Date: Friday, February 14, 2014
Category: General

RESNA, the Rehabilitation Engineering and Assistive Technology Society of North America, has released a new position paper, “The Application of Wheelchairs, Seating Systems, and Secondary Supports for Positioning vs. Restraints.” The purpose of the position paper is to give equipment providers and practitioners information, guidance and recommendations regarding the appropriate use of postural supports in settings where physical restraint policies are in effect. The position paper is not intended to replace clinical judgment related to specific client needs. 

Developed through RESNA’s Special Interest Group on Seating and Wheeled Mobility, the paper highlights:

• The beneficial use of postural supports for people who use wheelchairs, which can result in greater freedom of mobility and function not possible otherwise.
• US regulations and policies regarding restraints, including definitions, which vary depending on the context: community vs. institutional setting, hospital setting vs. long term care, pediatric vs. adult, etc. 
• The use of seating components in transportation, in order to clarify the definitions of restraints within this context.
• Optimal seating assessment, which may reduce the need for secondary supports that could be perceived as restraints.
• Clinical indications and contra-indications for the use of seating components with specific intent to limit movement, rather than influence posture. 

 “By documenting current regulations and best clinical practice, we hope to inform the discussions that are happening every day in long term care facilities, schools, and other venues regarding the use of postural supports versus physical restraints,” said co-author Michelle L. Lange, OTR, ABDA, ATP/SMS of Access to Independence, Inc. “Practitioners can use the information in this paper to support appropriate postural supports that will improve the function and mobility of their clients.”

RESNA regularly publishes position papers and guides on assistive technology. Other position papers and resources available on the website for free include:

• The Application of Pediatric Power
• The Application of Seat Elevating Devices
• The Application of Tilt, Recline, and Elevating Legrests for Wheelchairs
• The Application of Ultralight Manual Wheelchairs
• The Applicaton of Wheelchair Standing Devices
• Wheelchairs Used as Seats in Motor Vehicles
• Wheelchair Service Provision Guide

Besides Lange, the other authors are Michael Babinec, OTR/L, ABDA, ATP, Invacare Corporation; Elizabeth Cole, MS, PT, US Rehab; Barbara Crane, PhD, PT, ATP/SMS, University of Hartford, CT; Steven Dahling, ATP, RET, Rusk Institute of Rehab Medicine; Delia Freney, OTR/L, ATP, Kaiser Permanente; Barbara Jungbluth-Jermyn, M.Ed, BS PT, ATP, Mobility in Focus, LLC; Yunn-Yi Pau-Lee, PT, MA, Lakeview School, NJ; Donald N. Olson, PT, ATP, North Dakota Life Skills and Transition Center; Jessica Pederson, MBA, OTR/L, ATP/SMS, Rehabilitation Institute of Chicago; Cynthia Potter, DPT, PT, PCS, Healthquest Community Services; David Savage, ATP/SMS, RET, Community Services Group; and Mary Shea, MA, OTR/L, ATP, Kessler Institute for Rehabilitation.

The position paper is available for viewing and downloading on the RESNA website at http://www.resna.org/Resources/Government-Relations/RESNA-Policy-Position-Statement.