95715-1 - HD Rehab
Contents
1. REQUIREMENTS USE OF THE WHEELCHAIR THE CAREGIVER S REQUIREMENTS THE USER IS TALL EXTENDED SEAT DEPTH EXTENDED HEIGHT BACKREST SYSTEM LONG LEGREST LENGTH INCREASED SEAT HEIGHT THE USER IS SHORT SHORT FOOTREST LENGTH REDUCED SEAT DEPTH BACK DISTANCES LOWERED SEAT HEIGHT E G UPRIGHT TRANSFER THE USER HAS NARROW HIPS AND WIDE BACKREST SYSTEM 4 OR 8 CM BROAD SHOULDERS THE USER HAS BROAD HIPS AND NARROW BACKREST SYSTEM 4 CM NARROW SHOULDERS THE USER S CENTRE OF GRAVITY IS BACK MOUNTED SEAT UNIT LOCATED A LONG WAY FORWARD E G ABDOMINAL OBESITY THE USER S CENTRE OF GRAVITY IS REAR POSITIONED DRIVE WHEELS LOCATED A LONG WAY BACK E G FORWARD MOUNTED SEAT UNIT AMPUTATION LIMIT THE ANGLE OF SEAT TILT THE USER HAS A LARGE BACKSIDE gt SELECT THE FLEXI BACKREST SYSTEM INSTEAD OF A FLAT BACKREST LOOSEN THE FLEXI BACKREST STRAPS TO MAKE SPACE FOR THE USER S BACKSIDE THE USER HAS AN ENLARGED THORACIC LOOSEN THE FLEXI BACKREST STRAPS MAKE SPACE FOR CAVITY THE USER S THORACIC CAVITY POSSIBLY USE A SOMEWHAT OPEN BACKREST ANGLE TO ELEVATE THE USER S LINE OF VISION THE USER SLIDES FORWARD ON THE CORRECT SEAT DEPTH BACKREST HEIGHT ARMREST HEIGHT SEAT AND LEGREST POSITION CORRECT SEAT TILT AND BACKREST ANGLE POSSIBLY REDUCE THE ANGLE OF THE LEGRESTS POSSIBLY TILT THE USER S PELVIS FORWARD WITH THE HELP OF THE FLEXI BACKREST STRAPS 2 POINT OR 4 POINT POSITIONING BELT2. and Document no 95758 entitled Reference Table balancing modes set out the different combinations of balancing and seat height raising lowering that are allowed along with the limitations that such adjustments may entail Please read these documents carefully before ordering special design adjustments 2 6 Seat tilting and backrest reclining The seat unit on the HD Balance wheelchair can be tilted 0 20 degrees please see Image 4a It is even possible to increase the angle of tilt to a range of 5 30 degrees but this could entail increased risk for tipping It is also possible to limit the angle of tilt Please see the Seat Tilt Backrest Recline Info Sheet for more information e IMAGE 4 The seat unit can be tilted y from approx 0 20 a and the back y rest can be reclined from 90 120 b Cj 6 rehab HD BALANCE Prescriber information 7 Please note than an individual risk assessment should be carried out by the prescriber in each individual case The body shape and weight of different users affects the wheelchair s balance to different extents RECLINING THE BACKREST The backrest can be continuously reclined from 90 120 degrees please see Image 4b The angle of the backrest is regulated with the aid of a gas spring that is assembled under the seat of the wheelchair The gas spring provides a lifting force that helps with the raising of the backrest The possibility to regulate the angle of t
3. D rehab HD BALANCE Prescriber information 18 19 dD rehab SELECT THE FLEXI BACKREST SYSTEM INSTEAD OF A FLAT BACKREST FLEXI BACKREST CUSHION WITH SIDE SUPPORT WINGS THORACIC SUPPORT STANDARD OR ADJUSTABLE HEMIPLEGIA ARMREST 2 POINT OR 4 POINT POSITIONING BELT TABLE TRAY COAMING FOR ARMREST COAMING S FOR ARMREST S SELECT THE FLEXI BACKREST SYSTEM INSTEAD OF A FLAT BACKREST CHOOSE SUITABLE FLEXI BACKREST SETTINGS DEPENDING ON THE REASON S CHEST HARNESS POSITIONING BELT EXTENDED HEADREST TUBE WEDGE SHAPED SIDE SUPPORTS ONE PIECE CALF SUPPORT FOOT BOX CALF PANEL CALF STRAP ONE PIECE FOOTREST FOOT BOX LOWERTHE SEAT UNIT POSSIBLY A SOMEWHAT SHORTER SEAT DEPTH UNLOCK FORWARD SEAT TILT 5 RIGHT HEIGHT FOR THE SEAT UNIT EXTENDED SEAT TILT 30 FIXED ANGLE BACKREST DEACTIVATE THE BACKREST RECLINE CONTROL SELECT A FLAT BACKREST ON WHICH TO BUILD THE GENTLE ADJUSTMENT SPECIAL ADAPTATION NARROW POSITIONED HAND RIMS SIDEUNIT EXTENDED HEIGHT ADJUSTABLE ANGLE PUSH BAR PUSH BAR EXTENDED amp BENDED ADJUSTABLE ANGLE PUSH BAR PUSH BAR EXTENDED DEPTH SEPARATE OPERATING HANDLES THE USER LEANS TO THE SIDE THE USER S ARM ARMS FALL S OUTSIDE THE ARMRESTS THE USER S HEAD HANGS FORWARD THE USER PRESSES HIS HER KNEE S AGAINST THE LEGREST S KNEE JOINT THE USER S
4. weakened The total width of the wheelchair can instead be narrowed by moving the hand rim closer to the wheel and level with the hub Narrow positioned hand rim 2 9 Brakes As standard a HD Balance wheelchair is equipped with push bar side units with a combined main brake and parking brake the caregiver brake The HD Balance 24 model is also equipped with separate parking user brakes These can also be ordered as an optional extra for the HD Balance 16 model The combined main brake and parking brake the caregiver brake can be deselected from both the HD Balance 16 and HD Balance 24 model COMBINED MAIN BRAKE AND PARKING BRAKE THE CAREGIVER BRAKE The brake levers are located under the push bar operating handles and are operated by the caregiver from the back of the wheelchair The parking brake consists of a socket that locks the brake into parked mode PARKING BRAKE USER BRAKE On the HD Balance 24 model there is a separate parking brake for the user This brake is a tyre brake and it is also possible to order this brake for the HD Balance 16 model if you so wish If the user has difficulty reaching the brake lever or if he she is not strong enough to operate the standard lever it is possible to order longer brake levers for the HD Balance 24 model HD BALANCE Prescriber information f ehab 2 10 Push bar As standard a HD Balance wheelchair is equipped with a push bar and height adjustable push bar side units T
