Performance Health Products. THE V-Trak SYSTEM ASSESSMENT MANUAL. Issue 3.1

Transcription

1 Performance Health Products THE V-Trak SYSTEM ASSESSMENT MANUAL Issue 3.1 July The information contained in this manual is the property of Performance Health Products Limited, Unit 32 Village Farm Road, Village Farm Industrial Estate, Pyle, Glamorgan, CF33 6BL and may not be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, nor stored in any retrieval system of any nature without the express written authority of Performance Health Products Limited.

2 TABLE OF CONTENTS Chapter Page TABLE OF CONTENTS... 2 LIST OF ILLUSTRATIONS... 4 SAFETY NOTICES... 7 INTRODUCTION DESCRIPTION ASSESSMENT KITS ASSESSMENT PROCESS THE V -TRAK SYSTEM BACKRESTS THE ASSESSMENT PROCESS SELECTING THE BACKREST Option 1 - One Piece Backrest Option 2 - One Piece Backrest combined with an Additional Segment Option 3 - Fully Segmented Backrest Option 4 - Tandem Backrests using an Additional Set of Hardware Selecting Segments Creating Cavities Extending the Height Adding Segments to One-piece backrests Trunk Taper Risk Assessment - Overloading SELECTING THE MOUNTING HARDWARE Mounting Blocks Badger or Vixen Wheelchairs Attachment Arms Central Mount Central Mount/Arm Assembly SELECTING ACCESSORIES V-Trak Headrests and Headrest Accessories Third Party Headrest Adapters V-Trak Thoracic Supports V-Trak Supplementary Accessories Alternative Covers INSTALLING THE SELECTED COMPONENTS ASSEMBLING AND INSTALLING THE BACKREST Joining Segments ASSEMBLING AND INSTALLING THE MOUNTING HARDWARE Mounting Blocks Installation of Standard Mounting Blocks...35 Issue 3.1 Page 2 of 52

3 TABLE OF CONTENTS (Continued) Chapter Page Installation of Universal Mounting Blocks (MB-R-UE and MB-R-US) Installation of Iniversal Mounting Blocks (MB-UN) for NETTI and ETAC Wheelchairs Central Mount and Arms Central Mount/Arms Assembly INSTALLATION AND POSITIONAL ADJUSTMENTS INTRODUCTION BACKREST ADJUSTING THE BACKREST SHAPE - AXXIS RANGE Adjusting Zone Adjusting Zone 2 to ADJUSTING THE BACKREST SHAPE - COMFORT (THERAPOD) RANGE Adjusting the Vertical Profile REMOVING AND REPLACING THE V-TRAK BACKREST INTRODUCTION REMOVING THE BACKREST REPLACING THE BACKREST MAINTENANCE, WARRANTY AND ORDERING MAINTENANCE WARRANTY ORDERING USING THE PRESCRIPTION FORMS - UK ONLY ORDERING FROM YOUR DEALERS - OUTSIDE THE UK LIST OF APPENDICES...51 Appendices Appendix 1 Appendix 2 Appendix 3 Appendix 4 Appendix 5 Appendix 6 Standard Assessment Kits - Contents Mounting Block Packs - Contents The V-Trak Axxis Prescription Order Form The V-Trak Comfort Prescription Order Form The V-Trak Classic Prescription Order Form Crash Testing Certificate Issue 3.1 Page 3 of 52

4 LIST OF ILLUSTRATIONS Figure Page 1 The V-Trak Ranges The V-Trak (One Piece Backrest Illustrated) One Piece Backrest One Piece Backrest Combined with an Additional Segment Standard/Quick Release Hinge Fully Segmented System Tandem Backrests Combining Segments Alternative Combinations Creating Cavities Trunk Taper Mounting Hardware Components Assembled Mounting Hardware Tube Gauge Mounting Block Selection Universal Mounting Blocks The Badger Mounting Kit Attachment Arms Central Mount Central Mount/Arm Assembly Minimum and Maximum Dimensions Standard Bead Cushion Headrest (HS SC) Extended Bead Cushion Headrest (HS AC) Standard Winged Head Support (HS AW) Large Winged Head Support (HS AWL) Track Extension Track Extension In-situ Third Party Headrest Adapter Third Party Headrest Adapter In-situ Headrest Adapter Thoracic Support - Right Hand Thoracic Support - Inverted Thoracic Pads Thoracic Pad Orientation - Vertical Thoracic Pad Orientation - Rotation Thoracic Pad Profiling Otto Bock STS System Shell Stabiliser/Wrap Adjuster (BM STA) Issue 3.1 Page 4 of 52

