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Sitting guide

More participation & better learning

Doing homework, sitting still for classwork and studying: As a father of two school-age children, I know how exhausting and at the same time important this is for children. A quiet learning environment with their own desk and a suitable chair helps children to concentrate. And not the kitchen table with a chair that's far too big.

Children with disabilities should also be able to reach their full potential. For mental development and learning, children must be able to participate in lessons and daily activities in an alert, attentive and focused manner.

Sitting well on the right chair is the basis for motor skills for writing, playing and eating. Easy handling, the right functions and, last but not least, an appealing look promote participation in the classroom community, with friends and family. The right learning chair for kindergarten, school and at home creates the basis for the best possible development of children.

Why does a chair make the difference?

Whether with or without a handicap - a good sitting posture is crucial for the mental and motor development of children. A therapy chair makes it easier for children with disabilities to participate and helps them learn.

Sitting posture plays an important role in the development of activities and participation in everyday life for all children. With good sitting posture, children can more easily participate in everyday activities at home, such as sharing meals with family at the table, using the computer at the table, or recreational activities with friends and family. At school, the child sits in class and at home on homework. Studies show how important good sitting posture is, especially when learning. Being able to sit properly means more participation. Only those who feel comfortable can concentrate better in class. That's why children need a chair that is comfortable and gives them the right support.

The right sitting posture is the be-all and end-all

A good sitting posture follows basic ergonomic principles that allow movement and flexibility. The aim is to avoid one-sided stress and tension, prevent pain and fatigue, and promote activity and independence. Concentration, learning and well-being can also be improved with the right chair.

Easier learning through an "active" sitting posture - this is how it works:

Those who sit properly are better able to participate in class & recreational activities. To achieve an active sitting posture, you should 3 Principles be observed:

Stable seat base:

The pelvis, thighs and feet must be adequately supported for stable sitting. This enables children to actively participate in lessons and leisure activities.

Free range of motion:

The freedom of movement of arms, hands and head also promotes movement and activity. For example, children can lean forward - an important movement sequence for numerous everyday activities.

Support for the back:

Stability with simultaneous mobility in the trunk, shoulders and head improve balance in the back For further support, armrests can be used, for example.

So all win

Last but not least, the "right" therapy chair or good seating promotes interaction with family and friends and thus participation in everyday life - a quality of life for both child and parents.

Hello!

"Be sure to get advice on questions about assistive devices: From your child's therapist, from the children's rehab specialist dealer or even from us. I would be happy to name a specialist dealer near you."

Anette Detjen, Rehab Counseling

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Simply try it out at home free of charge and without obligation

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When & Why does my child need a therapy chair?

Many parents feel uncertain: "Do we really need to worry about a therapy chair as long as our child can sit in a normal chair despite a handicap?" "It pays to try it out," say experts. Because the extra support promotes development.

Children with disabilities are often less active during the day than their peers. They participate less often in activities and tend to spend more time sitting.

Support, comfort and stability are required so that they do not tire but can concentrate well. A therapy chair can be adapted to your child's individual needs with different seating surfaces and backrests. This makes it easier to sit upright and remain attentive.

Karen Lyng, Occupational Therapist / Master's Degree in Rehabilitation

Ergonomics is the key

"For children with disabilities, good ergonomics when sitting is of great importance. This is because many activities take place while sitting. But good sitting ergonomics at the workplace is also important for caregivers and therapists, e.g. during care or therapy for children and adults."

Self-determined and active with handicap

Children with mobility impairments have different needs due to their specific disability. They benefit from a therapy chair.

Because of their handicap, they often have problems with balance, muscle weakness, paralysis, pain and fatigue. Many cannot move freely and have a limited range of action. To adopt an under-supportive sitting posture, they need stability, safety and comfort.

A therapy chair offers a supportive seat, options for manual or electric seat height adjustment, a supportive backrest, armrests and a braking system. Whether in the classroom or during leisure time, the chair allows children to better engage and participate in everyday activities.

In particular, an uncomplicated electric height adjustment can be used quickly and easily by the child itself. If the seat fits the table height perfectly, children don't tire as quickly and playing and learning is simply more fun. It often turns out that the chair makes them more active. They move around while sitting or use it like a walker to be mobile indoors.

Therapy chair provides calm and concentration

For children who quickly become restless or have concentration difficulties due to ADD /ADHD, a normal chair does not provide sufficient support.