5. 95758 REFERENCE TABLE BALANCING MODES 95759 REFERENCE TABLE BALANCE CONFIGURATIONS 95801 95850 ASSEMBLY INSTRUCTIONS 95930 95950 INFO SHEETS The latest versions of these documents are always available at our website www hdrehab se along with other useful documentation HD BALANCE Prescriber information f ehab 7 OVERVIEW OF OPTIONS Tables 1 2 and 3 below provide an overview of the options and settings available for HD Balance Please note that some of these alternatives could affect the wheelchair s set up possibilities or restrict its use Please refer to the relevant Info Sheet for each section before making your decision regarding the configuration of the wheelchair TABLE 1 OPTIONS TO BE DECIDED ON AT THE TIME OF ORDERING THE WHEELCHAIR AND THAT CAN T BE ALTERED AT A LATER STAGE 50 16 24 38 42 46 STANDARD EXTENDED 45 55 CM 50 60 CM REINFORCED SEAT CHOCK STANDARD BACKREST AND WHEEL FRAME ABSORBING BACK MODEL SEAT WIDTH LENGTH SEAT FRAME FRAME REINFORCEMENT TABLE 2 OPTIONS THAT CAN BE DECICED ON AT THE TIME OF ORDERING THE WHEELCHAIR OR THAT WITHOUT WITHOUT WITHOUT WITHOUT 5 30 SEPARATE OPERATING HANDLES FLAT EXTENDED NARROW 4 EXTENDED WITH OUT SIDE SUPP FIXED ANGLE 105 CALF STRAP WITHOUT WITHOUT BACKWARD 3 CM DECREASED 3 CM 0 30 ADJUSTABLE ANGLE PUSH BAR EXTENDED amp BE
6. HD Balance wheelchair features separate footrests as standard The height depth and angle of these separate footrests are adjustable As an alternative it is possible to order a one piece footrest or foot box Both of these are height adjustable and the angle of the one piece footrest can also be adjusted All footrests can be used with both the adjustable angle leg rests and the fixed angle leg rests A shorter variety of footrest is available for users with short legs Heel straps and pads for the footrests can be ordered as accessories You can find more information about how to combine long and short footrests with different lengths of leg rest in the Leg Rests Info Sheet art no 95933 10 D rehab HD BALANCE Prescriber information 3 6 Armrests There are three varieties of armrest available the standard armrest the low armrest and the hemiplegia armrest STANDARD ARMRESTS The standard armrest consists of a height and depth adjustable padded armrest plate and a padded side support The height and depth of the armrest plate can be adjusted without the use of tools When it comes to the height setting there is a graduated scale so that the armrests can easily be set to the same height The depth of the armrest plate can be regulated to provide support for the user s elbows in different sitting positions For example the armrest plates can be pushed forward to provide support when getting up from the chair and they can be p
7. LEGS GET STUCK END UP BETWEEN THE CALF SUPPORTS THE USER S LEGS GET STUCK END UP BETWEEN THE FOOTRESTS THE USER KICKS HIS HER WAY FORWARD THE USER MAKES UPRIGHT TRANSFERS THE USER REQUIRES A MORE RECLINED POSITION IN THE WHEELCHAIR THE USER CANNOT OR MAY NOT CHANGE THE POSITION OF HIS HER HIPS THE USER REQUIRES GENTLE ADJUSTMENT OF THE BACKREST THEWHEELCHAIR IS TOO WIDE FOR E G DOOR OPENINGS THE PUSH BAR IS TOO LOW FOR THE CAREGIVER EVEN WHEN IT IS SET TO THE HIGHEST POSSIBLE POSITION THE PUSH BAR IS TOO LOW BECAUSE THEWHEELCHAIR IS OPERATED IN A RECLINED POSITION THE CAREGIVER BANGS HIS HER TOES ON THE POWER PACK THAT HAS BEEN ASSEMBLED UNDER THE WHEELCHAIR THEWHEELCHAIR S PUSH BAR PREVENTS THE USE OF A STAIR CLIMBER HD BALANCE Prescriber information Info Sheet 95930 1 FOLDER HD Balance dD balance jeneration PUBLICATION DATE 2012 08 08 ADDITIONAL READING User Manual HD Balance 95701 1 Measures 95719 1 FOLDER Individual customisation FOLDER Accessories NZ gu d ae adaptation Overvi Configuration options for HD Balance jew of the ccessories available to HD Balance Jed 4 Prescription Form 95750 1 DOCUMENT INFORMATION ART NO 95715 1 VERSION B 20 D rehab HD BALANCE Prescriber information
8. NDED WITHOUT FLAT WIDE 8CM EXTENDED WITH SIDE SUPP FIXED ANGLE 90 LONG CALF PANEL FOOTBOX HEMIPLEGIA PNEUMATIC SOFT GRIP FORWARD 3 CM BACKWARD POS 5 INCREASED 5 CM 5 20 FIXED 90 105 INCREASED HEIGHT USER BRAKE STD ON BALANCE 24 PUSH BAR EXTENDED DEPTH EXTENDED FLEXI EXTENDED WIDE 4CM STD WITHOUT SIDE SUPP AMPUTEE SHORT ONE PIECE ONE PIECE SHORT LOW HEIGHT POLYURETHAN SLIM ENDAST 24 STAINLESS STEEL NARROW STD PLACEMENT STD PLACEMENT STD PLACEMENT STD0O 20 5101058 06 STANDARD CAREGIVER BRAKE PUSH BAR STD STANDARD FLEXI SAME AS SEAT WIDTH STD WITH SIDE SUPP ADJUSTABLE ANGLE STANDARD SEPARATE SEPARATE STANDARD STANDARD POLYURETHAN STANDARD ALUMINIUM STANDARD HD BALANCE Prescriber information CAN BE REPLACED CHANGED BY AUTHORISED TECHNICAL PERSONNEL BALANCING OF SEAT UNIT POSITION OF WHEEL SEAT HEIGHT SEAT TILT BACKREST ANGLE SIDE UNIT BRAKE PUSH BAR HANDLES SEAT CUSHION BACKREST SYSTEM BACKREST WIDTH BACKREST CUSHION LEGRESTS LEGREST LENGTH CALF SUPPORT FOOTREST FOOTREST LENGTH ARMREST TYRE HAND RIMS POSITION OF HAND RIMS 4 rehab 17 TABLE 3 SETTINGS THAT DETERMINED ARE DETERMINED BY THE PRESCRIBER DURING THE TESTING OF THE
