and very much look forward to working with the global teams to further enhance the education and user experience of SmartDriverdquo Doebele said l

SunriseMedicalcom serves three communities mdash consumers providers and clinicians mdash with a newly upgraded mobile-friendly design that also offers additional educational resources and an enhanced social media section (under the OneSunrise hashtag)

0116mm_MMBeat1317indd 16 121015 1257 PM


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Report Accessibility Privacy amp Campus Support Can Be Key to College SuccessGoing from high school to college mdash especially when that includes moving and living away from home mdash is a big step in any young adultrsquos life When that young adult also has a disability an already huge process can become even more complicated A new report from a team of researchers at Ball State University in Muncie Ind sheds light on the features and factors that can increase the chances of a successful transition and university experience

The study is named ldquoPre-Enrollment Considerations of Undergraduate Wheelchair Users amp Their Post-Enrollment Transitionsrdquo published in the Journal of Postsecondary Education amp Disability

Researchers discovered that choosing a college ldquois more complexrdquo for a student with a disability than for peers without disabilities and that transitioning from high school to college can be difficult

But the researchers also noted that students eventually ldquorelishedrdquo college life ldquoFrom being able to get to and from class on their own to hanging out with friends a feeling of independence was the key to inte-grating into collegerdquo the report said ldquoJust like other students these students had learned how to navigate the higher education setting and self advocate for their needsrdquo

The study said that strong support in the form of disability services was one of the criteria that students with disabilities and their fami-lies looked for when choosing a college Students also wanted ldquowide availability of automated doors on buildings and residence hall rooms special housing for wheelchair users a community where wheelchair users were visible and prevalent one-on-one faculty mentorships a student support group local accessible transportation and the director of disability services clearly visible on campusrdquo

Half of the studyrsquos participants indicated that being able to live in a

Home Medical Equipment (HME) in Garden City New York has been acquired by National Seating amp Mobility (NSM) HME provides seating wheeled mobility and home accessibility equipment throughout New York City including all of the boroughs

In a November announcement of the acquisition NSM indicated it had gained ldquofive seasoned and highly qualified ATPs along with repair techs processors and customer service representativesrdquo

HME owner Bill Tobia said of the acquisition ldquoIrsquom happy that the NSM philosophy closely aligns with ours We know that our clients will be served with the care and attention they are used tordquo

NSM CEOPresident Bill Mixon added ldquoAs we continue to grow our footprint in the northeast wersquore pleased to add the expertise and dedi-cation of all the HME staff members Bill and his team have created a great company that we are proud to bring into the NSM familyrdquo l

private room with its own accessible bathroom was a very important factor in their decision making since many students with disabilities were accom-panied by aides who assisted them with activities of daily living such as bathing and getting dressed

Researchers made several recom-mendations to colleges as a result of their study

bull Create a well-developed disability services office with professional staff that can facilitate appropriate accom-

modations and also instruct students on how to be independentbull Invest in making the campus accessible to wheelchair usersbull Provide regular training for admissions staff members on access to

college and accessibility issuesbull Provide multiple ways for students who use wheelchairs to become

socially integratedbull The disability services staff andor housing personnel need to

provide information to students regarding attendant care which many students need to live in a campus residence hallThe study noted that about 227 million college students in 2008

reported that they had a disability The Ball State University research team was composed of Roger Wessel a higher education professor in the Department of Educational Studies Darolyn Jones an English professor Larry Markle director of Ball Statersquos Office of Disability Services and Christina Blanch a doctoral candidate in educational studies

Wessel said in light of the study ldquoStudents in wheelchairs with their families should be encouraged to seek out available resources on campus especially from disability services offices to help create a seamless academic and social transition Competent and student-centered staff in a disability services office can make the transition process smootherrdquo l

NSM Acquires Home Medical Equipment of NY

Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM


One of the first things you discover upon trying to learn about transverse myelitis is how little is currently known about it

Go searching for transverse myelitis information online and yoursquoll find a few facts and observations regularly repeated Transverse myelitis (TM) is inflammation of the spinal cord often

resulting in damage to myelin the protective insulation around nerve cell fibers

Damage to the spinal cord can result in symptoms such as paralysis pain loss of bowel and bladder control sensory changes such as numbness or tingling in the limbs and muscle weakness

It can affect people of any age but there is a statistical spike in TM onset for two age groups children aged 10 to 19 and adults aged 30-39

Recovery can vary with some patients regaining significant function and others remaining seriously and permanently affected TM patients who remain paralyzed or continue to experience signif-

icant muscle weakness may require seating amp wheeled mobility equip-ment to live as independently as possible That means they could be coming to you for evaluation support and assistive technology

A Personal Journey Sanford J Siegel is president of the Transverse Myelitis Association (myelitisorg) which also advocates for consumers with acute dissemi-nated encephalomyelitis (inflammation of the brain and spinal cord) and neuromyelitis optica (inflammation of the optic nerve and spinal cord)

In speaking with Mobility Management Siegel notes that he has ldquono

medical training at all but Irsquove been totally immersed in this for over 20 yearsrdquo Thatrsquos when his wife Pauline a kindergarten teacher was diag-nosed with TM Following that the Siegels worked with a family in Tacoma Wash whose young daughter had been diagnosed with TM to create an organization to support and educate affected individuals and families

That was in 1994 and at that time Siegel says there were no medical centers of excellence for TM and no physicians specializing in it Today Siegel says ldquoThere is a transverse myelitis center at Johns Hopkins mdash Dr Carlos Pardo-Villamizar is the director of that center There is a trans-verse myelitis center at University of Texas Southwestern in Dallas the head of that center is Dr Benjamin Greenberg There is a specialist at University of Cincinnatirsquos medical center Dr Allen DeSenardquo

The establishment of TM centers Siegel explains is important not just so newly diagnosed patients can get the best care and rehabilita-tion but also so doctors can systematically collect information on those patients ldquoThey understand that thatrsquos how wersquore going to learn about the disorderrdquo Siegel says ldquoAnd because they have established these centers they attract more patients than anywhere else because they hung the shingle uprdquo

ATP Series

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e_x

shut

tersto

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By Laurie Watanabe

Symptoms Can Mimic SCI amp Multiple Sclerosis but Transverse Myelitis Has Its Own Challenges

