Prescriptive Seating Book

As an Occupational Therapist who actively engaged in the recommendation of seated-mobility equipment for more than 20 years, Diane Ward synthesized her knowledge, experience and insights into this book to help bridge the gap between therapists’ understanding of clients’ needs and the assistive technology suppliers’ knowledge of wheelchairs and seated-mobility equipment.

As an Occupational Therapist, Diane’s therapeutic focus is client-centered with the goal of optimizing clients’ potential for health, independent function, and meaningful activity. The achievement of these goals demanded that her clients have seated-mobility equipment that fit their lifestyles, their environments, and  their bodies.

In Prescriptive Seating, Diane presents some ground-breaking materials that are designed to increase the seating team’s prescriptive certainty when recommending seated-mobility equipment.

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Prescriptive Seating includes:
• Observations about how human function is affected by sitting and the chair.
• A framework for uniform terminology to describe the sitter’s needs and equipment.
• A discussion of the clinical ramifications of seated-mobility equipment parameters.

Prescriptive Seating is essential for the seating novice – providing a foundation for the development of prescriptive reasoning strategies. It is useful for occupational and physical therapists who already work with seating teams, offering them the tools to more clearly communicate their clients’ seated-mobility needs. For equipment specialists and third-party funding agents, this book provides insight into the prescriptive rationale that ensures successful selection of seated-mobility equipment.

Contents         206 pages, index, 54 charts and illustrations

Part I -Theory: Prescriptive Seating as a Therapeutic Process
1. Perspectives That Mobilize the Human Potential
     A Philosophical Overview
Evolutions In Prescriptive Seating
Evolutions in Seating Assessment
Prescriptive Events and Reasoning Processes

2. Prescriptive Relationships Between the Sitter and the Seat
     Characteristics of Seated Existence
The Domains of Prescriptive Fit

3. A Uniform Approach to Seating Terminology
     The Need for Standard Terminology
Distinguishing the Sitter From the Seat
Starting References

Part II – Application: Selection of Equipment Parameters
4. Angular Specifications of the Human Support Surfaces
     System Tilt Specifications, Seat to Back Angle Specifications,
Angular Specifications of the Supports for the Head and Extremities

5. Linear Specifications of the Human Support Surfaces
     Seat Size and Linear Placement, Back Support Size and Linear Placement,
Head Support Size and Linear Placement, Arm Support Size and Linear Placement,
Lower Leg Support Size and Linear Placement, Foot Support Size and Linear Placement

6. Interfacing Surface Specifications
     Contact Areas, Interfacing Shape, Interfacing Pressure,
and Temperature Interactions, Durability, Weight, and Size

7. Mobility Base Specifications
     Angular Configuration and Modifiability, Power Source, Mobility Base Size,
Linear Relationships Between the Seating System and Mobility Base,
Mobility Base Weight, Wheel and Tire Specifications,
Foldability and the Ease/Speed of Disassembly/Assembly, Frame Rigidity and Flexibility


 Book Review      by Karen A. Bena, MS, OTR/L
 American Journal of Occupational Therapy,  November/December 1996, Volume 50, No 10, p 914

This book contains the fundamental theory and application of prescriptive seating, which has not been presented in other texts. The purpose of the book is to (a) support seating specialists in practicing with excellence in their daily work, (b) encourage researchers to discover more economical and reliable methods for clinically evaluating clients’ seating needs, and (c) inspire seated mobility manufacturers to continue developing products that prescriptively respond to sitters’ individual needs.

Part I discusses a theoretical frame of reference for the practice of prescriptive seating as a therapeutic activity and introduces a uniform approach to seating terminology. The author presents a philosophical overview, evolutions in prescriptive seating and seating assessments, and reasoning processes. Her approach emphasizes the need to focus on and evaluate the client’s seating potential. The seating assessment is an interactive process that involves interview; physical, cognitive, and emotional evaluation; and simulation of proposed equipment. This part is well presented and complemented by easy-to-follow charts and diagrams. Chapter 3, A Uniform Approach to Seating Terminology, is hard to conceptualize in one reading. The discussion of the planes and axis of motion is confusing and difficult to understand without having the clinical experience of prescriptive seating to visualize these concepts. For prescriptive seating team members to use this uniform approach, they need to read the text and practice the concepts together. The illustrations are helpful in demonstrating the points, but time is needed to digest the information for application in the second part of the book.

Part II applies the prescriptive seating theory and uniform terminology from Part I to the selection of equipment to meet clients’ individual needs. All body segment position options are discussed individually then as an interactive whole, with consideration given to environmental demands. The author’s knowledge and experience of prescriptive seating is evident through her clinical examples of equipment and how the seating system functions as a whole. Case studies and photos of actual client seating systems would have fit well in this section, unless the author plans to use these in volume II.

Overall, this text is a great resource, provides a foundation for professionals working in prescriptive seating and for students interested in learning the basics, and establishes a comprehensive framework and uniform terminology. The illustrations, references, and suggested readings in each chapter complement the information presented by the author. This book will enhance the occupational therapist’s skills in helping the seating team incorporate the client’s physical, cognitive, and psychosocial needs and accent the clients’ role in the prescriptive seating team.

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