Name of the Procedure:

Reclining Back Addition to Pediatric Size Wheelchair (HCPCS Code: E1014)

Summary

This procedure involves adding a reclining feature to a pediatric wheelchair. This modification allows the wheelchair's backrest to recline, offering improved comfort and support for children with mobility challenges.

Purpose

The reclining back addition is designed to enhance support and comfort for children who spend extended periods in their wheelchairs. It aids in better posture, reduces pressure on the spine, and helps prevent pressure sores and fatigue.

Indications

• Muscular dystrophy
• Cerebral palsy
• Spinal muscular atrophy
• Severe scoliosis or other spinal abnormalities
• Postural instability

Preparation

• No fasting or specific medication adjustments are generally required.
• A seating assessment by a physical or occupational therapist to determine wheelchair specifications.
• Measurement of the child's current wheelchair to ensure compatibility.

Procedure Description

1. Assessment and Measurement: A healthcare provider evaluates the child's current wheelchair for compatibility and takes precise measurements.
2. Selection of Equipment: Choose an appropriate reclining back system that fits the pediatric wheelchair.
3. Installation:
   • Disassemble the existing wheelchair backrest.
   • Attach the reclining back mechanism to the wheelchair frame.
   • Ensure all screws and bolts are secured tightly for safety.
4. Final Adjustments: Customize the angle and tension of the reclining feature to maximize comfort and support.
5. Safety Checks: Perform a thorough safety check to ensure the reclining function operates smoothly and safely.

Duration

The installation typically takes 1 to 2 hours.

Setting

This procedure is usually performed in an outpatient clinic or a rehabilitation center specializing in mobility aids.

Personnel

• Physical or Occupational Therapist: For assessment and measurements.
• Rehabilitation Specialist or Technician: For installing the reclining back feature.

Risks and Complications

• Mechanical Failure: Rare issues with the reclining mechanism, which can be prevented with proper installation and regular maintenance.
• Pressure Sores: Although the reclining back is meant to reduce this risk, improper use can still lead to pressure sores if not monitored.

Benefits

• Enhanced Comfort: Immediate improvement in seating comfort.
• Reduced Pressure Sores: Better weight distribution reduces the risk of pressure sores.
• Improved Posture: Better support for the spine and overall posture.

Recovery

• Minimal Downtime: The child can use the wheelchair immediately post-installation.
• Follow-Up: A follow-up appointment may be needed to ensure everything is functioning correctly and to make any necessary adjustments.

Alternatives

• Tilt-in-Space Wheelchair: Offers similar benefits but with a different mechanism that tilts the entire seating system.
• Customized Seating Systems: Tailored for specific needs but may be more costly and time-consuming.

Patient Experience

• During Procedure: The child will not participate during the actual installation; minimal discomfort.
• After Procedure: Improved comfort and support; caregivers should regularly check for signs of pressure sores and ensure the system operates smoothly.
• Pain Management: Generally not required, but caregivers can ensure comfort and safety.

With these enhancements, children with mobility challenges can experience a significant improvement in their day-to-day comfort and overall quality of life.