9. S 4 rehab HD Balance Comfort wheelchair lt Prescriber information English ELI elc y rehab WE MANUFACTURE QUALITY OF LIFE HD Rehab helps people to improve their quality of life Our products help to create a comfortable safe and simple existence for users relatives and caregivers HD Rehab offers products designed to assist people with disabilities Our primary product area is wheelchairs which we have been designing developing and manufacturing for over 40 years We never compromise when it comes to quality Precision safety for users and caregivers functionality and design are vital catchwords for us We can almost promise that regardless of which other wheelchair you use you will notice the difference when you try one of our wheelchairs FLEXIBLE CREATIVITY IN PRODUCT DEVELOPMENT Whether you are a user a family member or a caregiver we want to hear your wishes and points of view Our designers and developers work closely together on the production of our products in our premises at Liding Our creative employees use their specialist knowledge experience and imagination to find solutions for each individual s unique requirements 2011 HANTVERKSDESIGN amp REHABILITERINGSPRODUKTER 2 4 reha b HD BALANCE Prescriber information 5 1 GENERAL 4 1 1 Target group Areas of use 4 1 2 Testing and adjusting the wheelchair 5 2 CHASSIS 5 2 1 Models 5 2 2 Frame rei
10. WHEELCHAIR 4D rehab ROTATION WIDTH ANGLE ANGLE HEIGTH BRACKET FOR BACKREST SYSTEM DEPTH DEPTH DEPTH DEPTH ANGLE ONLY THE ANGLE ADJUSTABLE MODEL ACTIVATION OF FORWARD TILT 5 DEPTH 7 POS HEIGHT BACKREST SYSTEM INDIVIDUALLY ADJUSTABLE FOR EACH USER INDIVIDUALLY ADJUSTABLE DEPENDING ON USER WEIGHT HEIGHT HEIGHT ANGLE HEIGHT HEIGHT HEIGHT SEAT TILT SEAT BACKREST BACKREST SHAPE 7 8 STRAPS BRAKE TILT LOCK ARMREST STD ARMREST HEMIPLEGIA LEGREST ADJUSTABLE ANGLE CALF SUPPORT FOOTREST PUSH BAR PLEASE SEE THE RELEVANT INFO SHEET ABOUT EACH ACCESSORY FOR MORE HD BALANCE Prescriber information INFORMATION ABOUT THE DIFFERENT SETTINGS AVAILABLE FOR THE ACCESSORIES 8 THE PROBLEM SOLVER The problem solver can be used to assist prescribers to provide the user with the best possible sitting position or to satisfy the requirements that exist It can also be used to help solve problems that may arise on account of the user s patterns of movement or the nature of the surroundings The problem solver only provides suggested solutions It is always the responsibility of the prescriber to carry out an assessment of the user s situation and to decide which measures are appropriate in each individual case The table is divided into four sections THE USER S BODY PROBLEMS THAT CAN ARISE
11. accessories that are available for the HD Balance wheelchair Please read the latest version of the relevant info sheet carefully before selecting and using an accessory The latest versions of the info sheets are available at our website www hdrehab se An assessment must always be carried out as to whether an accessory might entail increased risks for the user before a decision about the use of the accessory is taken For example it could be a matter of the risk of the user getting squashed of him her getting stuck between the accessory and the wheelchair or of an increased risk of the wheelchair tipping over The assessment of potential risks is particularly important when it comes to users with special patterns of movement such as in the case of users with spasticity exaggerated movements etc HEADRESTS AND NECK RESTS Two alternative means of supporting the user s head neck are available a headrest and a neck rest The headrest provides somewhat enhanced and scooped support for the head The neck rest is a bit smaller and softer and provides support for the back of the neck The headrest and neck rest are also available with a sideways adjustable head support cushion and with brackets for side support Side support can be used on one or both sides and is available in both a fixed angle and an adjustable angle design THORACIC SUPPORT There are two varieties of thoracic support available standard and adjustable These are used to p
12. dels is very well balanced and easy to manoeuvre A well placed point of balance and a short wheelbase contribute to these characteristics If the wheelchair is to be used by several different users each user s special requirements must be taken into consideration Furthermore the wheelchair s upholstery on the backrest and seat cushion should be washed or changed before each new user starts using the wheelchair Washing instructions can be found on the upholstery The maximum allowable user weight is stated in the Table of Measurements Document no 95719 IMAGE 1 Model 24 lo the left and Model 16 to the right 4 rehab HD BALANCE Prescriber information 1 2 Testing and adjusting the wheelchair Prescription should always take place before beginning to use a HD Balance wheelchair This applies to a new wheelchair as well as when an existing wheelchair changes users Please be aware that a new prescription could be required if a user s disability changes or new requirements arise All prescriptions and adjustments of the wheelchair MUST be carried out by authorised personnel HD Balance should be tested and the settings should be adjusted by trained personnel Prescribers An assessment of the user s safety should be carried out in conjunction with this process Instructions about how the wheelchair is to be used should have been given to users family members assistants or caregivers at the time the wheelchair is p
13. elchair is equipped with a depth adjustable seat plate to provide the user with a good support area and maximum pressure distribution The depth is adjusted via a lever located under the seat plate The seat plate is equipped with Velcro for attaching the seat cushion SEAT CUSHION A HD Balance wheelchair is equipped with cut to shape seat cushion made of foam with a comfortable seat indentation thigh support and pommel The front edge of the seat cushion 8 D rehab HD BALANCE Prescriber information 9 is angled with an overhang which minimises the risk for pressure on the hollow of the user s knee The seat cushion is attached to the seat plate with Velcro There are three alternatives available when it comes to the seat cushion s upholstery grey Trevira standard black Trevira or Dartex disinfectable Extra seat covers that can be placed over the existing cover are available as accessories in black Trevira These are elastic and can be slipped over the existing seat cover to provide an extra washable layer of protection The extra seat covers are available both with and without incontinence protection 3 2 Backrest FLEXI BACKREST SYSTEM As standard a HD Balance wheelchair is equipped with the Flexi backrest system The Flexi backrest system consists of the Flexi backrest frame with seven adjustable straps as well as the Flexi backrest cushion The straps can be adjusted to provide the user with good pelvic and lu