5 LIST OF ILLUSTRATIONS (Continued) Figure Page 39 Extended Shell Stabiliser/Wrap Adjuster (BM STX) Cushion Retainer (BM ACR) Secondary Arm System - Standard Secondary Arm System - Thoracic Version (BM SAT) Harness Carrier Harnessing Kit for Secondary Arms (BM AHK) Recycling Kit (BM ARK) Alternative Covers Backrest Systems Joining Segments Hinge Adjustment Mounting Block Positions Installation of Standard Mounting Blocks Mounting Blocks MB-R-UE and MB-R-US Angled to Rear Mounting Blocks MB-R-UE and MB-R-US Installed to Front Mounting Blocks MB-R-UE and MB-R-US - Use of Spacers Mounting Blocks MB-UN Angled to Front Mounting Blocks MB-UN Angled to Rear ETAC Tube Inserts Assembly of Central Mount and Arms Assembly of Central Mount/Arms Assembly Attaching the Backrest Adjusting the Backrest Height Adjusting the Backrest Angle Backrest Fore/Aft Adjustment Backrest Asymmetric Adjustment Backrest Extreme Rearward Adjustment, Blocks to Rear Backrest Extreme Rearward Adjustment, Blocks to Front Asymmetrical Adjustment - Axxis Vertical Profiling - Axxis Access to Adjustments - Axxis Strapping Arrangement - Comfort (Therapod) Adjusting the Vertical Profile - Comfort (Therapod) Vertical Profiling - Comfort (Therapod) Backrest Removal and Replacement Loose Cover Washing Instructions Issue 3.1 Page 5 of 52

6 Intentionally Blank Issue 3.1 Page 6 of 52

7 SAFETY NOTICES Earlier V-Trak Systems This manual provides support and instructions for current V-Trak systems. If the V-Trak system you are using does not correspond with the illustrations in Chapter 1 of this manual, please refer to the Issue 2.0. Installation This system must be prescribed and installed by suitably qualified personnel in accordance with the guidance and instructions contained in this manual. Always observe good engineering practices: Make sure that all fasteners are installed and are tightened correctly and evenly Make sure that all locking nuts are installed and are tightened correctly and evenly Check that the system is correctly aligned and operating smoothly. Stability All seating and cushioning devices can affect stability and handling characteristics of the host wheelchair. Check the final installation to determine any changes and alert and instruct the user accordingly. Transportation When a wheelchair fitted with the V-Trak system is used as seating for transportation, the following precautions must be taken. The host wheelchair should be secured within a vehicle in accordance with the manufacturer s recommendations. Identify and observe any statutory regulations and/or guide-lines applicable in the country of use (UK - refer to the Department of Transport Guidelines leaflet VSE87/1 The Safety of Passengers in Wheelchairs on Buses ). The V-Trak system is secured to the wheelchair by locking levers on either side of the system. Check that the locking levers function correctly and secure the system to the wheelchair before transportation. After installing the wheelchair in a vehicle, use an approved three point shoulder and pelvic safety belt securely fastened to the vehicle. To reduce the risk of possible whiplash injuries, a correctly adjusted head support should be fitted to the system. Guidance for User/Carer Make sure that the user receives a completed Installation and User Guide and understands the contents. Servicing The instructions given for installation and adjustment have been determined on the basis that the system will be checked periodically by qualified personnel. The minimum periods are once every year for adult users and once every six months for children. Special circumstances may require more frequent servicing intervals. Crash Testing Refer to Appendix 6. Issue 3.1 Page 7 of 52

8 INTRODUCTION V-Trak is the trade name of a fully adjustable, wheelchair backrest system, which covers most aspects of postural management and is designed to replace the ubiquitous canvas back. The V-Trak components are used in combination with the wide range of backrests specifically designed for comfort and to cater for extreme clinical requirements. The system is an open system for special seating needs. It is compatible with a wide range of V-Trak and third party accessories to allow the specification of the best combination of products for the client. This manual does not seek to train or direct clinicians in the process of seating, it merely illustrates the range and uses of available components that may be used to achieve the desired results of the Assessor. However, the versatility of the system ensures that the skills of professional seating clinicians can be fully deployed. Further information can be obtained from: Performance Health Products Limited Unit 32, Village Farm Road Pyle, Mid Glamorgan CF33 6BL UK Tel: +44 (0) Fax: +44 (0) php@talk21.com Issue 3.1 Page 8 of 52

9 CHAPTER 1 - DESCRIPTION The full range of V-Trak products includes AXXIS, Comfort (based on the Therapod shell) and Classic ranges. The relationship between these ranges is illustrated in Figure 1. Boxed ranges are a convenient way of ordering a limited, popular range of backrest sizes. They use a single product code to specify a complete system, containing both backrest and all mounting hardware. The Classic range allows every item to be specified and ordered as a single item. 1.1 Assessment Kits Figure 1 The V-Trak Ranges Assessment kits contain a selection of components to enable the clinician to determine the most appropriate backrest and to achieve a representative installation for accurate assessment. Note: The backrest and components specified may differ from those used for the assessment. There are four assessment kits available: Mounting Assessment Kit (KIT-M) Contains a selection of mounting components to attach the Backrest to your choice of wheelchair. Axxis Backrest Kit (KIT-AX-B) A selection of Axxis one-piece and segmented backrests to provide a wide range of permutations. Comfort Backrest Kit (KIT-CO-B) Contains four sizes of Therapod backrests which form the basis of the Comfort range of backrests. Axxis and Therapod backrests can be combined if required. Accessory Kit (KIT-A) Contains a selection of the most commonly used accessories to extend the clinical capacity of the V-Trak System. The contents of the four standard assessment kits are listed in Appendix 1. Issue 3.1 Page 9 of 52