You need more comfort, stability and support for the right sitting posture. A few little extras help you focus: A height adjustment so your feet are firmly planted on the floor or a support. Specially shaped and padded seat and back surfaces for more stability. And an easy-to-use brake that gives children a sense of security.

A therapy chair can always be adapted to the child's personal needs. This applies to the seat height as well as to practical accessories, e.g. an electric brake. For those who prefer it simple, there are chairs with just a few important adjustment options - for maximum concentration in the classroom.


One chair - a thousand possibilities for children with disabilities

Where is a therapy chair actually used? The answer is: wherever children are out and about alone or together in everyday life. Whether in kindergarten, at school or during leisure activities - a therapy chair means safety, flexibility and participation.

Useful companion for playing and learning

"I can do it all by myself!" - Children with disabilities also want as much freedom and independence as possible at home, in kindergarten, at school or in institutions. A therapy chair is therefore an important companion for them. It provides security and support for everyday activities with family and friends, such as eating, doing homework or playing.

All children want to be "like the others" and sit on a chair that is similar to the other chairs in the classroom. That's why a special school or therapy chair is not so different from an ordinary school chair. Most children accept their special chair well once they realize the benefits it brings. Classmates and friends accept the therapy chair once they have learned more about it and know what purpose it serves and exactly how it works. So it is important to talk to each other about the subject.

In kindergarten as well as in rehabilitation and care facilities, the chair is a useful helper for any activities that take place while sitting. It also promotes children's mobility with its large, lightweight casters as well as the push bar and a central brake for caregivers.

At school, a therapy chair allows adaptation to very different desks thanks to electric or manual height adjustment. Children with and without a handicap are therefore always at eye level.

To meet the demands of everyday life, a therapy chair must be robust. It should be easy to operate and adaptable for a wide range of activities. Safety is also an important consideration. This applies not only at home, but especially where other children and caregivers handle the chair. A simple, safe brake is therefore highly recommended.

Teachers also want a simple and safe chair, as they have to take care of many children at the same time. It should be easily adaptable to the child's needs as well as different activities. A therapy chair can "grow" with the child. Seats and backrests are easily changed depending on the size and individual need.

For parents, the focus is on ensuring that their child sits well and can participate in all activities at school and at home. They want an uncomplicated model that they can easily adjust in height. The chair should also promote the child's mobility by allowing him to push himself off with his feet or be wheeled around the house by his parents.

Karen Lyng, Occupational Therapist / Master's Degree in Rehabilitation

A chair for all occasions

"The school day demands a certain flexibility from the children. During breaks, classrooms are frequently changed. In order for children with disabilities to be able to participate everywhere without any problems, their chair should be easily and quickly adaptable - to different table heights as well as to different work situations."

René Müller, Works / Mathematics Teacher

"In the workshop and the music room, we have different desks than in normal lessons. A chair that can be adjusted in height is therefore a great thing!"
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Lisa-Marie, 9 years

"Laura has the most beautiful chair in our class. She can roll around with it and make herself really tall. I think that's really cool!"
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Requirements for modern therapy chairs

Simple and functional - when it comes to therapy chairs for active kids, the principle is "less is more!" After all, the girls and boys want to be as independent as possible with their chair. In exchange with parents and teachers, experts have developed solutions.

Practical functions for more participation

Therapy chairs should precisely meet the individual requirements of children. However, most girls and boys do not need a highly complex chair. They need a model that allows them to be active and participate in normal everyday life with their peers.

A design that children like

The chair's appearance is important because children do not want to stand out and want as much normality as possible, even with a handicap. A good therapy chair does not stigmatize, but supports with its design the togetherness during learning and playing.

Flexibility for school and leisure

Whether at school or at home - the therapy chair must be able to cope with the children's moving everyday life. That's why it's important to be able to adapt it to different learning and play situations in just a few simple steps.

Individual equipment according to needs

A good therapy chair is customizable. If it is to be suitable for a wide range of disabilities and needs, it must be available in different versions.

Support for therapists and caregivers

The use of therapy chairs also means relief for all those who work with and care for the children. Large wheels promote mobility. A height-adjustable seat makes it easy to get in and out of the chair.

Expert advice

A thorough analysis of the child's needs and requirements is important in order to select the right chair and accessories. Professional advice from therapists and rehab experts helps to put together the right model.

