Invacare SHAPE SENSOR User Manual

SHAPE SENSOR USER MANUAL

SPECIAL NOTES

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WARNING/CAUTION notices as used in this manual apply to hazards or unsafe prac­tices which could result in personal injury or property damage.

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As regards restraints - seat belts - it is the obligation of the DME dealer, therapists
and other health care professionals to determine if a seating restraint is required to
ensure the safe operation of this equipment by the user. SERIOUS INJURY CAN OC­CUR IN THE EVENT OF A FALL FROM A SHAPE SENSOR.

It is also Invacare’s position that the SHAPE SENSOR be in a proper transport posi­tion and secured before transporting the shape sensor in a vehicle of any type.

NEVER transport the back sensor panel unless it is locked in the retracted position
or the back sensor panel removed and position standing up or on its side. DO NOT
position the back sensor panel on its front side (w/printed grid).

When transporting the shape sensor, ALWAYS loosen the clamp blocks at the front of
the frame and fold the support legs.

SPECIAL NOTES

NOTICE

WARNING

DO NOT OPERATE THIS EQUIPMENT WITHOUT FIRST READING AND UN­DERSTANDING THIS MANUAL. IF YOU ARE UNABLE TO UNDERSTAND THE
WARNINGS AND INSTRUCTIONS, CONTACT AN INVACARE REPRESEN­TATIVE BEFORE ATTEMPTING TO USE THIS EQUIPMENT - OTHERWISE IN­JURY OR DAMAGE MAY RESULT.

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SAFETY SUMMARY

SAFETY SUMMARY

WARNINGS

DO NOT use unauthorized parts, accessories, or adapters other than authorized by
Invacare.

Both gas cylinders MUST be operational and adjusted properly BEFORE using adjust­able back. DO NOT operate the adjustable back if only one (1) of the gas cylinders
is operational or adjusted properly.

Extreme caution is advised when it is necessary to move an UNOCCUPIED shape
sensor. Invacare recommends using two (2) assistants and making thorough prepa­rations. Make sure to use ONLY secure, nondetachable parts for hand-hold sup­ports. DO NOT attempt to lift the Shape Sensor by the seat sensor, back sensor,
armrests, or legrests. Use the base frame for lifting purposes. Lifting by means of
the removable (detachable) parts of a Shape Sensor may result in injury to the
assistants or damage to the Shape Sensor.

Before attempting to transfer in or out of the Shape Sensor, every precaution should
be taken to reduce the gap distance. Turn both casters toward the object you are
transferring onto. When transferring to and from the Shape Sensor, ALWAYS EN­GAGE BOTH WHEEL LOCKS. NOTE: This activity may be performed independently
provided you have adequate mobility and upper body strength.

A NOTE TO WHEELCHAIR ASSISTANTS
When assistance to the client is required, remember to use good body mechanics.
Keep your back straight and bend your knees.

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ALWAYS engage both wheel locks while changing the orientation of the Shape
Sensor modules.

When adjusting the seat depth, make sure the adjustment knobs are securely locked
in place.

To maintain stability and safety, make sure the client is properly positioned in the
Shape Sensor before reclining or inclining (reverse recline).

When adjusting the back angle, DO NOT remove the back angle adjustment knobs,
as they help secure the back sensor to the frame.

When returning the client in the Shape Sensor to the full upright position, more body
strength will be required for approximately the last twenty (20) degrees of incline
(reverse recline). Make sure to use proper body mechanics (use your legs) or seek
assistance to avoid injury.

The Shape Sensor has a weight limit of 300 lbs.

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TABLE OF CONTENTS

TABLE OF CONTENTS

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Special Notes........................................................................................................................... 2

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Safety Summary ...................................................................................................................... 3

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Introduction to the Manual ...................................................................................................... 5

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Quick Start ............................................................................................................................... 5

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History ..................................................................................................................................... 5

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Appropriate Applications of the T echnology .......................................................................... 7

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Client Profiles and Disability Types......................................................................................................... 7

T erminology and Parts Description ........................................................................................ 8

Unpacking and Assembly ....................................................................................................... 9

Transporting ...........................................................................................................................11

Locking the Back Sensor Panel ........................................................................................................... 11

Transporting a disassembled Shape Sensor ........................................................................................... 12

Transporting an Assembled Shape Sensor .......................................................................................... 12

T ransfers................................................................................................................................ 13

Independent......................................................................................................................................... 13

With a Sliding Board ............................................................................................................................ 13

With a Mechanical Lift Aid .................................................................................................................... 13

Stand and Pivot ................................................................................................................................... 14

Two Person Lift ................................................................................................................................... 14

Creating a Silhouette® System .............................................................................................. 14

Commonly Asked Questions ................................................................................................ 21

T roubleshooting.................................................................................................................... 22

Technical Notes ..................................................................................................................... 22

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INTRODUCTION

INTRODUCTION TO THE MANUAL

A user centered approach is needed to meet the
unique needs of each individual. The use of this
manual requires that the clinician have an under­standing of their own needs as well as the clients
they are serving. Individuals with good clinical skills
may find the sections on “Orienting the client on the
surfaces” to be common sense and be totally baffled
by some of the more technical aspects. The
“techies” may shy away from manipulating
someone’s pelvis with their hands, but be right at
home electronically digitizing these same surfaces.