0116mm_TM1824indd 18 121015 1108 AM


ATP Series

copy 2016 Columbia Medical LLC A Drive Medical Affiliate All trademarks stated herein are the properties of their respective companies

wwwcolumbiamedicalcom | 8004546612wwwdrivemedicalcom | 8007312266

INTRODUCING

SPROUTtrade FOLDING PEDIATRIC WHEELCHAIRDesigned with convenience in mind

COMPACT FOR STORAGE amp TRANSPORTThe patent pending frame easily fits in the trunk of a family sized cars

OPTIONAL INDEPENDENT WIDTH amp DEPTH CONFIGURATIONSeat width and seat depth can be ordered independently

OFFERS UNSURPASSED GROWTH CAPABILITYThe frame can grow in width through four sizes 12 14 16 amp 18

While that progress is laudable so much about TM from cause to prognosis remains unknown

How Does Transverse Myelitis PresentWhat the medical community does know about TM includes the fact that despite having some symptoms in common with spinal cord injury TM is an autoimmune disorder rather than a neurological one

As Siegel says ldquoThe spinal cord was totally fine until the immune system went at it So a spinal cord thatrsquos damaged from trauma mdash the analog is that the immune system is doing damage to the spinal cord in the same way that trauma is doing damage to the spinal cordrdquo

Siegel says physicians donrsquot entirely know what the immune system is doing during the onset of TM But they do know that inflamma-tion is the result ldquoA lot of the damage that is caused in a trauma to the spinal cord is caused by disruption of blood supply to the cordrdquo he says ldquoSame thing happens in an inflammatory attack Because it is such a small chamber that the spinal cord is housed in the inflammation is also going to constrict blood supply So itrsquos not just the inflammation and itrsquos not just the immune system that is going to cause damage Itrsquos also the same sort of issue as [with] a trauma the constriction of blood supply to the nervesrdquo

Pain muscle weakness and unusual sensations such as numbness or tingling are reported by many TM patients Siegelrsquos wife Pauline had

noticed lower-back pain for days prior to the acute onset of TM ldquoShe thought she pulled a muscle in her backrdquo Siegel recalls ldquoShe

didnrsquot feel right for about a week she was complaining about this lower-back pain And then on a Sunday night she was taking a shower got out of the shower had this horrible stabbing pain in her lower back and went over on the floorrdquo

Pauline was instantly paralyzedldquoIt happened immediately to her but the fact of the matter is that it

was probably over a period of a week that this inflammation had started up in her spinal cordrdquo Siegel now says ldquoWhatever happened on that Sunday night when what was a minor thing became a major catas-trophe I canrsquot tell you And Irsquom not sure that modern medicine can describe it either because I donrsquot think they really understand what happens at that critical massrdquo

Loss of bowel and bladder control mdash eg bowel incontinence loss of the ability to urinate mdash is also common ldquoIrsquom thinking that at acute onset around 80 percent of people who have TM have bowel and bladder problems and that many of them are not urinatingrdquo Siegel says ldquoTheyrsquore losing the ability to urinate at acute onsetrdquo

Siegel listed the major symptoms of TM Paralysis or motor weakness TM can strike anywhere along the

spinal cord so some TM patients require ventilators to breathe Spasticity

0116mm_TM1824indd 19 121015 1108 AM


Understanding Transverse Myelitis Paresthesias (ie abnormal sensations such as ldquopins and needlesrdquo

prickling and numbness) and nerve pain Bowel and bladder dysfunction Sexual dysfunction Fatigue Depression

ldquoAnd then there are all these secondary problems which you find in traumatic SCI like autonomic dysreflexia pressure wounds and similar sorts of problemsrdquo he adds

What Medicine Does amp Doesnrsquot KnowWhile the cause of traumatic spinal cord injury is obvious much less is known about what causes TM In fact the medical community is still seeking answers to some very basic questions about TM

Starting with how common it isldquoWe do not have great datardquo Siegel acknowledges He says TM

centers probably have the best collections of data but thatrsquos basically confined to what they gather from their own patients The medical community does know that transverse myelitis is rare mdash ldquoI believe the published incidence is 1 to 5 in a million and that incidence study was actually done in Israel in 1980rdquo Siegel says ldquoIt was probably a pretty good study because they have a centralized medical system so they were able to go to their hospital systems to count up numbers which we do not have here in the United Statesrdquo

The industryrsquos best estimate is between 30000 and 35000 people in the United States are currently living with TM While there are those statistical spikes for people aged 10-19 and 30-39 people of any age can

experience a TM event Siegel says hersquos aware of seniors in their 70s or 80s having TM and he has heard too many stories of parents putting a seemingly healthy baby to bed at night only to find the baby paralyzed in the morning

Accurately diagnosing TM is also still evolvingldquoFormal diagnostic criteria for transverse myelitis were not done

until 2002 and it was done by Dr Douglas A Kerr who was the first transverse myelitis specialist in the worldrdquo Siegel says ldquoHe started the TM center at [Johns] Hopkinsrdquo

Siegel says the medical community has been aware of TM for a century but he adds ldquoTherersquos really not very much understood in the grand scheme of things about all autoimmune disorders We really donrsquot know what causes them So TM is inflammatory and it is believed to be autoimmune And I say believed to be autoimmune because therersquos no biomarker and theyrsquove not found an auto-antibody

ldquoOne characterization of TM is post infectious About a third of cases are associated with some kind of viral bacterial or fungal infec-tion What seems to be happening is a person is coming out of that infection they might have had My wife had the flu and she was coming out of it Her symptoms were diminishing she was feeling better And she started noticing lower-back painrdquo

Siegel lists what else the healthcare industry knows about TM ldquoIt is for most people mono-phasicrdquo ie most patients experience a single attack rather than multiple ones ldquoEssentially the way TM gets diag-nosed is [physicians] identify inflammation in the spinal cord through MRI and a spinal tap It can happen at any level in the spinal cord and they donrsquot understand why at one level versus another levelrdquo

A research study being conducted at University of Texas Southwestern is seeking young participants who have recently been diagnosed with transverse myelitis or acute flaccid myelitis

The study is being led by Benjamin Greenberg MD MHS director of the Transverse Myelitis amp Neuromyelitis Optica Center at University of Texas Southwestern in Dallas