Useful accessories

There is a wide range of accessories for almost all chairs, so that every child gets his suitably equipped chair.
Karen Lyng, Occupational Therapist / Master's Degree in Rehabilitation

Better working conditions for teachers and caregivers

"Not only children with disabilities benefit from therapy chairs, but also their caregivers. Simply helping children to stand up and sit down with a height-adjustable therapy chair is a relief for their backs. Thanks to the large, smooth-running wheels, caregivers can move the child back and forth in the school building without effort."

How to properly adjust the chair

Putting the child on the therapy chair and adjusting the height is not enough in most cases. The chair must fit the child - it must be "adapted" to the child. Your child's therapist or rehab counselor will take care of that. - Only when the seat, backrest and footrest are optimally positioned will the child benefit from the new chair.

Notes on ergonomics

The ergonomics must be right. - This is especially true for children with disabilities, because they spend a lot of time sitting. However, good ergonomics is not a specific sitting posture, but rather a change to different sitting positions for a wide range of daily tasks.

Use the seat and backrest adjustment options to vary the child's sitting posture and adjust the seating position depending on the activity.

The child should sit as close to the table as possible so that he or she can comfortably attend to his or her task without having to bend or strain the back and neck area too much. Also make sure that the height setting and seat angle are correct.

It is important to carefully review the personal needs of the child before deciding on a particular chair and appropriate accessories. It is advisable to seek professional advice here. A therapist or other caregiver should always support the child later in adjusting the chair correctly. Keep in mind that the seating position is optimally adapted to the child's current activity!

Pelvis position

Stability is crucial for activity. Ensure a neutral pelvic position. Support this stable sitting position with the appropriate adjustment of the seat and good foot contact with the footrest or floor. The neutral pelvic position is important so that the lower part of the body forms a stable base and muscles and joints are used optimally.

Soft padded ergonomically shaped seats and backrests are recommended for even more support and comfort.

Upper body support

A perfectly fitting backrest promotes the stability of the body. Therefore, pay attention to the size, because a backrest with too small a support surface reduces stability. Use the backrest as well as the armrests and the table as supports.

To counteract lower back pain, choose an adjustable backrest. Adding a seat tilt makes it easier to maintain an upright posture and get into forward lean. The ability to actively lean forward is critical for many activities.

5 steps to adjust a therapy chair

SEAT HEIGHT: Make sure the child's feet are flat on the floor or footrest.

BACK REST: Adjust the height of the backrest so that it primarily supports the lower back.

SEAT TILT: Most children use the seat in a "neutral" position. Forward tilt supports an upright, active posture. The backward tilt supports stable sitting.

FOOT SUPPORT: Make sure that the child's feet are on the floor or on the footrest. This is the only way to ensure sufficient balance and stability.

ARM REST: The shoulders should be relaxed. The arms rest on the armrests to avoid shoulder pain.


Which dimensions are decisive - and why?

Every child is different. To find the right therapy chair, the child's personal needs and requirements must be known. The body measurements are the be-all and end-all. But children grow, of course. And the degree of their disability may change. Check every year to see if the chair needs to be readjusted. The following measurements are crucial.

Seat width

The better the seat width fits, the more upright the child sits in his therapy chair.

The seat width is determined while sitting at pelvic height. It is measured from one outer side of the thigh to the other. Precise pelvic guidance is the ideal prerequisite for remaining stable during upper body activities.

Mentally add two centimeters so that there is still room for the clothes.

Seat depth

For the child to be able to sit properly and stably, it is also important to have an optimum seat depth. The seat depth is the distance between the back line and a point about two fingers' width above the back of the knee.

This gives the lower legs enough room to move and keeps them well bled.

Lower leg length

The child's feet should be at a 90° angle on the footrest or floor. Now measure the line between the back of the knee and the sole of the foot.

A therapy chair always has a height-adjustable seat with gas pressure spring or electric adjustment. It is best to seek professional advice on this.

Choose gas spring for children who can stand and walk, electric adjustment for children who are unable to do so.

Back height

A perfectly fitting back height is important so that the child adopts a healthy sitting posture and sits stably enough. The backrest of a therapy chair can be adjusted in position, height and inclination.

Seek advice to ensure that the chair really suits the child.

A lumbar support gives additional support to the lower part of the back during a wide variety of activities.