14. frame seat frame and backrest frame to increase its strength It is also possible to add a more flexible backrest to the wheelchair This saves wear and tear on the wheelchair s components but must be assessed in each individual case For the user s safety more regular and careful maintenance is required when using a wheelchair for which the frame has been reinforced The life span of the wheelchair will also be shorter in these cases 2 3 Choice of seat width There are four seat widths available for HD Balance 38 42 46 and 50 cm In order to be able to further adjust the seat width to suit the user extra side paddings are available as accessories which can be attached to the side supports in order to reduce the seat width Please see the Chassis Info Sheet for more information 2 4 Choice of seat depth HD Balance is available with a standard or extended seat frame The wheelchair with the extended seat frame is also equipped with an extended seat plate and an extended seat cushion Please see the Chassis Info Sheet for more information HD BALANCE Prescriber information f ehab 5 2 5 Balancing the wheelchair The wheelchair is well balanced in its standard design and suits most users requirements One should always strive to achieve a satisfactory standard configuration but in certain special cases the wheelchair s basic configuration may need to be changed This should be very carefully considered and any possible ris
15. he backrest can be taken away and replaced with a fixed angle backrest that can be set to an angle between 90 and 105 degrees This can be specified when the wheelchair is ordered or the change can be made by an authorised technician at a later time CONTROLS The seat tilt control is green and is located on the right hand side of the push bar while the backrest recline control is grey and is located on the left hand side of the push bar Each of these controls should be adjusted individually in other words not at the same time Please only use moderate force when adjusting the controls 2 7 Wheels HD Balance is available in two models HD Balance 16 which has 16 rear wheels and HD Balance 24 which has 24 rear wheels Both models are equipped with 7 175 mm front castors All tyres on a HD Balance wheelchair regardless of the model are solid and puncture proof as standard As an alternative it is possible to order pneumatic tyres and tyres with a Flexel tube to make the wheelchair easier to manoeuvre when the user is heavy The rear wheels are equipped with a quick release function 2 8 Hand rims The hand rims on a HD Balance wheelchair are made of aluminium as standard As an alternative it is possible to order other hand rims that are plastic coated for better grip and hand rims in stainless steel that are more durable than the aluminium ones The hand rims may not be removed since the wheel construction will then be
16. he side units can be 12 cm higher than the standard push bar and it is also possible to order separate operating handles a when the caregiver who will be pushing the wheelchair is tall As alternatives it is possible to order separate operating handles an extra depth push bar or a push bar that is both elevated and bent All the alternatives can be ordered with extended side units push bar handles These are used in situations where the caregiver who will be pushing the wheelchair is tall Furthermore it is possible to order an adjustable angle push bar that can be set to three different positions angles SEPARATE OPERATING HANDLES can be selected if for example a stair climber is to be used THE EXTRA DEPTH PUSH BAR can be selected if for example a power pack is to be used THE ELEVATED AND BENT PUSH BAR can be selected if the user will mostly be using the wheelchair in the tilted seat and or reclined backrest mode THE ADJUSTABLE ANGLE PUSH BAR can be easily regulated based on the user s sitting position and or the caregiver s height 2 11 Anti tip device An anti tip device is part of the standard equipment on all HD Balance models Please note that the anti tip device for the 16 model is somewhat different in design from the anti tip device for the 24 model Please make sure that you use the right anti tip device for the right model The height of the anti tip device can be set to three different positions heights and i