Entitled CAPTURE (Collaborative Assessment of Pediatric Transverse Myelitis Understand Reveal Educate) is described as ldquothe first to combine assessments from healthcare providers and patients relative to pediatric transverse myelitis (TM) outcomesrdquo A news announcement about the study said the Transverse Myelitis Association patients and healthcare facilities throughout North America would be participating

The researchers are seeking children who have been diagnosed with TM or acute flaccid myelitis and are within 180 days of the initial onset of symptoms The study will consider participants from birth up to age 18 years (if the teen was age 17 when onset occurred)

ldquoThe study is designed to assess the current state of pediatric TM

including acute flaccid myelitis in terms of diagnosis treatment and outcomesrdquo the announcement said ldquoUltimately it will lead to an improved understanding of the current status of care for individuals

afflicted with TM and reveal what are the current best practices Patients will educate clinicians and the study will educate the broader healthcare system about what outcomes are important and achievablerdquo

The study also seeks to ldquodevelop a multi-metric outcome measure based on combined patient-generated and provider-generated data that can be used in future controlled trialsrdquo

Study participants could need to travel to the closest of five participating research

centers at three-month six-month and 12-month intervals or could enroll in the studyrsquos virtual equivalent Children will be examined by physicians and the children and their parents will be asked to complete questionnaires

For more information contact Rebecca Whitney at (855) 380-3330 extension 5 rwhitneymyelitisorg or Tricia Plumb (214) 456-2464

Patriciaplumbutsouthwesternedu

Transverse Myelitis Study Seeks Pediatric Participants

ATP Series

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0116mm_TM1824indd 20 121015 1108 AM


The fact that magnetic resonance imaging (MRI) can diagnose TM shows how the medical community is still at the beginning of under-standing the disease

ldquoMRIs were not discovered until the 1980srdquo Siegel says ldquoThey were discovered and they were put into sort of general population use in the 1990s I just told you the diagnosis is done with MRI and spinal tap So people have been diagnosed with TM over a long period of time and itrsquos a diagnosis of exclusion

ldquoIt is not a new diagnosis However we are in a totally different land-scape today than we were I would say 10 or 15 years ago from the time that Dr Kerr started this specialization We understand so much more about this disorder than we did previous to his specialization Having said that we donrsquot know the cause There is no biomarker and it remains a diagnosis of exclusion And it is likely that what doctors call TM is more than one thing So we are at the baby steps of under-standing what this is therersquos no doubt about itrdquo

Difficulty in Diagnosing amp RespondingOne of the reasons TM is so difficult to diagnose Siegel says is its symptoms can be seen in a range of other conditions as well

ldquoIrsquoll sometimes get phone calls from these people [who believe they might have TM] and what I have to say to them is there is abso-lutely no way you can diagnose TM from symptoms because there are a large number of things that can happen to the human body that can cause exactly those same symptoms People can get neuropathies from diabetes People can get all of these paresthesias or bowel and bladder issues or mobility motor weakness from a disc problem from stenosis There are vascular problems that can cause these symptoms Lupus and Sjogrenrsquos and other rheumatic disorders can cause similar types of symptomsrdquo

Knowing the best way to respond to acute TM mdash ie while the inflammation is occurring mdash is another critical piece of information that healthcare professionals donrsquot yet have

ldquoTo me the most significant unknown is we donrsquot know what it isrdquo Siegel says ldquoThatrsquos number one Number two is therersquos a window to treat this disorder and that is while the inflammatory attack is going on Once the inflammatory attack has resolved mdash I donrsquot want to diminish the significance of it by any means but the only thing we can do for a patient is aggressive rehabilitation therapy The only way to spare the spinal cord is to knock down the inflammatory attack as quickly and as effectively as possible because the inflammation is damaging the cordrdquo

But Siegel points out that to date ldquoThere has not been a single scien-tific study not a single clinical trial on any acute therapies for trans-verse myelitisrdquo

Instead he notes ldquoAll of the decisions being made about how we treat a person acutely is based on expert judgment So we are at the very beginnings of understanding this disorder but it is a significant group of people in the USrdquo

Siegel surveyed Transverse Myelitis Association members from 1997 to 2004 in a study that involved more than 500 respondents

ldquoWe looked at whether or not the distribution of our cases could be explained in any other way besides population size of the staterdquo he says ldquoIt was just a very very simple analysis And it has its flaws because we didnrsquot ask people how long [they] lived in that state We took their current address and we looked at the distribution and we asked the question lsquoCan you explain the distribution of TM from these 500-some patients based on anything beyond population size for that particular statersquo

ldquoAnd the answer to that question was no The largest numbers were in California and New York and the smallest numbers were in Utah and Rhode Island And they sort of distributed by population size in between So you could conclude that it sort of looks random in its distributionrdquo

Treating inflammation during the acute event of TM is critical but the apparent randomness of TM incidents means patients experi-encing a TM event donrsquot go to one of the few TM specialty centers but rather ldquoThey go to their community hospitals down the streetrdquo Siegel says ldquoAnd because it looks random in its distribution that community hospital down the street probably hasnrsquot seen a whole lot of itrdquo

That can lead to difficulties in getting the right treatment during a critical window of time

ldquoI listen to nightmare experiences from patients in emergency rooms all the timerdquo Siegel says ldquoBecause if a person goes into an emergency room with the symptoms of traumatic spinal cord injury and they have no history of traumatic spinal cord injury mdash no car accident no diving board accident no fall mdash and [physicians] do all of the imaging studies and they see no compression of the cord and they see no evidence of any structural explanation that could explain what theyrsquore thinking looks like traumatic spinal cord injury itrsquos an unpleasant experience for the patientrdquo

When more neurologists learn about TM often from the few specialists in the country the ripple effect can be encouraging

ldquoDr Kerr Dr Greenberg Dr Pardo and the other doctors who are developing expertise in these rare disorders have done a tremendous job of educating neurologistsrdquo Siegel notes ldquoI am going to say that over my 20 years of doing this work I have noticed a very significant improvement in better diagnosis more rapid diagnosis and more rapid treatment which makes a difference Getting a diagnosis and getting people on aggressive acute treatment as rapidly as possible makes a difference It sure seems like it does So it matters and these doctors are passionate about getting the education out thererdquo