Mobile in the classroom - application example

School is not just about cramming knowledge - promoting independence and togetherness is just as important. School therapy chairs, which facilitate handling for teachers and caregivers, promote activity in the classroom.

The board hangs too high to do a task in front of the class on the board while sitting.

No problem if the therapy chair has a simple, generous height adjustment.

With push handle and easy-rolling casters, maneuvers easily in tight spaces.

Comfortably back at the group table with classmates in the study group.

Watch the video: Application example on the blackboard


Accessories for therapy chairs

Once a therapy chair has been selected, the question of accessories arises. True to the motto "as little as possible but as much as necessary", it is important that the accessories support the child's movement potential and do not restrict existing abilities.

Footrest

A footrest provides stability and "grounding" for the child. In therapy chairs, they are attached directly to the seat. When the seat height is adjusted, the support moves with it so that the feet do not dangle in the air. This helps the child stay focused and calm, regardless of the height of the table. There are other accessories for footrests, such as foot straps for additional support on the support. The footrest can also be used as a step when the child climbs onto the chair or down.

Thoracic pads and thigh guide

Thorax pads are suitable for children who need support on the sides and front of the torso. Height, depth and width are adjustable. They can be swung off to allow further movement.

A padded thigh guide is used to support the thighs from the front and the pelvis from the back. It can be individually adjusted in depth and angle. As a result, children sit stably and their range of movement is restricted as little as possible.

Both supports are suitable for children who need extra stability from the front and sides.

Abduction block

An abduction block guides the child's thighs and prevents the legs from rolling over, as this leads to an unstable, slouching sitting posture. This allows children to maintain a good and comfortable sitting position.

Lap belt

A pelvic belt is suitable for children who still need a lot of support when sitting. The belt provides optimal support for the pelvis and ensures that children do not slide forward off the chair. A four-point pelvic belt provides even more safety and stability.

Headrest

For many children with disabilities, a headrest is very important. It provides safety and support during seated activities. For children who often move uncontrollably, the support prevents serious neck and head injuries. Height, depth and angle can be adjusted as needed for best possible head and neck support.

Push bar

There are also useful accessories for the child's caregivers. The multi-adjustable push bar can be adjusted in height, depth and angle to suit the caregiver so that they can move the child over short distances without effort. The handle is simply removed in a few simple steps if required.

Therapy table

If children move around uncontrollably, they often can't sit at a table with other children as well. Others simply need a little more privacy or space for communication aids. A therapy table can be adjusted in height, width and depth to match the child's sitting position. It can be folded away and removed from the chair.

Karen Lyng, Occupational Therapist / Master's Degree in Rehabilitation

Accessories for more quality of life at work

"We all want good working conditions. Teachers and school assistants get exactly the support they need in everyday life with special school and therapy chairs. The adjustable seat height makes it easier for children to stand up and sit down, thus also relieving the burden on caregivers. Because they no longer have to work with their backs bent when the child needs help. A push handle and large, smooth-running wheels provide support when changing classrooms during breaks."

Status survey - What assistive devices does my child need?

A needs assessment form makes it easier for parents, caregivers, and providers to clearly describe and document a supply of assistive technology.

Many stakeholders are involved in the provision and use of assistive devices. In order to find the best possible aid for the child's development and participation in the respective environment, it is advisable to clearly document and describe the need.

For example, the following information is gathered:

  • general information about the child
  • accompanying therapeutic measures
  • Classification of the degree of disability (e.g. according to GMFCS)
  • Body functions (physical and mental)
  • Activities and participation

The classification of motor impairments in children with cerebral palsy is based on the Gross Motor Function Classification System (GMFCS for short) of the ICF. The GMFCS system includes five levels. The classification is based on the ability for independent mobility and the need for assistive technology support. Parents can help with the classification, as they can usually assess their child well. GMFCS is simple and quick to use, requiring only about 15 minutes for experienced professionals.

Stage I

Free walking without limitation; limitation of higher motor skills.

Stage II

Free walking without walking aids; limitation in walking outside the home and on the street.

Level III

Walking with walkers; limitation in walking outside the home and on the street.

Stage IV

Independent locomotion limited; children are pushed or use e-wheelchair for outdoors.

Stage V

Independent locomotion severely limited even with electrical aids.