10 1.2 Assessment Process The assessment process comprises: Selecting the appropriate backrest Selecting the correct hardware Assembling the selected components Adjusting the selected components to the client s needs Ordering the selected components. 1.3 The V-Trak System (refer to Figure 2) The system consists of two mounting blocks that are fixed, one on each side, to the tubular sections of the wheelchair. Each mounting block is connected, through a locking lever, to a horizontal arm. The arms are joined by a central mounting assembly which is secured to the backrest track. 1.4 Backrests Backrests are available in one-piece or segmented forms. Each backrest has internal strapping that can be adjusted to alter the contours and response of the backrest. The Axxis range also incorporates integral lateral support at pelvic and thoracic levels. The segmented system uses adjustable hinges to connect each segment. This allows numerous combinations of one-piece and segmented backrests and extensive shaping options. Mounting Block Locking Lever Arm Central Mount Wheelchair Upright Backrest Track Backrest Figure 2 The V-Trak System (One Piece Backrest Illustrated) Issue 3.1 Page 10 of 52

11 CHAPTER 2 - THE ASSESSMENT PROCESS 2.1 Selecting the Backrest Although there is no hard and fast rule as to which backrest should be deployed, the following information should be considered to ensure the client s needs are fully met. Adjustment of the internal strapping allows considerable variation in the vertical (lumbar) profile. The degree of lateral support required will determine which of the ranges is most suitable. Backrests from the Therapod (Comfort) range deflect inwards in response to loading which can provide additional symmetrical lateral support. This can be further adjusted using stabilisers from the range of accessories. However, extended lateral support is provided as an integral feature of the Axxis range and is provided at thoracic and pelvic level with significant asymmetrical shaping possibilities and precise positioning. In some cases, choosing a wider Axxis backrest and using the maximum inward adjustment of the integral lateral support will provide the extra deep contouring and support required. The extensive range of backrest positioning available aids the fine-tuning of the seat length. Correct seat length is important to achieve effective pressure relief. It is essential to establish a virtual fulcrum so that the position of the feet can be adjusted to give relief under the ischial tuberosites. This will maximise the area of limb contact for pressure distribution and to correctly position the fulcrum. It is also important to consider varying degrees of backrest recline to help transfer some of the pressure from the seat to the back. In cases where an additional postural support has been used, such as foam-in-place or a carved foam seating system, the selection of the host wheelchair has usually been a compromise. This can result in a wheelchair that may be wider than necessary but long enough to accommodate the bulk of the postural device. By using the V-Trak system, the best balance between comfort, pressure relief and function should be achieved without compromise. Using the Backrest Assessment Kits (KIT-CO-B and KIT-AX-B): There are four options available when selecting the backrest. Option 1: Option 2: Option 3: Option 4: A one piece backrest available in different widths and heights. Option 1 combined with an additional segment. A fully segmented backrest. The height and width of this type of backrest will determine the style and quantity of segments required. Option 3 but with an additional set of mounting hardware which provides additional shaping possibilities and/or extra strength. Issue 3.1 Page 11 of 52

12 2.1.1 Option 1 - One Piece Backrest (refer to Figure 3) Many special needs seating clients can be successfully accommodated using a one piece backrest. This allows quicker assessment and may reduce discomfort of the client during prolonged assessment. This is the most commonly used backrest and is available in both the Comfort (Therapod) range and the Axxis range. With widths ranging from 33 cm (13 in) to 50 cm (20 in) the Axxis range provides the greatest range thereby covering both adult and paediatric requirements. The Comfort (Therapod) range is available in only two widths 43 cm (17 in) and 38 cm (15 in) and in three heights (refer to Appendix 1 for full range and dimensions). In both ranges, the vertical profile of each backrest can be varied by adjusting the internal strapping to suit the clinical requirements of the client. This is of particular benefit when trying to promote an effective lordosis of the lumbar region or to accommodate a flexed lumbar region. The ultimate selection may depend upon the need for integral lateral support and/or asymmetrical shaping which is provided in the Axxis system. See Chapter 4 - Adjusting the backrest shape. Figure 3 One Piece Backrest Option 2 - One Piece Backrest combined with an Additional Segment (refer to Figure 4) This option provides the client with all the benefits of postural management associated with Option 1 with the addition of two important advantages: Firstly day to day management of the client is made easier using the V-Trak system. For example, it may be decided that a one piece backrest is best suited to meet the postural requirements of the client, but there is concern that the height of a high backrest may create difficulties for the carer. An alternative solution would be a low backrest joined with a backrest extension, using a quick release hinge (refer to Figure 5), would provide the equivalent support of a one-piece high backrest but with the advantage of easy removal and, therefore, access to the client. Secondly, postural management can be improved. For example, if the client has a fixed kyphosis of the cervical spine and subsequent flexion around the lumbar region, the one piece backrest would be unable to offer the desired level of support required around the upper thoracic area. By selecting the smaller backrest and adding a segment, the hinge can be adjusted to accommodate whatever level of flexion is required. This ensures the correct level of support is not compromised. Issue 3.1 Page 12 of 52

13 Figure 4 One Piece Backrest Combined with an Additional Segment Figure 5 Standard/Quick Release Hinge Option 3 - Fully Segmented Backrest (refer to Figures 6) This is a more advanced form of backrest. Combining separate segments allows the configuration of any shape and size of backrest required. The selection of segments determines the height, width and shape of the completed backrest system. The hinge joining each segment allows different spine profiles to be accommodated and facilitates intervention where required. Figure 6 Fully Segmented System Issue 3.1 Page 13 of 52