Siegel then mentions something that probably sounds familiar to Continued on page 24

I definitely see changes in people over time without any limit on that time

mdash Sanford J Siegel

ATP Series

0116mm_TM1824indd 21 121015 1108 AM

Serving the Seating amp Wheeled Mobility Community

The rst place to go when yoursquore going places

eMobility - complex rehab eletter delivered directly to your inbox

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For more information contact Lynda Brown lbrown1105mediacom

bull News and exclusive interviews with complex rehab newsmakers mdash eMobility brings you the CRT details you want to knowbull Special Focus eletters throughout the year on Accessibility Power Chairs Seating Pediatricsbull Updates on upcoming webinars white papers and other rehab resources

Sign up for eMobility todaymobilitymgmtcomemo

WebinarsComplex Rehab Educationbull One hour of education with a real-time QampA session and you donrsquot have to leave your deskbull Get insider information directly from manufacturers with our Clinician Confi dential series

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mobilitymgmtcombull Online resource 247 for seating and mobility news products research and morebull Hundreds of highlighted products amp technology viewable by topic or by manufacturerbull Extensive article archives going back as far as 2004












ATPs and clinicians who know that seating amp wheeled mobility topics arenrsquot discussed much in university lecture halls

ldquoThe doctors that specialize in this are a group of physicians who are a sub-group of neurologyrdquo he explains ldquoIt looks to me like you could go through all of medical school and if you get a slide on TM as part of your medical training thatrsquos probably about as much as yoursquore going to get And how much yoursquore going to be exposed to TM even as a neurology resident is probably going to depend on where you do your residency Doing a neurology residency doesnrsquot mean yoursquore going to learn very much about TM If yoursquore at Hopkins yoursquore probably going to get some exposure If yoursquore at UT Southwestern yoursquore going to get some exposurerdquo

But if yoursquore a physician doing your residency outside the few TM specialty centers ldquohow much exposure yoursquore going to get itrsquos not going to be a lotrdquo

What ATPs amp Seating amp Mobility Clinicians Should ExpectPatients with TM may largely experience treatment during the acute event and during subsequent rehabilitation thatrsquos similar to what trau-matic SCI patients experience

ldquoIf a person presents with paralysis mdash and I believe many become paralyzed or at least develop significant enough motor deficits that theyrsquore going to end up in a rehab hospital mdash theyrsquore going to show up as a TM patient in a rehab hospital that treats people with traumatic SCI and strokerdquo Siegel says ldquoAnd theyrsquore going to be treated in exactly the same ways as a person with a traumatic SCI [Healthcare profes-sionals] have no reason to do anything else with them There isnrsquot a therapist in those centers thatrsquos going to say lsquoThis person has TM we need to do these things as opposed to what we do for a person who has a traumatic SCIrsquo Theyrsquore treated exactly the same way Is that good I donrsquot know But I know that we probably donrsquot know to do anything differently for those [with TM]rdquo

Siegel says aggressive rehab seems to bring good results for TM patients but he adds ldquoWe have lots of mobility issues We are supporting the orthotics industry We have lots of people in chairs including my wife There are so many complicating issues in TM because of problems like spasticity and contracturesrdquo

How different life will be after TM depends on what part of the spinal cord was impacted and how much recovery occurs Recovery may be one of the ways that TM can significantly differ from traumatic spinal cord injury

ldquoIt depends on where on the cord theyrsquore impactedrdquo Siegel says ldquoIt depends on the severity of the attack And it depends on their recovery My wife got back enough function that she doesnrsquot have to cath shersquos able to urinate on her own Bowel [control] didnrsquot come back as well

but itrsquos a very manageable symptom for her She doesnrsquot have as much spasticity as most people have so she was very fortunate in that regard Wasnrsquot fortunate on the nerve pain at all Shersquos got horrible nerve pain But she went from being totally paralyzed to having I would say decent mobility Shersquos not going to walk a city block but she can get up and transfer and she can use a walker to go across the room Thatrsquos a huge thingrdquo

At least partial but significant functional recovery from TM can be possible for years after the initial onset of symptoms Siegel says

ldquoThis is purely anecdotalrdquo he notes ldquoBut Irsquom going to say that from my observation I definitely see changes in people over time without any limit on that time Definitely in the way of sensory People change dramatically where somebody had no temperature sensation and then they get temperature sensation back Or they had no sensation and some kind of sensation returns It may not be normal sensation but if you felt nothing and now yoursquove got something thatrsquos change I defi-nitely see that

ldquoAnd people get back motor strength In my experience Irsquove never seen somebody who was totally paralyzed be able to gain back enough motor function that they were walking on their own Irsquove not seen that But Irsquom going to tell you that I think the doctors in our community think that really aggressive physical therapy could get a person out of a chairrdquo

So what are best practices for working with patients with TMldquoAt the end of the day when yoursquore getting a person fitted for some

kind of assistive device whether they need a walker or a scooter or a chair yoursquore going to look at the same things that everybody else is looking atrdquo Siegel says ldquoAre they having problems with pressure wounds Do they need to be doing pressure releases Do they have enough upper-body strength to wheel a wheelchair The same issuesrdquo

And while ATPs and clinicians always need to consider how their seating amp wheeled mobility clientsrsquo needs change over time it may be especially important with this population given how patients with TM can regain function years after their initial event

ldquoPatients need to be evaluated over time because things changerdquo Siegel says ldquoWhat worked for a person last year might be different than what would work best for them this year Symptom changes can be fairly dramatic for a person with TM over time and that [should be kept] in mind while people are being evaluated for the sorts of adaptive equipment theyrsquore using for ambulationrdquo

Itrsquos clear that consumers with TM can experience wide ranges of symptoms for reasons not yet well understood by healthcare profes-sionals And that their prognoses can vary more than those of consumers with more typical spinal cord injuries But Siegel points out that this truth hardly makes TM more idiosyncratic than other mobility-related conditions

ldquoEveryonersquos on a unique journey with TM because there are so many variablesrdquo he acknowledges ldquoWhere on the cord How severe the damage How good the recovery How complicated the symptoms

ldquoBut the MS population is also tremendously variable And donrsquot you also have that with traumatic SCIrdquo