17. ks should be carefully assessed in each individual case MOVING THE DRIVE WHEELS The drive wheels can be assembled in two different positions front and rear according to Image 2 As standard the HD IMAGE 2 The rear wheel has a Balance is delivered with the drive wheels in the front position Tests have shown that this provides a wheelchair that is easy to drive and that has sufficiently good stability for normal users For maximum stability the drive wheels can be assembled in the rear position This provides a more stable wheelchair that is somewhat heavier to drive If the user often sits with a significantly reclined backrest and seat the rear wheel position should be used BALANCING THE SEAT UNIT SHIFTING THE CENTRE OF GRAVITY The balance plates that connect the wheel frame and the seat frame can be exchanged for alternative varieties The seat unit can thus be moved forward or backward Please IMAGE 3 The positioning of see Image 3 the balance plates SETTING THE HEIGHT OF THE SEAT UNIT The height of the seat can be adjusted by exchanging the balance plates for a lower or higher variety It is also possible to lower the height of the seat on the HD Balance 24 by changing to smaller drive wheels and castors Always be aware that the risk for tipping could increase when you change the balance and height of the wheelchair Document no 95759 entitled Reference Table balance configurations
18. ly and are used to mount the belt onto the wheelchair s seat frame in the desired position SPOKE PROTECTION Spoke protection can be assembled on 20 and 24 drive wheels The spokes are hidden behind a transparent plastic disc that eliminates the risk of injuries to hands and fingers EXTRA SIDE PADDINGS The extra side paddings enable you to adjust the width of the seat according to the user 12 rehab HD BALANCE Prescriber information and provide extra stability for the hips and thighs They are attached to the inside of the armrest s side support with the help of a pocket at the front and Velcro at the back BAG HOOK The bag hook is assembled onto the push bar and is intended for use with lighter types of bags and other such items Please remember that the risk for tipping increases if more weight is applied to the wheelchair and or if the wheelchair s seat and or backrest are angled backwards IV POLE The IV pole is used to give the user the possibility to sit up in the wheelchair even when an IV drip or tube feeding is being administered When the seat is tilted and or the backrest is reclined the angle of the mount is adjusted so that the IV pole can be kept vertical The IV pole is removable The IV pole entails an increased risk of tipping especially in case of heavy drip bags and when the seat is tilted COAMING FOR ARMREST The coaming for the armrest is assembled onto the armrest rail and prevents the u
19. mbar support It is also possible to create extra space for the user s backside or hunched back by loosening the straps Good side support for users who lean to the side can be achieved by loosening all the straps and scooping the backrest cushion The Flexi backrest system is also available in an extended version for tall users Please see the user instructions for information about how to adjust the Flexi backrest system If additional support for the trunk is required it is possible to order a thoracic support Please see the Accessories section for more details FLAT BACKREST As an alternative to the Flexi backrest system it is possible to order a flat backrest consisting of a solid backrest plate in aluminium The flat backrest is also available in an extended version for tall users ADJUSTING THE HEIGHT OF THE BACKREST There are two ways to adjust the height of the backrest One way is via the tracks in the Flexi frame for stepless height adjustment If further height adjustments are required the backrest brackets can also be moved somewhat along the backrest frame s side tubes BACKREST CUSHION The Flexi backrest cushion is made of foam with cut to shape side wings in order to provide soft but stable side support As an alternative it is also possible to order a flat backrest cushion made of foam that does not have wings The same backrest cushions that are used with the Flexi backrest system are also used with the flat backres
20. n sometimes entail limitations and certain risks More information is available in the document entitled Risk Info Special Adjustments art no 95707 HD Balance is a manual comfort wheelchair intended for use by persons in need of sitting comfort support and stability that is superior to what active and all round wheelchairs can provide The multitude of possible settings gives the user an individually customised sitting position that is well balanced and that provides maximum pressure relief A complete user manual is always delivered with the wheelchair Make sure that the user manual is always available when the wheelchair is used The abbreviated user instructions supplied in the plastic pocket on the back of the wheelchair are only intended as a supplement to the main user manual Functions such as the tilting seat and reclining backrest provide good possibilities to create variation between a stable and active sitting position and a relaxed resting position Please be aware that sitting in the same position for a long time without changing position can lead to discomfort and harmful pressure Symptoms of harmful pressure could be pain and redness of the skin that could eventually give rise to pressure related sores HD Balance is intended for use in everyday situations both indoors and outdoors and it can be propelled forward by the user himself herself or the caregiver The standard design of both the HD Balance 16 and HD Balance 24 mo