14 2.1.4 Option 4 - Tandem Backrests using an Additional Set of Mounting Hardware (refer to Figure 7) This is the most advanced form of backrest. The versatility of a segmented backrest is further enhanced by the use of two pairs of mounting arms and by eliminating the joining hinge. In such cases, the upper and lower sections can be adjusted independently. This allows the creation of extreme three dimensional support for complex conditions such as Scoliosis. Figure 7 Tandem Backrests Selecting Segments (refer to Figure 8 and 9) The simplest segment is half the height of a one-piece backrest. Segments are available in four widths corresponding to the widths of the one-piece backrests. Before the adjustment of the integral lateral support, the horizontal curvature of the segments is symmetrical; in vertical section they are wedge shaped, more so at the centre than at the sides. When two segments are combined, with the tracks forming a straight line and with the wedges joining at their deepest part, the resulting convex lumbar curve will replicate that of its corresponding one-piece backrest. From this starting point, the lumbar curve can be increased by rotating the segments backwards about the joining hinge or can be decreased by the opposite action (refer to Figure 8). However, the segments can also be joined with the thinnest parts adjacent and in this configuration, with the tracks in a straight line, the combined segments will present a concave curve (refer to Figure 9). Again, this can be increased or decreased by changing the angle between the segments. Therefore, there are two starting positions (refer to Figure 8 and 9). From these, adjustments can be made to suit convex or concave extremes. Issue 3.1 Page 14 of 52

15 Figure 8 Combining Segments Figure 9 Alternative Combinations Creating Cavities (refer to Figure 10) It is possible to join the backrests in a further configuration where the thick part of the backrest can be assembled adjacent to the thin part of the second segment. This has the effect of creating a cavity which is at its greatest in the centre of the horizontal curve and diminishes towards the horizontal extremities. Such cavities can be helpful for accommodating swellings or areas of sensitivity on or near the spine by avoiding or minimising contact. Figure 10 Creating Cavities Issue 3.1 Page 15 of 52

16 2.1.7 Extending the Height Further segments can be added in any orientation to provide even taller backrests. To ensure the best conformity to the size and shape required, segments are also produced in reduced heights, in each of the four widths. Backrest extensions are available and are intended primarily as a way of extending the top of the backrest to provide: Additional shoulder support (especially for kyphosis when combined with additional back angle). A convenient mounting position for head supports. A means of elevating shoulder harness attachment points to minimise compression forces of the spine during forward movement. However, these backrest extensions can be used in any combination where the therapist decides they will be clinically efficacious. Examples include deploying the backrest extension at the bottom of a backrest for pelvic support. Due to the absence of internal straps there is significantly less resilience in this component, which is beneficial when trying to stabilise the pelvis. However, this is now largely replaced by the Axxis segments where resilience can be adjusted using the unique internal strapping system. Backrest extensions have been used as head supports, also as a single backrest element Adding Segments to One-piece Backrests Another application for backrest segments is to extend the height of a one-piece backrest either at the bottom or at the top. With the increased range of sizes in the Axxis segments it is possible to combine extra segments with widths different from that of the main backrest. The smaller segments can also serve as adjustable headrests, thereby augmenting the extensive range of head supports Trunk Taper (refer to Figure 11) Different widths of segments can be combined in order to cater for different body shapes e.g. tapering outward from shoulder to hips and vice versa. Combined equal-height segments are symmetrical about their horizontal central line and can therefore be inverted. Backrests combining two different segment heights are not vertically symmetrical. Figure 11 Trunk Taper Issue 3.1 Page 16 of 52

17 Risk Assessment - Overloading When combining three or more segments it is important to consider the effective loading of the system by the following four factors: Client height Client body mass Centre of gravity Client behaviour If, in the therapist s opinion, the result of any of these individual or combined factors carries a risk of overloading, there are two strengthening options available in the system which should be considered. These are: Use of secondary arm Use of two separate Central Mount/Arm Assemblies. Refer to Accessories, Section 2.3 for more details Issue 3.1 Page 17 of 52

18 2.2 Selecting the Mounting Hardware Mounting hardware can be specified in two ways: By ordering from the range of complete, boxed systems which contain the backrest together with all the necessary hardware By ordering mounting hardware as separate items to suit more specific applications such as foam in place, carved foam seating or individual backrests. The following guidance applies to selecting individual mounting components from the Classic range. Mounting hardware consists of three separate elements; Mounting Blocks, Attachment Arms and Central Mount (refer to Figure 12 and 13): Central Mount Arm Mounting Block Figure 12 Mounting Hardware Components Figure 13 Assembled Mounting Hardware Mounting Blocks Mounting blocks, supplied in pairs, are clamped to the wheelchair uprights and form the connection of the Backrest to the wheelchair. The style and size of the wheelchair tubing determines the size and type of mounting block required. For example, a wheelchair tubing of round section, 22 mm (7/8 in) diameter, will require the mounting block MB R 22. To assist in the in the identification of the tubing size a tube gauge is available (refer to Figure 14) If the wheelchair tubing is square, mounting blocks are available for a parallel or diagonal configuration to allow variations in seat depth similar to those available with round tubes. Some of the many standard configurations are shown in Figure 15. Figure 14 Tube Gauge Issue 3.1 Page 18 of 52