Understanding Transverse Myelitis

ATP Series

Continued from page 21

It is for most people mono-phasic mdash Sanford J Siegel

0116mm_TM1824indd 24 121015 1108 AM


The mantra for complex rehab technology (CRT) could be ldquoThere are no absolutesrdquo In this industry no two clients are alikehellipnot to mention that they change as they age or as medical conditions progress

So very little in the CRT world is black and white always or never on or off Except of course when it comes to alternative driving controls for power wheel-chairs mdash in particular the ones using switch systems which by definition are either on or off going or stopped

Right

Exploring New Boundaries for Head ArraysSwitch-Itrsquos new Dual Pro proportional head array seeks to get ATPs and seating amp mobility clinicians to rethink what they expect from head arrays

The Dual Pro will get immediate buzz for its two sensors one for Proximity (Crawl) and the other for Force (Force) Used in combi-nation Switch-It says the sensors can replicate the type of propor-tional driving delivered by joystick systems

But Robert Norton Switch-Itrsquos VP of sales added that the Dual Prorsquos parameters can be directly dialed into the chair without requiring extra equipment mdash a potential time-saver for the seating amp mobility team

ldquoYou have full control on-board programmingrdquo he noted ldquoTherersquos no dongle no computer no software to download Itrsquos all right there on the back pad Adjust how much speed the user uses while they are in the Proximity range and then how much force is required to achieve 100-percent speed by using the Force sensors That is fully adjustable from all three pads individually So because there is no proportionality mdash there is no gradient to proximity switches obviously theyrsquore just on or off mdash what yoursquore actually adjusting is the percentage of speed of the chairrdquo

As an example Norton said ldquoIf the chair is set up at 100 percent and you have two of the five lights chosen for Proximity then theyrsquore going to go at 40-percent speed Each of the lights in that scenario would represent 20-percent speed So when [the client is] in the Proximity range they would go at 40-percent speed And then with the Force there are up to five lights as well The more lights [that the programmer chooses to use] the more force is required to activaterdquo

More Precision for Clients ATPs and clinicians who dial in head arrays for clients often need to fine-tune per each clientrsquos needs The Dual Prorsquos system can offer more precision to accommodate a range of abilities

Norton said ldquoIf I have somebody that just constantly wants to

Switch-Itrsquos Dual Pro May the Force (amp Proximity) Be with You

push on the back pad mdash or someone who has a hard time coming off of the back pad and was never a candidate for a head array because any time they would touch the back pad they would start driving mdash with this product I can actually turn off the Proximity and they have to press pretty deeply into the back pad to be able to drive So they can rest their head on the back pad and deliber-ately press back further to activate itrdquo

For Angie Kiger MEd CTRS ATPSMS marketing channel amp education manager at Sunrise Medical (which acquired Switch-It in spring of last year) the Dual Prorsquos ability to evolve with the client could be helpful during training The new head array can at any time operate as a traditional switch system

ldquoWhen I first start teaching someone who is very youngrdquo she said ldquoItrsquos on and off stop and go So by leaving [the Dual Pro] as a full-on switch option without adding any force or any sort of proportionality to it I can really work on that stopgo stopgo And as the client becomes much more confident in their skills I can get them to understand that I can give them proportional control of this chair So I think it helps with the learning curve for some of these clientsrdquo

The Dual Prorsquos adjustability could also be a boon for adults expe-riencing changes

ldquoTwo of the scenarios that have come up in some of the in-services and in speaking with cliniciansrdquo Norton noted ldquoare number one ALS mdash so they could very well drive with the propor-tionality at the beginning of using the head array and as they progress and lose muscle strength and ability you can move them over to just a straight proximity head array You can progress with them And then second going in the other direction mdash a new spinal cord injury [client] may have a [cervical] collar on and very limited movement they could drive as proximity All of a sudden that C-collar comes off and theyrsquove got range and they gain more strength in their neck Now you can start to give them more proportionality as they strengthen You can adapt either wayrdquo

0116mm_CRTShowcase2526indd 25 121015 1037 AM


Seeking the Best of Best of Both WorldsAndrew Parker Switch-Itrsquos product and engineering manager said the Dual Pro concept began as a pair of head arrays shown off to REHACARE attendees

ldquoWe did a pressure-based head control and we did an adjust-able proximity-based head controlrdquo Parker said ldquoWe got a bunch of feedback from the field and their electronics are very similar they complement each other So we decided to put them together We ended up putting proximity sensors inside the pres-sure head control so when your head gets within the proximity sensor it calibrates the pressure sensor Itrsquos a redundancy and safety [feature] Then we decided to make the proximity adjust-able and the pressure sensor adjustable and put them in the same head arrayrdquo

That according to Parker was not the biggest design difficulty The real challenge was ldquomaking it easy to program not needing a computer or a smartphone or anythingrdquo

As far as the type of client who could benefit from the Dual Pro Parker said ldquoAll the existing head controlhead array users out there that have good head control and really want more adjustability and the ability to control their wheelchair in a more fine-tuned mannerrdquo

Kiger added ldquoIf theyrsquove got someone who complains about their current head array they would be at the top of my priority list to

give [Dual Pro] a whirl The other one would be if someonersquos got really good head control but they fail at other things That would be the client I would look atrdquo

Norton said providers should find Dual Pro equally attractive from a funding perspective ldquoFor a dealer it is coded as a propor-tional head control as opposed to a proximity one so the reim-bursement on it is about $1200 higher than that of a standard head array Even if you use it as a fully switched system turn off the force on all three pads and just use it as a standard proximity head array it is still programmed as a proportional system and therefore is coded as a proportional head controlrdquo

The Dual Pro is currently available in two sizes adult and pedi-atric with Parker adding that more options and accessories are in the queue for 2016 But the Dual Pro is already robustly functional It can be configured so its user can completely turn the power chair off and on again without assistance

ldquoYou can set it to be a switched head control like wersquore used to so it would fit the current people using themrdquo Parker said ldquoYou can add in proportionality as they become proficient or as they want it in the field So it fits existing populations of people and then gives them some optionsrdquo

And the Dual Pro gives options to the seating amp mobility profes-sionals working with those populations As Norton said ldquoEvery user changes at some point rightrdquo l

