The Grand(e) Way to Support Transition from Child to Adult

06/04/2021
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Transitioning from child to adult is difficult at the best of times. For Ellie Matraves it was harder than usual- the 18 year old from Hertfordshire suffered trauma at birth resulting in brain injury and physical disabilities.

The combined efforts of her therapy team, parents, support workers, and prescription of appropriate equipment have meant that it has been a positive, beneficial experience, and the aid specified has been rated by the family as “one of the best pieces of equipment Ellie’s ever had”.

The equipment is a Grande vacuum posture cushion, supplied by AAT GB, and specified by Occupational Therapist Helen Robinson of Phoenix Occupational Therapy for Children and Physiotherapist Nicki Keech of Centaur Physiotherapy, who work together to manage Ellie’s conditions, alongside other members of her multidisciplinary team.

Ellie’s disabilities mean that she needs constant support and 24-hour care. She predominantly uses her foot for “manual” activities-using her iPad, crafting, doing her make-up, nails- all the typical usual home-based past-times for teenage girls. Her brain injury means it is very difficult for her to use her arms and hands for functional tasks.

When using her foot to do tasks, it is easier for her to be positioned on the floor in a seated position, but it was proving difficult to find equipment to support her adequately in that position, that still enabled her to maintain any muscle tone, function independently as much as possible, and met her aesthetic sensibilities. As a result, Ellie was spending most of her day sat in her wheelchair, making her frustrated and adversely impacting on maintenance- or improvement- of her dystonia,  spasticity and levels of fatigue. She could not use a conventional beanbag as she would slide off it, and it was unable to maintain her posture due to the strength of her extension movement patterns and dystonia.

Nicki has used AAT vacuum posture support cushions with other clients and felt the concept could be beneficial to Ellie. Helen agreed, and AAT supported the therapy team in assessing Ellie’s needs. Ellie had also used an AAT vacuum support cushion previously, to allow her to be seated safely on an aeroplane on a school trip abroad.

Now, a Grande vacuum posture cushion has been supplied; AAT trained Ellie’s parents Colin and Claire and Elie’s support worker in the use and adjustment of the Grande, enabling them to alter the configuration to suit Ellie’s needs as they change during the day, from upright to prone and anywhere inbetween.

AAT’s vacuum posture cushions differ from other similar systems on the market in that they are infinitely remouldable, by the carer, on site and at no additional cost. The system focuses on a beanbag which is exactly contoured as required without pressure points by moulding it to the shape needed, and then held in that shape by removal of the air inside by a pump. It means that one piece of equipment can suit various purposes, which reduces the cost of having to purchase multiple items. This is also beneficial where storage is limited.

It is quick and easy to adjust by allowing a little air back in to allow re-shaping, then applying the pump to remove the air and hold the new form.

“Ellie was reluctant to get out of her chair before she had the Grande. But she didn’t have many options- it was her chair or a mat on the floor, as she is very tall and her dystonic movements prevented Ellie from using conventional seating devices such as a standard bean bag,” observed Helen.

Added Nicki, “It is obvious that the Grande is being used all the time, not left under the bed or in a corner as previous pieces of equipment have been. Having the right equipment available to allow Ellie to have regular time out of her chair as part of her 24-hour postural management programme has already been beneficial and positive for Ellie. Improvement have been seen in her levels of fatigue, spasticity and dystonia in the short time that Ellie has had the Grande. It’s easier for her support worker to help Ellie to do her stretches, as it’s more comfortable for Ellie than lying on the floor. Improvements in her lower limb range of movement has also been noted subjectively. She is less fatigued, and there’s been a positive impact on her behaviour as she’s not so frustrated, nor impacted so much by postural fatigue or discomfort.”  

Said Ellie’s father Colin, “Ellie’s had lots of pieces of equipment in her life. This is one of the best pieces of equipment she’s ever had. It’s had such a positive impact on her- and the rest of the family- physically and mentally.”

Find out more about AAT’s Grande vacuum posture cushions here: https://www.aatgb.com/grande/ or the complete range here: https://www.aatgb.com/posture-cushions/

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