19 Figure 15 Mounting Block Selection Some wheelchair tubing is unique to specific models (for example Netti, Etac). Special mounting blocks are available for most sizes and styles of tubing in common use. Mounting blocks are also produced in Universal versions which will allow the attachment to 7 different round section tube diameters of 19 mm, 3/4 in, 20 mm, 22 mm, 7/8 in, 25 mm and 1 in. Product code MB-R-UE fits the above range of sizes but configured for Europe. Product code MB-R-US fits the above range of sizes but configured for USA. A further version, Product code MB-UN is designed for the Scandinavian (Nordic) wheelchairs NETTI and ETAC. MB-R-UE MB-R-US MB-UN Figure 16 Universal Mounting Blocks Issue 3.1 Page 19 of 52

20 2.2.2 Badger or Vixen Wheelchairs Backrests can be fitted to a Badger or a Vixen wheelchair in two different ways. The standard installation uses a pair of arms of suitable size in conjunction with a pair of square mounting blocks in either a parallel or diagonal format. A number of Badger wheelchairs were, however, manufactured with a section of tubing running horizontally across the back of the chair. In this case, the standard installation of mounting blocks and arms to the central mounting block and backrest will be restricted. In such cases, the Badger Mounting Kit (refer to Figure 17) may be used. This kit is designed to clamp securely on to the horizontal tube allowing the central mounting assembly CM STD2 to be mounted directly to it without the need for the mounting blocks or arms. There are two important points to consider when using the Badger Mounting Kit: As the Backrest is now bolted to the subframe it cannot be removed as normal. If Thoracic Supports are required these can only be installed using the Secondary Arm (BM SAT) which incorporates a Thoracic Support mounting option. Figure 17 The Badger Mounting Kit Attachment Arms (refer to Figure 18) Attachment arms, supplied in pairs complete with locking levers, are selected according to the seat width of wheelchair. When combined with the Central Mount/Arm Assembly each assembly has a predetermined working range. This will accommodate variations in the installation angle of the mounting blocks as well as variations in wheelchair width. Arms can be ordered simply in pairs or in the form of a combined Central Mount/Arm Assembly. Refer to Table 1. Issue 3.1 Page 20 of 52

21 2.2.4 Central Mount (refer to Figure 19) Figure 18 Attachment Arms The Central Mount, supplied as a single unit, joins the two arms and allows the attachment of the backrest. It also provides the range of positional adjustments available. It can also be supplied in the form of a combined Arm/Central Mount/Arm Assembly. Refer to Table 1. The Central Mount incorporates locking mechanisms to prevent accidental loss of final settings. Figure 19 Central Mount Central Mount/Arm Assembly (refer to Figure 20) When supplied as an assembled unit, the arms and central mount are configured to suit the nearest size of backrest subject to packaging limits. Figure 20 Central Mount/Arm Assembly Issue 3.1 Page 21 of 52

22 Table 1 Table of product compatibility - Wheelchair widths Mounting Hardware Product Code To Suit Wheelchair Widths Blocks Angled to Rear cm in Blocks Parallel (refer to Note 2) cm in Full Working Range Minimum Maximum mm in mm in CMA CMA CMA CMA CMA CMA Notes: 1. The prefix CMA denotes assembled products comprising a Universal Central Mount together with a pair of V-Trak arms. 2. Data under Blocks Parallel also applies to ETAC Cross wheelchairs. 3. Data under Full Working Ranges: The Minimum dimension for each product is achieved with the mounting blocks in a parallel configuration (refer to Figure 21). The Maximum dimension for each product is achieved with the mounting blocks angled in towards the centre of the wheelchair at an angle which extends the natural arc of the arm (refer to Figure 21). 4 As an assembly approaches its minimum size, the accessory holes will move into the Central Mount. This may affect the fitting of accessories such as Shell Stabilisers and Thoracic Supports. Format for Minimum Dimensions (Blocks Parallel) Format for Maximum Dimensions (Blocks Angled) Figure 21 Minimum and Maximum Dimensions Issue 3.1 Page 22 of 52

23 2.3 Selecting Accessories During the assessment, the client s postural needs may require the addition of accessories. The accessories fall into the following categories: V-Trak Headrests and Headrest Accessories Third Party Headrest Adapters V-Trak Thoracic Supports V-Trak Supplementary Accessories Alternative Covers V-Trak Headrests and Headrest Accessories Two styles of headrest are available, bead cushion and winged. Both styles fit directly into the mounting track at the rear of the backrest. The bead cushion type headrest is available in standard format, with a good range of adjustment, but also in extended format with a comprehensive range of adjustment and movement. The winged type of headrest is available, with a full range of adjustment, in standard and large sizes Standard Bead Cushion Headrest (HS SC) (refer to Figure 22) Frequently used as a neck support placed below the occipital area, this headrest can be adjusted for height, pitch, and has two forward positions 50 mm apart. It can also be moved off centre and rotated. The detachable cushion can be adjusted to control the shape and firmness. Figure 22 Standard Bead Cushion Headrest (HS SC) Issue 3.1 Page 23 of 52