Go to wwwmobilitymgmtcomrenew and use priority code MHR to keep Mobility Management coming to your mailbox Because if your subscription stops that would be a real pain


mobilitymgmtcom


The clinical term for an ice cream headache (aka brain freeze) is sphenopalatine ganglioneuralgia

To keep receiving your free monthly editions of Mobility Management you need to regularly renew your subscription

Our auditing agency requires us to annually verify your information and confirm that you wish to continue receiving Mobility Management magazine Please take a moment now to renew your subscription information

Brain Freeze Half 0116indd 1 12915 316 PM

Switch-Itrsquos Dual Pro



Acta-ReliefThe all-new Acta-Relief integrates the flexible adjustable BOA closure system that allows the back to offset the center of pres-sure and better remove pressure points from the spine so equal and stable pressure distribution is accomplished in an ldquooff-the-shelfrdquo back design The Acta-Relief is available in 16 18 and 20 widths and 18 20 or 22 heights

Comfort Company(800) 564-9248comfortcompanycom

Java DecafDesigned for kids the Decaf can be flexed specifically to support the unique contours of a growing childrsquos body without losing seat depth and with accurate support contact through the pelvis lum-bar and thoracic spine The Decaf is available in permanent or quick-release configurations Patented FlexLoc hardware allows Decaf to be adjusted in multiple axes

Ride Designs(866) 781-1633ridedesignscom

Nxt ArmadilloA three-section modular shell adjusts to fit the unique contours of the userrsquos spine The upper section adjusts 40deg anterior20deg posterior middle section provides widthheightdepthangle adjust-ment lower section adjusts 30deg anterior or posterior when locked into position The E2620E2621 back is available in 14-22 widths and 16 and 18 heights

Dynamic Health Care Solutions(866) 875-2877dynamichcscom

AGILITY SystemThe AGILITY series offers three depth models (Minimum Mid and Max Contour [pictured]) all of which can be made custom and two hardware options quick release and fixed Accessories include swing-away laterals fixed laterals headrest adaptor plate and a multi-axis offset headrest by Therafin Corp

ROHO Inc(800) 851-3449rohocom

Nxt OptimaOffering true height adjustment the Nxt Optima HA features an up-per panel that adjusts 16-20 and is separate from the lower panel which remains fixed to control the pelvis The Optima is available in 35 475 and 65 contours from 16 to 24 wide It offers 25deg of posterior or anterior adjustment The series is coded E2620E2621


ADI CF SeriesThis backrest series from Ac-cessible Designs Inc features a carbon fiber shell and 1 open cell foam with attached 25 EVA backing plus lightweight alumi-num hardware and a breathable AirMesh cover Mounting options include Fixed ELITE (stationary mountingfixed positioning) Point PRO (stationary mountingadjustable positioning) Quick Release 4 Point PRO and Width-Adjustable ELITE

Stealth Products(512) 715-9995stealthproductscom

Matrix CustomThe Matrix design provides opti-mal seating and positioning while maximizing pressure relief and promoting airflow The custom-molded system can be easily adjusted for postural correction and conditions and can grow or decrease in size to meet chang-ing client needs Five general back-only sizes require minimal customization beyond shaping

Matrix Seating USA(800) 986-9319matrixseatingcom

Icon BackThe Icon series provides versatil-ity and comfort to users who want more support than sling upholstery can provide For the seating professional Icon provides fast installation and a wide range of adjustability Low Mid Tall and Deep styles are available from 12 to 24 wide with heights scaling to width and dependent on style

VARILITE(800) 827-4548varilitecom

backrests marketplace

0116mm_BackrestMarketplace27indd 27 121015 148 PM


How critical is fit for a consumer using an ultralightweight manual chair Clinicians will talk about the impor-tance of being able to efficiently propel for a lifetime particularly if a new ultralight user is young ATPs will talk about how a chairrsquos light weight or transportability will benefit a consumerrsquos lifestyle

But maybe the biggest indication of the importance of a great fit comes from consumers themselves and how far theyrsquore willing to go to find the right answer

A Fit Not Quite RightThat was the case with Alexandria Allen now 22 diagnosed with T12-L4 paraplegia following a car accident at age 17

Listening to Alex tell her story in her own words (see sidebar) reveals an irrepressible spirit combined with enormous determination Calling herself ldquoa quick learnerrdquo Alex adapted well to living with her disability What she couldnrsquot adjust to however was the difficulty in getting a wheelchair that fit her properly

And Alexrsquos difficulty was not limited to a single incident Brandon Edmondson OTATPCRTS director of clinical sales amp outcomes for Permobil said of Alexrsquos history ldquoShe has had three chairs not counting a temporary rental in only four short years since her injuryrdquo Alex

described her previous chairs as ldquoextremely too large and heavyrdquo and was feeling increasingly desperate to find a better solution

She was so determined to find a chair that fit that she purchased one out of pocket mdash to no avail Still relatively new to the world of seating amp wheeled mobility Alex went looking for a solution at an Abilities Expo event for consumers

Alexandriarsquos Challenges amp GoalsAt the Abilities Expo Alex met Ginger Walls PT MS NCS ATPSMS clinical education

specialist at Permobil and Terry Mulkey TiLite VP of sales for the eastern region

They noted Edmondson reported that Alex ldquoneeded some assis-tance with stability as she has a rod placement (rods T8-S1) and found herself sliding out of chairs in the past She was also experiencing some moderate shoulder pain due to an inefficient propulsion set-up Shoulders were abducted too far secondary to chair widthrdquo

Alex and her new team were seeking a chair ldquoas light as possible for loading and self-propulsionrdquo Plus Edmondson said ldquoWe just wanted to make sure we got her chair right after all her struggles and personal investment into getting a chair that was fit for herrdquo

The team decided on a TiLite TR (titanium rigid chair) with an Ergo

Getting the Right Fit

ClientAlexandria Allen 22

DiagnosisSpinal cord injury T12-L4 paraplegia

Major GoalGetting a chair that fits

Meet the Client

CAD drawing of Alexandria Allenrsquos chair

How We Roll Ultralight Case Study

0116mm_CaseStudy2829indd 28 121015 1010 AM


Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen

seat a tapered frame with a tapered ROHO cushion and Spinergy LX wheels Modifications included 2deg of camber and minimal wheel spacing

