SEATED MOBILITY: Seating and Pressure Cushions for use on wheelchairs
For non-mobility seating and pressure cushions,refer to the Clinical Criteria for Alternative Positioning and/or Pressure Cushions for Stationary Seated Surfaces
Included accessories or modifications / Clinical Criteria / Eligible Prescriber / Aditional Information
STANDARD ACCESSORIES
Pelvic belt – 2 point
Standard foam, gel or static air pressure reducing cushion
Standard Tray
Standard head rest
Pre-contoured seat base/cushion / Provided on request / Registered occupational therapist or registered physiotherapist *
CUSTOMISED ACCESSORIES or MODIFICATIONS
Provided on customised manual and power wheelchairs
Gel; combination; and static air pressure relieving cushion / Plus meets at least 1 of the criteria below:
  • Ongoing clinical need for pressure relieving cushion
  • History of pressure injury
/ Registered occupational therapist or registered physiotherapist with > 1 year experience and 3 previous prescriptions** / Complete Question 4 in ERF and provide details of Pressure risk assessment tool used
Additional pelvic positioning
components e.g. hip blocks, obliquity
wedges, sacral pad, added to customise
a cushion / Contouring of cushion alone isinsufficient to position pelvis due to pelvic obliquity, tilt or rotation
Non-standard pelvic belt or stabilisers
e.g. - 4 point pelvic belt orpelvic keepers/ rigid devices / Meets at least 1 of the criteria below:
  • Standard pelvic belt is not sufficientto secure pelvis
  • Increased muscle tone, extensor
tone, primitive reflex activity is present
Headrest - customized:
Off set mounting, non-standard head rests without anterior head or neck support / Meets all criteria below:
  • Standard options trialled and not suitable
  • Required for postural control, safety or security during mobility, communication and/or activities of daily living

Thigh positioning:
Abductor/ leg divider/ pommel/adduction block/ thigh guides / Meets all criteria below:
  • Adduction/abduction or wind sweeping is present
  • Contouring of cushion alone isinsufficient to position upper leg

Foot positioning supports
Ankle huggers, foot straps or toe straps
Not provided to address behaviour issues / Meets at least 1 of the criteria below:
  • Foot/ankle position needs correction
  • Legsand feet in danger of injury due to movemetn disorder
  • Stability required for functional tasks

Thoracic supports/ lateral supports / Meets at least 1 of the criteria below:
  • Person uses a wheelchair for positioning for functional activities as person is unable to sit independently
  • Person requires additional trunk support to optimize independent mobility or to complete activities of daily living.

Contoured back support / Standard options trialled and not suitable
Plus meets at least 1 of the criteria below:
  • Person uses a wheelchair for positioning for functional activities as person is unable to sit independently
  • Person requires accomodation of body shape or additional support to optimize independent mobility or to complete activities of daily living.

Harness – H style
Harness – backpack style
Shoulder keepers – rigid supports
Not provided as an alternative to a vehicle restraint or to address behaviour issues / Meets all criteria below:
  • A pelvic belt or pelvic stabiliser is fitted
  • Sufficient lateral support is available to ensure airway protection
  • Style of harness is compatible with harness safety guidelines
  • Harness is required to provide additional anterior support to the trunk
/ Provide details of the activities and frequency of use, for which a soft tray can not be used and a hard tray is required.
Custom tray / Meets at least 1 of the criteria below:
  • Core ADL’s (such as mealtimes)
performed in the chair
  • Used to mount communication device; power wheelchair controller or environment control units (ECU)
  • Additional postural support for thetrunk is needed. (prop with upper
limbs)
Two trays – 1 x soft and 1 x hard / Meets all criteria below:
  • Additional anterior support is required during transport
  • Soft tray can not be used for functional activities due to the need to mount a communciation device, power wheelchair controller or environmental control system (ECU) on tray

Custom arm rests / Standard armrests have been trialled not able to provide sufficient support
Gel padding / History of pressure injuries that are atributable to wheelchair componentary
CUSTOM-MADE ACCESSORIES AND MODIFICATIONS
Backrest:
Custom moulded backrests / Meets all criteria below:
  • Customised and off the shelf options have been trialled and not suitable
  • Body shape or asymmetries requires more lateral and postural support to maintian a sitting posture than can be provided with the use of laterals and/or tilt in order that a person is participate in ADLs
  • Mat evaluation has been completed
  • Consideration has been given to how system will accommodate any further or changes
/ Registered occupational therapist or registered physiotherapist > 3 year experience and 5 previous prescriptions** plus 1 or more member of multidisciplinary team / Information regarding functional outcomes of trials of standard items is required.
List members of team in ERF
Seat Base:
Custom moulded / Customised and off the shelf options have been trialled and do not meet needs due to at least 1 of the criteria below:
  • Complex postural needs present
  • Fixed postural deformity or nonstandard
  • size
  • High risk or history of recurrent pressure injuries
  • Pelvic obliquity, tilt and/or rotation present

Specialised Head Restsproviding
  • anterior support
  • head and shoulder support
Neck Support – Supports not connected to
the seating system that support the head
and neck anteriorly / Meets all criteria below:
  • Head cannot be supported upright against gravity
  • Seating system provides stability to pelvis and trunk and includes well-fitting pelvic belt and thoracic support.
  • Other options have been trialled and unsuccessful, including tilt and recline.
  • Risks from injury to the head and
neck during core activities, including transport, have been identified and minimised
  • Plan for training person and carers is in place
/ Input from medical team is required if respiratory issues are identified and to ensure that there are no contra-indications for the use of proposed head and/or neck support
Ventilator trays or mounting for respiratory equipment
Additional battery or power connections for ventilator through PWC are not provided / Meets all criteria below:
  • Person requires fulltime need for respiratory support
  • Bags and other forms of mounting are not suitable
  • Type of ventilator and mounting required has been confirmed with respiratory team

Excluded accessories or modifications /
  • Second covers for cushions, backrests or headrests
  • Head rests with included chinor neck supports
  • Hi-lo/indoor bases for wheelchairs

Glossary / Seating systems – seat and back support surfaces and their attachment hardware, plus those accessories deemednecessary (RESNA)
Off the shelf seating:- commercial positioning or pressure relief equipment for use in a wheelchair, varying in size and composition, available for purchase from a supplier.
Customized seating:- commercial equipment selected, positioned, adjusted or modified to suit individual need asdirected by a therapist.
Custom made seating:- seating fabricated by a technician to provide positioning and /or pressure relief as guided by a therapist.
Identification Of

**Previous prescriptions do not need to be for EnableNSW funding

EnableNSW Seated Mobility Appendix C Seatiing and Accessories and modificationsAugust 2016