24 Extended Bead Cushion Headrest (HS AC) (refer to Figure 23) As the standard bead cushion but with a chassis that provides a greater range of movement and in more planes to help accommodate asymmetrical requirements. Figure 23 Extended Bead Cushion Headrest (HS AC) Standard Winged Head Support (HS AW) (refer to Figure 24) In addition to the full rage positional adjustments, this headrest provides a winged head support. Both left and right wings can be manually shaped for customised support of the head. Figure 24 Standard Winged Head Support (HS AW) Large Winged Headrest (HS AWL) (refer to Figure 25) As the standard winged head support but wider and deeper and with more options for shaping the wings. Figure 25 Large Winged Headrest (HS AWL) Issue 3.1 Page 24 of 52

25 Track Extension The track extension extends the track at the rear of the Comfort (Therapod) backrest so that it continues to the top of the backrest. It can then accommodate a headrest or other accessories (refer to Figure 26). It can also be used with low backrests to raise the headrest mounting position to a suitable height (refer to Figure 27). Figure 26 Track Extension Figure 27 Track Extension In-situ Issue 3.1 Page 25 of 52

26 2.3.2 Third Party Headrest Adapters If a client s needs are best served by a third party headrest for assessment and/or permanent use, a headrest adapter is available to provide a location and securing point for the third party headrest. Headrest adapters are available in three sizes to accept the most commonly used third party headrests: Headrest Adapter HA 14 (refer to Figure 28 and 29) This size of adapter is for use with headrests with a stem size of 13 mm (0.5 in) such as those from the Otto Bock range of headrests Headrest Adapter HA 17 (refer to Figure 28 and 29) This size of adapter is for use with headrests with a stem size of 16 mm (.625 in) Headrest Adapter HA 20 (refer to Figure 28 and 29) This size of adapter is for use with headrests with a stem size of 20 mm (.7 in) most commonly found in the Whitmeyer range of head injury supports. Headrest Stem Headrest Adapter Track Figure 28 Third Party Headrest Adapter Figure 29 Third Party Headrest Adapter In-situ Headrest Adapter (refer to Figure 30) The headrest adapter HAPAEG provides an alternative mounting for third party headrests which include the standard fixing block supplied with many headrests, eg. the 1 inch square tube in the USA. The harness attachment plates HAPATT include fixing points for third party seating restraints (harnesses) when used with a headrest adapter HAPAEG. HAPAEG HAPATT Figure 30 Headrest Adapter Issue 3.1 Page 26 of 52

27 2.3.3 V-Trak Thoracic Supports (refer to Figure 31 and 32) Quick Release Thoracic Support System (TS2 LH and TS2 RH) The quick release thoracic support system can be installed on the V-Trak system in two ways: By fixing directly on to the V-Trak arm through the accessory fixing holes By fixing on to the track at the rear of the backrest by means of one of the secondary arms available Note: The medium (TS2 MP) and large (TS2 LP) thoracic pads must be ordered separately Attachment to the V-Trak Arms There are two cylindrical spacers at the end of the thoracic bracket where it is mounted on to the V-Trak arms, these can be used to vary the height setting of each bracket, which can be set at different heights independently to satisfy particular needs (refer to Figure 31). It should be noted that the right hand (client s right hand) thoracic support can be inverted and mounted beneath the V-Trak arm on the client s left side and vice versa; therefore providing the option of support at a much lower level and of combining the two levels of support if required. Caution: If the supports are inverted it is essential to use the two cylindrical spacers together between the arm and bracket to prevent a conflict between the release button and the mounting block (refer to Figure 32). It is important to remember that the starting height of the thoracic system is partly determined by the position of the V-Trak arms. If, by repositioning the arms to achieve a specific Thoracic Support height, the pivot point becomes vulnerable, a secondary arm may be required to restore stability of the backrest angle. Quick Release Button for Removal of the Thoracic Pad V-Trak Arm Spacers Mounting Block Spacers Mounting Block Figure 31 Thoracic Support - Right Hand Figure 32 Thoracic Support - Left Hand (Inverted for Right Side Application) Issue 3.1 Page 27 of 52

28 Thoracic Pads (TS2 MP and TS2 LP) (refer to Figure 33) When ordering either the Right (TS2 RH) or Left (TS2 LH) Quick Release Thoracic System the Thoracic Pads are ordered separately. The pads are available in Large (TS2 LP) and Medium (TS2 MP) and can be mounted in either a horizontal or vertical position. Once in position the pads can be rotated about their fixing points and may be shaped to the client s requirements by bending the plate along the bend slots (refer to Figure 36). A choice of asymmetrically placed mounting slots provides a further means of adjusting the height of each pad independently (refer to Figures 34 and 35). Figure 33 Thoracic Pads Figure 34 Thoracic Pads Orientation - Vertical Adjusting the Thoracic Supports (refer to Figure 36) Figure 35 Thoracic Pads Orientation - Rotation There are many ways to independently adjust the height, width, asymmetry and orientation of the thoracic supports. Refer to the installation and adjustment instructions that accompany each product. Figure 36 Thoracic Pad Profiling Issue 3.1 Page 28 of 52