A Fit for Alexandriarsquos LifeldquoAlexrsquos case is unfortunately an example of what happens all too often to young and capable clientsrdquo Edmondson said ldquoShe was provided with several chairs that were just not fit to her and were too big for her She chose some options that were only needed rarely that increased the weight of her chair and some others

for style without regard for weight and functionrdquoThat made everyday life in those chairs much more difficult than

it had to be ldquoIt is possible to address bothrdquo Edmondson said of those factors ldquoand paying attention to both made this chair a huge success for her in the real world The extra space in her old chair affected her posture her push efficiency and most importantly her function She stated lsquoI just never felt like I was sitting straightrsquo The wider seat and frame put her too far away from her activities of daily living tasks Reaching items on countertops and making transfers were all a larger challenge than they needed to berdquo

From a propulsion perspective Edmondson added ldquoShe also didnrsquot have great wheel access The chair had a higher-than-necessary center of gravity which in turn limited her wheel center of gravity adjustment Lowering her center of gravity overall allowed her wheels to be placed at an optimal position mdash 40 mdash which sounds aggressive but in reality is very achievable if the chair isnrsquot built too highrdquo

On the postural side ldquoThe new chair had an Ergo seat which

she trialed at Abilities Expo and it was chosen for stability and the improvements it made in her posturerdquo Edmondson said ldquoIt also helped to accommodate her range-of-motion limitations in her spine Special attention was also paid to the seat taper and footrest spacing so she wouldnrsquot have to be constantly managing her lower extremities Her legs and feet stay in place now much better and the narrower front end lets her get closer to everything shersquos trying to pull up close to and fits in tighter spaces with easerdquo

As for seating ldquoShe has a tapered ROHO cushion that was achieved by simply deleting a couple of cells on the outer edges This provided a lightweight solution while maximizing her skin protectionrdquo

Timely SolutionsThe overall result has been an ultralightweight chair thatrsquos a better fit mdash clinically as well as for Alexrsquos lifestyle mdash than previous chairs

ldquoWe should all continue to be mindful that function and ability for clients like Alex lie in our handsrdquo Edmondson said ldquoWouldnrsquot it be nice if as a rehab community we could get her as functional as possible sooner It shouldnrsquot have taken Alex four years and paying out of pocket for one along the way that still wasnrsquot right to finally receive a chair that allowed her to be truly independent and functional Wersquove got to continue to learn that these chairs are really lessons in physics and when you pay attention to the physics of the specs yoursquore choosing yoursquoll create a better outcome for your clients

ldquoShersquos a great example of why we need to all continue to improve our skills and pay attention to the detailsrdquo l

Hello everyone My name is Alexandria Allen When I was 17 years old I was involved in a serious motor vehicle

accident leaving me paralyzed from the waist down Growing up with a disabled grandfather through my teen years the drastic change wasnrsquot hard to accept I am a quick learner and with much perseverance I found ways to adapt and overcome my disability

To my dismay I would find out what is extremely hard to stomach about a disability is the difficulty in getting a wheelchair that is properly fitted Every chair I have ever received was incor-rect I was so desperate I finally decided to buy a chair on my own and pay out of pocket

I was hoping to finally get something more suitable which ended up being sized extremely too large and heavy Nothing is more depressing when you canrsquot get a wheelchair that feels like itrsquos equipped to fit your needs and lifestyle Itrsquos not like a pair of

shoes you can just go back to the store to return Since I have only lived with my disability for four years I never knew

what was wrong with my chairs I just knew I never felt right in them Disappointed with my outcomes and being relatively new to my injury I decided to go to the Abilities Expo to see what all the hype was about

That is when I met the guys from Permobil and TiLite and was immediately drawn to the company I was extremely enthused to meet people that were so determined to help not only me but anyone that had questions They werenrsquot only interested in answering questions either They were set on making sure I was set up with the perfect chair for once in my life

I was set up with Terry Mulkey and Ginger Walls who spent an exten-sive amount of time double-checking measurements and discussing every

part of the chair with me I never met anyone more knowledgeable l

Introducing Alexandria

Alexrsquos old chair ldquoYou can see that shersquos not centered and it has a lot of space combined with a very wide front endrdquo Brandon Edmondson said

Alexrsquos new chair is a rigid titanium TiLite TR with an ergonomic seat and a tapered ROHO cushion



MM EditorialAdvisory Board

Josh Anderson PermobilTiLite

Mike Babinec Invacare Corp

Pat Boardman Astrum Healthcare

Lois Brown Consultant

Beth Cox The VGM Group

Susan Cwiertnia VARILITE

Jay Doherty Quantum Rehab

Amit Gefen Tel Aviv University

Rick Graver Medtech Services

Ryan Hagy Numotion

Chuck Hardy NMEDA

Julie Jackson Invacare Corp

Angie Kiger Sunrise Medical

Kara Kopplin ROHO Inc

Karen Lundquist Ottobock

Joe McKnight Access Medical

Steve Mitchell Cleveland VA Medical Center

Amy Morgan Permobil

Julie Piriano Pride Mobility Products Quantum Rehab

Lauren Rosen St Josephrsquos Children Hospital of Tampa

Mark Smith Wheelchairjunkiecom

Rita Stanley Sunrise Medical

Barry Steelman Stealth Products

Stephanie Tanguay Motion Concepts

Cody Verrett ROVI

Group Publisher Karen Cavallo(760) 610-0800

Sales Assistant Lynda Brown(972) 687-6710

Advertising Fax (866) 779-9095

ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31

National Mobility Equipment Dealers Association (NMEDA) 7

PermobilTiLite 32

Pride Mobility ProductsQuantum Rehab 3

Stealth Products 2

advertisersrsquo indexCompany Name Page


Comfort Company 27

Dynamic Health Care Solutions 27

Matrix Seating USA 27

Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page

0116mm_AdIndex30indd 30 121015 149 PM

Be free

The NEW SmartDrivereg MX2 is a revolutionary power assist device that gives greater freedom and power to chair users than ever before

wwwmax-mobilitycom

bull SIMPLE Convenient single-unit design with built-in rechargeable battery pack

bull INTUITIVE Intelligent wrist control senses your movements and knows when yoursquore ready to stop and when yoursquore ready to get moving

bull POWERFUL Dynamic drive system cruises up hills and over thick carpet

bull FLEXIBLE Innovative design moves with you for wheelies and curbs and optional mounting bar even makes it compatible with folding chairs

bull LIGHTWEIGHT So light you wonrsquot even know itrsquos there

Find a dealer near you and take a test drive today

Experience it at permobilcom

THE F5 CORPUSreg

FEATURING AP TILTJen Goodwin

Permobil user since 2013Anterior tilt must be clinically recommended by a licensed professional Additional support features such as knee blocks and chest straps may need to be prescribed See More