21. nforcement 5 2 3 Choice of seat width 5 2 4 Choice of seat depth 5 2 5 Balancing the wheelchair 6 2 6 Seat tilting and backrest reclining 6 2 7 Wheels 7 2 8 Hand rims 7 2 9 Brakes 7 2 10 Push bar 8 2 11 Anti tip device 8 3 SEAT UNIT 8 3 1 Seat 8 3 2 Backrest 9 3 3 Alternative backrest width 9 3 4 Leg rests 10 3 5 Calf supports and footrests 10 3 6 Armrests 11 4 ACCESSORIES FOR THE HD BALANCE WHEELCHAIR 12 5 TOOLS ASSEMBLY 14 6 ADDITIONAL INFORMATION 14 6 1 Care and maintenance 14 6 2 Ergonomics amp Patient safety 14 6 3 Transportation in vehicles 15 6 4 Permitted changes and combination agreements 15 6 5 Special adaptation 15 6 6 Other documentation 15 7 OVERVIEW OF OPTIONS 16 8 THE PROBLEM SOLVER 18 ADDITIONAL READING 20 HD BALANCE Prescriber information f ehab 3 1 GENERAL 1 1 Target group Areas of use This prescriber information is aimed at those who want to have some overall information about HD Balance and the possibilities it provides prior to prescribing the product This prescriber information is just one part of the documentation that is available regarding HD Balance and you should also read the User Manual art no 95701 the Info Sheet art no 95930 and the Table of Measurements art no 95719 All documents are based on a HD Balance wheelchair with standard configuration It is possible to specify an alternative configuration but you should think carefully before doing so because this ca
22. nt by reducing the risk for the patient sitting in an incorrect position User cards can be ordered separately if they need to be replaced A HD Balance wheelchair is ergonomic for caregivers The wheelchair s short wheelbase contributes to good characteristics when it comes to driving and manoeuvring the wheelchair Thanks to well designed balancing it requires very little effort to tilt the seat unit The seat tilt and backrest recline controls are positioned so that they are easy to reach and 14 D rehab HD BALANCE Prescriber information one can maintain one s hold on the push bar while adjusting these controls The positioning of the controls also contributes to a more symmetrical working position for the caregiver 6 3 Transportation in vehicles A HD Balance wheelchair is tested and approved in accordance with ISO 7176 19 2008 for the transportation of users in vehicles while they are strapped in to the wheelchair A headrest neck rest should be used when travelling in a vehicle The instructions provided in the user manual should always be followed carefully On the wheelchair s rear wheel frame there are transportation brackets and the front attachment points are marked on the front part of the wheel frame A HD Balance wheelchair can easily be collapsed for transportation without a user Please see the Table of Measurements Document no 95719 for the relevant measurements and dimensions in relation to transp
23. ortation situations 6 4 Permitted changes and combination agreements The use of other suppliers products together with a HD Balance wheelchair is regulated by way of combination agreements Our instructions and recommendations must be followed in order for the CE marking to be valid The document entitled Permitted changes with the CE marking intact art no 95724 specifies which changes are permitted to be made to a HD Balance wheelchair while still retaining the validity of the CE marking as well as information about which combination agreements that exist The document is available at our website hdrehab se and is updated on an on going basis 6 5 Special adaptation If a user requires further special adjustments to his her wheelchair in addition to the alternatives provided for in the standard HD Balance product range HD Rehab can make specially customised products You will find more information about this in the document entitled Information about specially customised products art no 95431 6 6 Other documentation The following documentation among others is available related to the HD Balance wheelchair 95701 USER MANUAL 95707 RISK INFORMATION CONFIGURATIONS AND ACCESSORIES 95710 ABBREVIATED USER INSTRUCTIONS 95717 OVERVIEW OF OPTIONS 95718 OVERVIEW OF ACCESSORIES 95719 TABLE OF MEASUREMENTS 95720 TECHNICAL INFORMATION 95724 PERMITTED CHANGES 95725 RECONDITIONING INSTRUCTIONS 95730 MAINTENANCE INSTRUCTIONS
24. racket It is used as reminder to facilitate the placement of the headrest neck rest or thoracic support in exactly the same position as the prescriber has set HD BALANCE Prescriber information f ehab 13 5 TOOLS ASSEMBLY The most common settings on a HD Balance wheelchair can be achieved with the aid of the following tools Under the cross beam of the seat there 15 10 amp 13 mm wrench attached with Velcro Please note that certain settings require the assistance of authorised technicians Assembling the Flexi backrest system Adjusting the height of the Flexi backrest 10 MM WRENCH 2 Adjusting the depth of the calf plates Adjusting the angle of the foot plates Assembling and adjusting the height of the thoracic support mount Adjusting the seat tilt inertia PHILLIPS SCREWDRIVER Assembling the belt mount Assembling the pommel mount 3 MM ALLEN KEY Assembling adjusting the profile stop Assembling the push bar separate operating handles 4 MM ALLEN KEY Adjusting the depth of the separate footrests Adjusting the Thoracic Support Swing 6 ADDITIONAL INFORMATION 6 1 Care and maintenance In order to achieve the best safety and a long product life the wheelchair should be kept clean and in good condition Please see the maintenance instructions art no 95730 for more information All upholstery for the wheelchair s cushions and accessories is washable at 60 degrees washing instruc
