Attending the PMG Conference 2019 was a great couple of days, listening to and mixing with peers, all of whom have a passion for posture and mobility; hearing Vicky Curling and Suzanna Shari present the clinical case study “Feeling Hot! Hot! Hot!” was a particularly good learning experience for me. Being a professional working with people with profound seating and postural needs, I often see patients suffering with overheating and sweatiness, and it is known to be a detrimental factor in an individual’s comfort, social engagement, skin breakdown and quality of life.
It was gratifying to hear from Suzanna about the patient-focused team at the wheelchair service of Guys and St Thomas’ NHS Trust (GSTT) who weren’t prepared to provide the ‘normal’ moulded wheelchair and methods of ventilation for a patient who significantly overheated, when these were not meeting the clinical need.
Rafael required several clothes changes each day, was unable to have the heating on at home for other family members, required up to four fans to help cool, needed multiple changes of in-situ slings, and also had unwanted behaviour such as scratching. When the seating ventilation was improved, the results were a much better quality of life, not just for Rafael, but for his family and care team too.
Kings College Hospital Rehabilitation Engineering Division, where Vicky works as a Specialist Rehabilitation Engineer, manufactured a custom back support in collaboration with the GSTT wheelchair service. The company WheelAIR was contacted, and their product integrated into the custom back support by carving channels into the foam and mounting the fans around the back and bottom of the chair. Vicky reported that studies show that, when someone sits in a wheelchair, the back support will heat up 2.2 degrees Celsius within 30 minutes, and this increases as time goes on. The wheelAIR product can reduce this rise in temperature, which consequently reduces the amount of sweating.
From a physiotherapy perspective, providing patients with the optimum postural support in wheelchairs/seating is vital to minimise any future deterioration in posture. The added benefit of this cooling technology is that no aspect of postural support is compromised.
It was a great example of how relatively new technology is working successfully within NHS services to improve a patient’s quality of life by reducing overheating. This particular outcome was down to the pro-activeness and patient-centred focus of the GSTT wheelchair service; I do hope that other services will follow suit and, as a result, more patients like Rafael will benefit.
Photograph (left to right): Suzanna Shari and Vicky Curling at PMG Conference 2019