Back

Print

Mobility Management January 2016

Contents

Transverse Myelitis A Unique Journey

How We Roll Getting the Right Fit

Editorrsquos Note

People amp Places

MMBeat

Marketplace Backrests

Ad Index

adiridescom | stealthproductscomMark Zupan

S O L I D B A C K U PW H E N E V E RW H E R E V E R

ERGONOMICALLY DESIGNED for you and your lifestyle our seating system eases the strain on your lower back and is ideal for long days of great activityon the court and off

ADI Ad Finalindd 1 12815 905 AM










january


















6 Editorrsquos Note

8 People amp Places

13 MMBeat


30 Ad Index


mobilitymgmtcom


contents

splin

e_x

istoc

kcom

Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen

splin

e_x

istoc

kcom















CRTeditor







mobilitymgmtcom

Volume 15 No 1

January 2016

editorrsquos note

To Each Our Own

REACHING THE STAFF


















Photo

cour

tesy T

om Su

llivan

Tom Sullivan











and innovation























Paul Bergantino



TM

COMING SOON


convaidtrekker




























Van G Miller




















Josh Anderson

















mdash L Watanabe









mm beat
























0116mm_MMBeat1317indd 13 121015 1257 PM


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index










january


















6 Editorrsquos Note

8 People amp Places

13 MMBeat


30 Ad Index


mobilitymgmtcom


contents

splin

e_x

istoc

kcom

Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen

splin

e_x

istoc

kcom















CRTeditor







mobilitymgmtcom

Volume 15 No 1

January 2016

editorrsquos note

To Each Our Own

REACHING THE STAFF


















Photo

cour

tesy T

om Su

llivan

Tom Sullivan











and innovation























Paul Bergantino



TM

COMING SOON


convaidtrekker




























Van G Miller




















Josh Anderson

















mdash L Watanabe









mm beat
























0116mm_MMBeat1317indd 13 121015 1257 PM


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index














CRTeditor







mobilitymgmtcom

Volume 15 No 1

January 2016

editorrsquos note

To Each Our Own

REACHING THE STAFF


















Photo

cour

tesy T

om Su

llivan

Tom Sullivan











and innovation























Paul Bergantino



TM

COMING SOON


convaidtrekker




























Van G Miller




















Josh Anderson

















mdash L Watanabe









mm beat
























0116mm_MMBeat1317indd 13 121015 1257 PM


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index










and innovation























Paul Bergantino



TM

COMING SOON


convaidtrekker




























Van G Miller




















Josh Anderson

















mdash L Watanabe









mm beat
























0116mm_MMBeat1317indd 13 121015 1257 PM


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index




















Paul Bergantino



TM

COMING SOON


convaidtrekker




























Van G Miller




















Josh Anderson

















mdash L Watanabe









mm beat
























0116mm_MMBeat1317indd 13 121015 1257 PM


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index


TM

COMING SOON


convaidtrekker




























Van G Miller




















Josh Anderson

















mdash L Watanabe









mm beat
























0116mm_MMBeat1317indd 13 121015 1257 PM


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index




























Van G Miller




















Josh Anderson

















mdash L Watanabe









mm beat
























0116mm_MMBeat1317indd 13 121015 1257 PM


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index


















Josh Anderson

















mdash L Watanabe









mm beat
























0116mm_MMBeat1317indd 13 121015 1257 PM


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index
















mdash L Watanabe









mm beat
























0116mm_MMBeat1317indd 13 121015 1257 PM


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index


mm beat
























0116mm_MMBeat1317indd 13 121015 1257 PM


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index


mm beat




















Jon B

ilous

shut

tersto

ckco

m

0116mm_MMBeat1317indd 14 121015 1257 PM


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index


brieflyhellip

mm beat
















Imag

es co

urtes

y WHI

LL


Imag

e cou

rtesy

Purd

ue Re

sear

ch Fo

unda

tion

0116mm_MMBeat1317indd 15 121015 1257 PM


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index


mm beat



















0116mm_MMBeat1317indd 16 121015 1257 PM


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index


mm beat





















Monk

ey Bu

sines

s Ima

gess

hutte

rstoc

kcom

0116mm_MMBeat1317indd 17 121015 1257 PM














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index














ATP Series

splin

e_x

shut

tersto

ckco

m

By Laurie Watanabe


0116mm_TM1824indd 18 121015 1108 AM


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index


ATP Series



INTRODUCING

















0116mm_TM1824indd 19 121015 1108 AM




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index




























ATP Series

billio

npho

tosco

msh

utter

stock

com

0116mm_TM1824indd 20 121015 1108 AM






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index






















ATP Series

0116mm_TM1824indd 21 121015 1108 AM










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index










































ATP Series



0116mm_TM1824indd 24 121015 1108 AM




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index




Right




























mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index














mobilitymgmtcom












































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index





































Meet the Client





Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index


Photo

s cou

rtesy

TiLit

e amp Al

exan

dria

Allen




































Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index












Ryan Hagy Numotion

Chuck Hardy NMEDA







Amy Morgan Permobil







Cody Verrett ROVI




ad index

Amysystems 5

Columbia Medical 19

Convaid 9

MAX Mobility 31


PermobilTiLite 32


Stealth Products 2



Comfort Company 27



Ride Designs 27

ROHO Inc 27

Stealth Products 27

VARILITE 27

Company Name Page


Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index

Be free


wwwmax-mobilitycom








THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index


THE F5 CORPUSreg



Back

Print


Contents



Editorrsquos Note

People amp Places

MMBeat


Ad Index

january 2016 • vol. 15 no. 1 serving the seating & wheeled...

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