25. rovide the user with a more stable sitting position and to prevent the user from leaning to the side or at a forward angle The thoracic support is available with different mounts and in different sizes to suit users of varying size All types of thoracic support have the swing away function which allows one to swing away the thoracic support cushion for example in a patient transfer situation The mounts for the thoracic support are ordered separately or together with the thoracic support POMMELS There are two varieties of pommel available standard and forward mounted and they are available in two sizes large and small They are used to provide support to or separate the user s legs and are height adjustable The standard variety is also depth adjustable The pommel mount is assembled onto the seat plate TABLE TRAYS The table trays are available in wood oak and PC polycarbonate with space for the trunk Both varieties of table tray can be ordered with pads for the elbows The table trays have a small border that prevents objects from falling off The table tray brackets are available in two versions standard not lockable and lockable POSITIONING BELTS There are two varieties of positioning belt available a 2 point belt with two attachment points and a 4 point belt with four attachment points The length of the belt is adjustable with tightening straps set two positions from the middle The belt mounts are ordered separate
26. ser s arm from sliding off the armrest pad backwards or to the side This can be useful in a reclined sitting position or if the user s arm is weak after a stroke CHEST HARNESS BRACKET The chest harness bracket is intended to provide attachment points for various chest harnesses and similar products The chest harness bracket is assembled onto the wheelchair s Flexi backrest system and both sides of the chest harness bracket are individually adjustable in terms of height width and angle ADDITIONAL COVER FOR SEAT CUSHION The additional cover is pulled over the wheelchair s existing upholstered seat cover and facilitates the washing and quick changing of the seat cover The additional cover s upholstery in black Trevira is available in a standard and an incontinence variety HEEL STRAPS The heel straps prevent the user s feet from sliding backwards off the footrests They are assembled via the two rear holes on the footrests PADDING FOR FOOTRESTS The padding for the footrests is pulled over the footrests to provide a soft base for the user s feet if he she is sitting in the wheelchair without shoes SIDE SUPPORT PADDING FOR LOW ARMREST The side support padding is attached to the side support s plexiglass plate with the help of two pockets and is available as an accessory for the low armrest PROFILE STOP The profile stop is a clamp that is attached around the headrest s neck rest s bracket or the thoracic support s b
27. t There are three alternatives available when it comes to the backrest cushion s upholstery grey Trevira standard black Trevira or Dartex disinfectable 3 3 Alternative backrest width A HD Balance wheelchair can be equipped with a wider backrest to provide better support for users with broad shoulders and narrow hips It is also possible to equip the wheelchair with a narrower backrest for users who have a narrow upper body but are wider around the hips and backside HD BALANCE Prescriber information f ehab 3 4 Leg rests There are two varieties of leg rest available fixed angle leg rests and adjustable angle leg rests As an alternative it is also possible to order amputee leg rests The HD Balance wheel frame is designed in such a way that all types of leg rest can be used at 90 degrees with the standard configuration of the wheelchair without causing any disturbance to the castors The 90 degree position is useful for example when the user has knee contractures or in order to break up the stretch spasticity in the legs Leg rests are available in three different lengths standard short and long Please see the Leg Rests Info Sheet Art no 95933 for more information ADJUSTABLE ANGLE LEG RESTS Adjustable angle leg rests consist of an upper leg rest a calf support and a footrest They can be assembled and removed in a simple fashion involving the use of only one hand without the user s lower legs needing
28. t can also be turned and locked into inactive mode when for example you are passing over a curb or doorstep You should always have the anti tip device fully extended in active mode when there is a risk of tipping backwards and always remember to turn back and lock the anti tip device into position again if you have had it in inactive mode You can also place your foot against the anti tip device to gain a firm footing when for example the wheelchair is to be angled up onto its rear wheels PLEASE NOTE The risk for tipping can vary depending on the user s weight body shape and placement in the chair Other factors that affect the risk of tipping include the angle at which the seat is tilted the angle at which the backrest is reclined the angle of the leg rests the placement of the rear wheels and any additional load being placed on the chair s backrest The risk for tipping should always be checked in relation to the situation in which the wheelchair is being used at any given point in time and the anti tip device settings should be adjusted accordingly Please be aware that the wheelchair may NOT be used without the anti tip device 3 SEAT UNIT More information about measurements and dimensions how to change the settings and how accessories should be assembled is available in the user manual info sheet and assembly instructions The latest versions of these documents are available at www hdrehab se 3 1 Seat A HD Balance whe