29 Otto Bock STS System (TS VBL and TS VBR) (refer to Figure 37) The Otto Bock STS System can be used in conjunction with the V-Trak system. Fitting the STS system requires the V-Trak interface which is supplied in left and right hand versions. The interface product codes are TS OBL (left hand version) and TS OBR (right hand version). In the UK only, the STS system is available from PHP Ltd complete with the interface. The combined product references are TS VBL (left hand version) and TS VBR (right hand version). Figure 37 Otto Bock STS System V-Trak Supplementary Accessories Shell Stabiliser/Wrap Adjuster (BM STA) (refer to Figure 38) The plastic shells of the backrests are designed to flex in response to loading. This allows a percentage of body movement to be absorbed. This flexing can be adjusted or eliminated to suit the user. Shell stabilisers are attached to the V-Trak arms at the accessory holes. Supplied as a pair they can be adjusted to produce the required response from the backrest and to achieve symmetrical or asymmetrical deflection. Figure 38 Shell Stabiliser/Wrap Adjuster (BM STA) Issue 3.1 Page 29 of 52

30 Extended Shell Stabiliser/Wrap Adjuster (BM STX) (refer to Figure 39) As above but with a greater range of adjustment and the ability to apply pressure to the most suitable points on larger backrests. Figure 39 Extended Shell Stabiliser/Wrap Adjuster (BM STX) Cushion Retainer (BM ACR) (refer to Figure 40) This device prevents a seat cushion sliding back through any gap between the bottom of the backrest and the wheelchair canvas. Fitted into the track at the rear of the backrest, its position is fully adjustable to be effective for any position and/or orientation of the backrest. A cover is provided to conceal the mechanism when installed. Cushion Retainer Figure 40 Cushion Retainer (BM ACR) Secondary Arm System - Standard (refer to Figure 41) The standard secondary arm is designed to resist unwanted rotation of the backrest under severe loading by transferring the load directly to the wheelchair uprights. Such loading may be the result of a low pivot point and/or high body mass combined with behavioural loading such as flailing, spasms etc. The arm fits directly into the track at the rear of the backrest. Attachment to the uprights is by means of straps which are secured with Velcro for easy release and removal of the backrest. Available in two widths, it can be mounted as shown or inverted and used with harness attachment plates for use with third-party harnesses. Issue 3.1 Page 30 of 52

31 Figure 41 Secondary Arm System - Standard Secondary Arm System - Thoracic Version (BM SAT) (refer to Figure 42) As above but incorporates an alternative mounting point for V-Trak Thoracic Supports. Available in three widths; it can also serve as a mounting point for third-party harnesses when harness attachment plates are installed (refer to Figure 44). 43 cm (17 in) BMSAT17 38 cm (15 in) BMSAT15 33 cm (13 in) BMSAT13 Figure 42 Secondary Arm System - Thoracic Version (BM SAT) Harness Carrier (BM AHC) (refer to Figure 43) Supplied as a pair, these can be fitted at any convenient position on the backrest track and provide mounting points for third-party seating restraints. Both carrier plates can be rotated then locked in the most appropriate position. Figure 43 Harness Carrier (BM AHC) Issue 3.1 Page 31 of 52

32 Harnessing Kit for Secondary Arms (BM AHK) (refer to Figure 44) Secondary arms can be adapted to provide mounting points for seating restraints. The harness Kit provides two harness attachment plates, which bolt into the slots in the Secondary Arm. Figure 44 Harnessing Kit for Secondary Arms (BM AHK) Recycling Kit (BM ARK) (refer to Figure 45) The recycling kit contains all the parts vulnerable to wear. By replacing these items, the backrest mechanism can be restored to a serviceable condition suitable for re-issue. Figure 45 Recycling Kit (BM ARK) Alternative Covers (Backrest product code prefixed with CV for standard covers, prefixed with CVW for waterproof covers) (refer to Figure 46) Replacement and alternative covers are available, refer to price list for details. Figure 46 Alternative Covers Issue 3.1 Page 32 of 52

33 CHAPTER 3 - INSTALLING THE SELECTED COMPONENTS 3.1 Assembling and Installing the Backrest (refer to Figure 47) The Classic range includes both Axxis and Comfort ranges. The size and clinical capacity of both ranges can be increased by adding segments and/or accessories to standard one-piece backrests. The Axxis range can also be configured in a fully sectional or segmented form. Typically, the thoracic and lumbar regions are separate and joined by an adjustable hinge. Several segments may be joined. This will increase the height of the system while also allowing greatly increased range of shapes which can be accommodated. In addition segments may be joined top to top, bottom to bottom, top to bottom and vice versa in order to accommodate shapes or to create cavities where required. Figure 47 Backrest Systems Joining Segments (refer to Figure 48) To join segments together, use the special hinge provided (SH-SD, order separately). The hinge screws are long enough to locate in the safety locking holes in the backrest track and must be unscrewed sufficiently to achieve this Tighten both hinge screws keeping the hinge elements in a straight line to begin with. Issue 3.1 Page 33 of 52

34 Figure 48 Joining Segments Install the system in the wheelchair To adjust the angle between adjacent segments, unscrew the two hinge screws about four turns using a 10 mm spanner. There is no need to dismantle the hinge Slightly separate the hinge to allow the internal teeth to slide over each other Adjust the angle of the segment to the desired position. The hinge must be adjusted with equal underhang or overhang A (refer to Figure 49) Lock the hinge by tightening both screws with the 10 mm spanner. A A A A Figure 49 Hinge Adjustment Issue 3.1 Page 34 of 52