The “Quick Start” section will allow those with previ­ous Silhouette
sary steps to successful completion of a system. It
can also be used by everyone as a checklist to make
sure steps and information are not left out of the
process.

The clinician has a responsibility when using
the Silhouette
involved, not just a product. This process al­lows for increased flexibility and versatility , but
if not fully understood and practiced, it can lead
to misapplication.

Please read this manual at least once, cover to
cover. Do this before the first client arrives! Hope­fully, most of your questions will be answered, but if
they aren’t, call the customer service staff at
Invacare (1-800-451-3553).

Good luck using the Silhouette

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experience to confirm the neces-

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System as there is a process

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system!

QUICK START

1. Lock castors at the rear of the frame.

2. Check the seat and back surfaces for flatness
and plunger position.

3. Lock the back sensor panel. Depress the handle
and pivot forward.

4. Set and lock the seat depth. (Makes sure both
pointers read the same.)

5. Set and lock the back angle.

6. Apply data forms to the data panels.

7. Insert data forms into receiving channels.

8. Take baseline for seat and back.

9. Transfer client to Shape Sensor.

10. Orient client on Shape Sensor surfaces.

QUICK START (CONTINUED)

11. Readjust surfaces to fit client.

12. Adjust footrests and armrests.

13. Stabilize client and pull back sensor lever for­ward.

14. Modify back shape to fit client (scapula, lateral
trunk, etc.).

15. Record seat and back shape.

16. Confirm measurements for seat depth/tilt, back
height/angle.

17. Transfer client off of Shape Sensor.

18. Remove the data panels.

19. Record serial numbers onto order form.

20. Determine necessary modifications/options and
fill in order form. (cushion density, cushion cover,
rail cuts, leg length discrepancy, solid insert, lat­eral supports, headrest, pelvic strap, Perfor­mance™.)

21. Determine interfacing.

22. Complete order form.

23. Fax or modem in order.

HISTORY

In the late 1980’s the National Institute on Disability
and Rehabilitation Research (NIDRR) provided grant
funds to the University of Virginia’s Rehabilitation En­gineering Center to study the usefulness of custom
contoured cushions by individuals with a spinal cord
injury. This research was conducted primarily by
Drs. Steven Sprigle and Kao-Chi Chung along with
Tom Faisant RPT.

The results of this research showed that custom
contoured foam cushions provided statistically lower
pressure distributions than the clients’ usual cush­ions. Along with a decrease in pressure, the au­thors felt that improvements in posture and balance
were also realized. The researchers used an array
of 64 spring loaded plungers that were fitted with
linear potentiometers. When a client sat upon the
array of sensors, the amount of displacement at
each point was recorded by computer. The data
was later used to fabricate a cushion through the
use of a three-axis milling machine that carved a
block of HR (high-resilience) foam. This electronic
shape sensing system and computer assisted
manufacturing process was the start of the Silhou-

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ette

System used today.

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HISTOR Y

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FIGURE 1 THE ORIGINAL ELECTRONIC

SHAPE SENSOR

HISTORY (CONTINUED)

High quality polyurethane foam was chosen for cus­tom carving because of its low cost, low
maintenance,and dynamic qualities. Pressure
against the foam is equalized due to the contouring
of the surfaces which makes fatiguing of this mate­rial less of an issue. Beta site testing was conducted
at five separate facilities to help prove the effective­ness of this technology. The centers included: The
Institute for Rehabilitation and Research, Houston
Texas; Helen Hayes Hospital, West Haverstraw, NY;
Newington Children’s Hospital, Newington, CT; Na­tional Rehabilitation Hospital, Washington, DC;
Rancho Los Amigos Medical Center, Downey, CA.

Some of the results of this Beta site testing were
presented by Anita Perr OTR/L, Andrew Lincoln, MS,
and Thomas McGovern, MS, from the Rehabilita­tion Engineering center of the National Rehabilita­tion Hospital. The conclusion of their study was that
the Silhouette
from the users ishial tuberosities, an area prone to
tissue breakdown, to the thighs, an area better suited
for weight bearing.

Invacare saw the potential for this technology as a
natural progression of the company’s already strong
focus on customized contoured seating, and tech­nology transfer process was initiated. The electronic
shape sensing apparatus, along with the necessary
computer interface and software made this tech­nology difficult and expensive to apply. A group of
people, including Colin Mclaurin, Clifford Brubaker,
Dave Brienza, Stephen Springle, Peter Axelson,
Michael Heinrich, Eric-Jan Ginder and Michael
Silverman worked to develop a relatively low cost
and simple process.The idea was to change

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cushion effectively shifted pressure

FIGURE 2 THE MECHANICAL SHAPE SENSOR

the electronic sensing unit (Figure 1) into a mechani­cal measuring device that could be interfaced to a
central computer using simple paper forms. The in­dividual would still sit upon a blanket of individual
plungers, but their position would be recorded me­chanically in a manner similar to a credit card im­printer. When a plunger is moved, it pushes a cable.
This cable is attached to a pointer whose position is
recorded when a pressure roller is moved across its
surface. The pointer presses against a carbonless
form making a mark that corresponds to the depth of
the plunger at that location. The imprinted form can
be then faxed to a central location where it is digitized
to produce the custom contoured cushion.