Illustrations taken with kind permission from: "GMFM and GMFCS - Measurement and Classification of Motor Functions", Dianne Russel et al. Verlag Hans Huber, Hogrefe Verlag, CH-Bern, Ill. Prof. Kerr Graham, AUS-Melbourne.

Status survey to determine the need for aids

Use the survey form from rehaKIND e.V. to document the provision of aids.


What is the ICF and why is it so important?

The basis for the provision of assistive devices is not only legal requirements such as the entitlement to benefits for assistive devices, self-determination and participation in SGB XI. The ICF must be taken into account when assessing and justifying the provision of aids.

ICF means "International Classification of Functioning, Disability and Health".. (The ICF is a classification of the World Health Organization (WHO), which was first created and published in 2001 and is considered a globally recognized standard. It describes the current functioning, activity and participation of a person in order to derive participation goals, support measures and process recommendations.

Significance of the ICF for the provision of assistive devices

Aids are intended to ensure the success of medical treatment, prevent an impending disability or compensate for a disability. For the successful provision of an aid, an individual care concept must be created for the child.

For this purpose, the classification according to the bio-psycho-social model of the ICF is included. This model describes a current state of health and the interaction between the components. With the help of the ICF it is described what the child can do and what help and support he needs.

Objective: Auxiliary supply therapy chair

The ICF classification is used, for example, to request a supply of a therapy chair for children. The goal-oriented justification of the supply is always better than having to formulate an objection later. Example:

Health issue: Muscular dystrophy

Body functions and structures:

  • Strengthening of the trunk, shoulder and leg muscles
  • Compensate for degeneration of the musculature and defects in affected muscle groups

Activity: Within 8 weeks, be able to independently change sitting position by straightening the thorax and point to content on the board.

Participation: participate independently in school presentations directly on the blackboard or whiteboard

Environmental factor: Barrier-free classrooms with direct access to the blackboard, suitable aids (height-adjustable therapy chair for children) are available

Person-related factor: Strengthen self-esteem through active role in group work in school, motivation to actively participate in lessons available

The right to participation

"Time and again there is talk of the right to "participation", i.e. "being included in a life situation". For people with disabilities, there is even a legal right to participation in SGB IX and thus also to assistive devices such as gait trainers. This is because they promote self-determination and equal participation in social life. This active participation is an important building block in child development."

FAQ - Frequently asked questions

Does a therapy chair increase my child's mobility?
The therapy chair definitely increases your child's mobility - indoors and on short distances. Smooth-running castors with central brake support children who want to move around the room or change rooms. The child can push off with his feet or use the chair like a walker.
Why do I need to pay attention to the child's body weight when choosing?
If the child is too heavy, the chair may not be able to hold him or her properly. Therefore, please inform yourself about the maximum load capacity. You will find information in the user manual or directly on the frame.
Who can make modifications to the chair and supply custom accessories?
Structural modifications to the chair may only be carried out by trained specialists in suitable facilities or, for example, by orthopedic technicians in specialized shops. This also applies to special construction accessories. (We will be happy to name a specialist in your area: 04761 8860)
How many years is a therapy chair used?
Therapy chairs are suitable for reuse. This means that your health insurance company may provide you with a used chair. The chairs are designed to withstand extraordinary stress. If they are handled properly and serviced regularly, you will enjoy them for a long time. Your specialist rehab dealer or the manufacturer will inform you about the useful life of your therapy chair.
Does prescribing therapy chairs put a strain on my doctor's budget?

In contrast to medicines and remedies, the prescription of medical aids does NOT burden the physician's budget. Aids are paid for by the health insurance fund. That is why the provision of an aid must be approved by the health insurance company in advance. Info for differentiation:

  1. Medicinal products are substances intended for the cure or prevention of diseases (drugs)
  2. Remedies are all personal medical services, e.g. physiotherapy
  3. Auxiliary means are all material medical means that serve the treatment of the sick.
As parents, can we adjust the therapy chair ourselves if our child has had a growth spurt?

In fact, you can make many adjustments yourself if your child is no longer sitting well. These include, for example, the seat height and the positions of the backrest, footrest and armrests. However, have a professional make more complex modifications, such as changing the seat or backrest. Your child's therapist or a specialist dealer will certainly be happy to help.

My child cannot walk and would like to adjust the seat height himself. Is that possible?

Children who can hardly or not at all walk themselves are given a seat with electric height adjustment. They only have to press one button and are therefore relatively independent.