29. tions can be found on the inside of the upholstery Any errors and faults that arise should be rectified immediately How the wheelchair is used affects the need for maintenance In situations of strenuous use in the case of for example users with a high degree of hypertonia and special patterns of movement or when the wheelchair is used outside a lot more regular maintenance of the wheelchair is required The estimated life of the product when used normally by one and the same user is ten years This assumes that the wheelchair is cared for and maintained in accordance with the instructions provided in the user manual and the maintenance instructions When using a power pack in the case of frame reinforcements and other special design adaptations to the wheelchair and in the case of extreme use the estimated life of the product is reduced to 5 years In such cases the care and maintenance should be carried out at more regular intervals 6 2 Ergonomics amp Patient safety A HD Balance wheelchair is equipped with scales that indicate the current angle tilt of the seat and the backrest the angle of the knee joint and the height of the armrests and the depth of the seat In relation to these scales there is a user card in which the prescriber can enter the recommended settings for each individual user This is a good way to simplify the communication between prescribers and caregivers relatives users These scales improve the safety of the patie
30. to be stretched or straightened out The leg rests are adjustable from 90 180 degrees The placement of the upper leg rest s centre of rotation means that the length of the leg rest does not need to be adjusted for most users when the angle of the knee joint is altered length compensating FIXED ANGLE LEG RESTS Fixed angle leg rests are available as an alternative to the adjustable angle leg rests and consist of an upper leg rest a calf support and a footrest As with the adjustable angle leg rests the fixed angle leg rests can be assembled and removed in a simple fashion involving the use of only one hand without the user s lower legs needing to be stretched or straightened out The fixed angle leg rests are available in a 90 and 105 design as standard although they can also be specially made at an angle of your choice AMPUTEE LEG RESTS Adjustable angle amputee leg rests are available as accessories and can be adjusted at an angle from 140 180 degrees Amputee leg rests are removable and can be turned out sideways The height and depth of the amputee leg rest s padded calf plate is adjustable 3 5 Calf supports and footrests CALF SUPPORTS A HD Balance wheelchair features separate calf supports as standard As an alternative it is possible to order a one piece calf support calf panel and calf strap The height depth and angle of the separate calf supports and the one piece calf plate are adjustable FOOTRESTS A
31. ushed back when the user needs to get close to a table LOW ARMRESTS The low armrest consists of a height and depth adjustable padded armrest plate and a side support in plexiglass Pads for the side supports are available as accessories The height and depth of the low armrest is adjusted in the same manner as for the standard armrest The low armrest is used for short users or users with a hunched sitting position HEMIPLEGIA ARMRESTS Hemiplegia armrests are available in both a right handed and left handed version and consist of a padded upper armrest and a padded side support The upper armrest is shaped to provide support to the user s arms and can be adjusted in terms of height depth and width It can also be rotated in front of the body The hemiplegia armrests are for example used for users who lean to one side who have pain in their arm shoulder or who have their arm in a cast WEDGE SHAPED SIDE SUPPORTS As an alternative the standard armrests can be equipped with wedge shaped padded side supports In the case of external rotation of the hips these side supports straighten up the user s thighs to a parallel position The pressure is distributed along the thighs and the pressure point at the knee joints is reduced The wedge shaped side supports are somewhat longer than the standard side supports HD BALANCE Prescriber information f ehab 11 4 ACCESSORIES FOR THE HD BALANCE WHEELCHAIR Below is a list of the
32. ut into use Please feel free to use the user card as part of this process although it may not replace the carrying out of a personal review It is recommended to check the wheelchair s functions on a daily basis please see the user manual for more information 2 CHASSIS More information about measurements and dimensions how to change the settings and how accessories should be assembled is available in the user manual info sheet and assembly instructions The latest versions of these documents are available at www hdrehab se 2 1 Models HD Balance comes in two different designs one with 24 drive wheels and one with 16 drive wheels please see Image 1 The HD Balance 24 model is for users who can completely or partially drive the wheelchair themselves by using hand rims on the drive wheels This model also passes somewhat more easily over obstacles such as for example curbs HD Balance 16 is a transportation model for users who do not drive the wheelchair themselves The 16 wheels enable the caregiver to come closer to the user in different situations Please see the Chassis Info Sheet for more information 2 2 Frame reinforcement If the user has a pattern of movement behaviour that places more strain on the wheelchair than use by a normal user the user should use a wheelchair in a reinforced design This applies to users with for example a high degree of hypertonia spasticity The wheelchair is then reinforced in the wheel
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