The first mechanical shape sensors (Figure 2) were
designed to record only the shapes of seat cush­ions. The technology quickly proved its worth and
was expanded to include a back sensing panel.
When a client is seated on a Shape Sensor, gravity
is the only force necessary to produce the seat con­tour. Gravity can’t be used to form the back cush­ion, and a mechanism was developed that gently
pushes the plungers around the individuals back.

Along with the development of the Shape Sensor,
Invacare has created software (SeatMaker), inter­facing hardware, and the machinery used to pro­duce the cushions. A good idea has become a com­plete system.

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APPROPRIATE APPLICA TIONS OF THE TECHNOLOGY

FIGURE 3 ACTIVE USERS BENEFIT FROM

ENHANCED STABILITY

APPROPRIATE APPLICATIONS OF
THE TECHNOLOGY

The first step in producing a Silhouette® System is de­termining if the client is an appropriate candidate. The
following information on disability types and
contraindications is meant only as a general guide­line. The decision whether or not to proceed with
this technology requires that the clinician have suffi­cient background information and a solid under­standing of the clients physical needs. A mat evalu-

ation should always precede the fitting of the
client in the Shape Sensor. This assessment will

help determine the basic parameters of the support
surfaces.

Arthritis
Spina Bifida
Geriatric
Multiple Sclerosis
Muscular Dystrophy, early stages

Contraindications

Open skin ulcers (unless the client, clinician, and
caregivers have carefully designed the cushions sur­face to reduce pressure in this area, are able to care­fully monitor the wound site, and understand that
the cushion may require additional modifications or
replacement.)

High, or fluctuating tone that would collapse
the cushions support surfaces.

Severe orthopedic complications that require
maximum support and accommodation.

Significant effort is required during the simulation to
maintain the client in the desired posture. The sup­port to the client that is provided by the clinician should
be gentle in nature and able to be maintained during
the recording process.

The client can not shift their position independently or
be placed within the seating system consistently by
caregivers.

The client is either too large or too small to fit on the
Shape Sensor.

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Client Profiles and Disability Types
Seat only

The seat cushion can promote stability and balance,
(Figure 3) and provide good pressure relief for indi­viduals with the disability of:

Paraplegia
Quadriplegia, low level
Amputee

Seat and back

A system will provide a pressure relieving seat cush­ion that promotes stability and balance, along with a
back cushion that supports and aligns the trunk.
This can be used by individuals who have the dis­ability of:

Quadriplegia, low/high level
Cerebral Palsy, mild-moderate
CVA

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TERMINOLOGY AND PARTS DESCRIPTION

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TERMINOLOGY AND PARTS DESCRIP­TION (FIGURE 1)

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A. Armrest Receiving Sockets. The armrest receiv-

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ing sockets are located on the left and right side plates.

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These sockets act as receptacles for the armrests.

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The height of the arm rest is adjusted by loosening

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and tightening the knob attached to this receptacle.

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The armrests index into the receiving sockets and can

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provide a surface that the client can use to reposition

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themselves or to help with balance and pressure re-

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lief. The armrests are height adjustable.

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B. Back Angle Adjustment Knobs. These knobs

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are used to change the back to seat angle. The back

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angle adjustment knobs travel in these slots providing

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angle adjustability to the back.

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C. Back Grid. This grid is printed on the back sensor

panel to assist with determining back height and client
symmetry.

D. Back Imprint Handle. This handle is located at
the top of the back sensor panel and is used to move
the imprinter across the data panel. This handle
screws into the imprinter.

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E. Back Location Pointers. These blue pointers are

located on the left and right side plates, just forward of
the armrest sockets and are used to help align the back
sensor panel. The pointers should read the same num­ber on each side before locking the back sensor panel
into position. The location of these pointers is a critical
part of the requested information on the order form.

F . Back Pivot Pins. The back pivot pins are found on
both sides of the back sensor panel and are used to
suspend the back within the side plate receiving
notches.

G. Back Sensor Lever. This lever is located on the
left side of the back sensor panel and is used to push
the back plungers forward. This lever has a second­ary function that locks the back sensor panel in place.

H. Back Sensor. The back sensor panel contains
100 cable driven plungers that are used to capture the
shape of an individuals back.

I. Casters. These are the rear wheels which can be
locked to prevent rotation or rolling.

J. Clamping Blocks. The clamping blocks are lo­cated at the bottom front side of the frame and are
used to hold the folding legs into a locked position.

Data Forms. These are carbonless, pressure sensi­tive forms that attach to the data panels using self ad­hesive strips. There are separate forms for the seat
front and back. (Not Shown)

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FIGURE 1 TERMINOLOGY AND PARTS

DESCRIPTION

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WARNING

DO NOT use unauthorized parts, acces­sories, or adapters other than autho­rized by Invacare.

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