35 3.2 Assembling and Installing the Mounting Hardware (refer to Figure 50) Mounting Blocks Determine the most suitable position for the mounting blocks. Unless there are obstructions on the uprights or other limiting factors, the optimum location for the backrest pivot point will be at approximately as shown (refer to A, Figure 50) Typically this will be approximately 60% of the distance from the bottom of the backrest track. Each case will be different according to the client s body mass and likely behaviour and every effort should be made to balance the likely forces above and below the pivot point. The optimum balance point may not be practical due to obstructions on the wheelchair uprights or other reasons. If installations such as B and C in Figure 50 are required, it may be necessary to use a secondary arm at the top B or bottom C to transfer any excessive forces to the uprights. Refer to Catalogue or for product codes. A B C Figure 50 Mounting Block Positions Installation of Standard Mounting Blocks (refer to Figure 51) Remove the canvas backrest from the wheelchair according to the manufacturer s recommended procedures Remove the Mounting Blocks from their packing and dismantle Using the 5 mm Allen key remove the two screws (1) from the mounting block and withdraw the tightening wedges (2 and 3) and the pin block (4) Install one Mounting Block at the optimum height for the backrest, ensuring the screw holes are to the outside of the wheelchair and accessible for final positioning. Repeat the process for the second mounting block on the opposite side but approximately 50 mm lower than the first block Ideally the mounting blocks should be facing inward at an angle of approximately 45 degrees but they can be used in a parallel configuration to the front or rear of the wheelchair. If the tubes are not of round section the special mounting blocks available cannot be rotated but they can be mounted to the front or rear of the uprights Do not over tighten at this stage. Allow the mounting block to rotate under moderate pressure. Issue 3.1 Page 35 of 52

36 Figure 51 Installation of Standard Mounting Blocks Installation of Universal Mounting Blocks (MB-R-UE and MB-R-US) (refer to Figure 52, 53 and 54) Remove the canvas backrest from the wheelchair according to the manufacturer s recommended procedures Remove the Mounting Blocks from their packing and dismantle (refer to Appendix 1 for pack contents) Install as for standard mounting blocks but using additional clamps bands and/or spacers where necessary (refer to Figure 52). In most cases the pre-assembled mounting block will be suitable. Occasionally it may be necessary to use the additional Clamp Bands with or without the Spacer Shells to suit different diameter uprights as shown The mounting blocks are usually installed to the rear (refer to Figure 53) but may also be mounted to the front (refer to Figure 52) of the wheelchair uprights. In either case, always ensure the Clamping Screws are on the outside and therefore accessible for final adjustment and tightening Observe the correct position for any spacers which must not be in contact with the tightening wedges (refer to Figure 54). Screws Accessible Screws Accessible Figure 52 Mounting Blocks MB-R-UE and MB-R-US Angled to Rear Figure 53 Mounting Blocks MB-R-UE and MB-R-US Installed to Front Issue 3.1 Page 36 of 52

37 Figure 54 Mounting Blocks MB-R-UE and MB-R-US - Use of Spacers Installation of Universal Mounting Blocks (MB-UN) for NETTI and ETAC Wheelchairs (refer to Figure 55, 56 and 57) Remove the canvas backrest from the wheelchair according to the manufacturer s recommended procedures Remove the Mounting Blocks from their packing and dismantle Install as for standard mounting blocks but for NETTI Mk II and III in parallel configuration to the front or rear of the uprights. If V-Trak Thoracic Supports are to be fitted in the NETTI Mk II and III, the forward position will normally be required The mounting blocks may be installed to the front (refer to Figure 55) or rear (refer to Figure 56) of the wheelchair uprights. In either case, always ensure the Clamping Screws are on the outside and therefore accessible for final adjustment and tightening For ETAC (refer to Figure 57): Remove the plugs from the top of the uprights (1). Install the tube inserts (2) and make sure that the top flange fully contacts the top of the upright, locating the flange screw hole in line with the upright boss. Hold the flange firmly in place and install and tighten the screws (3) to retain the tube inserts. Issue 3.1 Page 37 of 52

38 Screws Accessible Screws Accessible Screws Accessible Figure 55 Mounting Blocks MB-UN Angled to Front Figure 56 Mounting Blocks MB-UN Angled to Rear Figure 57 ETAC Tube Inserts Central Mount and Arms (refer to Figure 58) When supplied as separate items these components will require assembling before mounting onto the wheelchair. If they have been supplied as an assembled item, refer to Para Using the arm pivot screws supplied with the universal central mount, attach the arms to the central mount as shown. Use the washers and locking nuts in the positions shown Set to the dimensions required for the host wheelchair Ensure the arms are in their foremost position and resting against the Locking Cams. Tighten lightly to aid later adjustment When assembled, proceed as for completed assembly refer to Para Issue 3.1 Page 38 of 52

39 Arm Pivot Screw Central Mount Arm Figure 58 Assembly of Central Mount and Arms Central Mount/Arms Assembly (refer to Figure 59) If supplied as a complete assembled item, the combined central mounting mechanism is supplied configured for its most likely application. If the Mounting blocks have been installed as illustrated on a wheelchair with regular widths of 26 cm (13 in), 38 cm (15 in), 43 cm (17 in) or 50 cm (20 in) the assembly can be installed as supplied with minor adjustments to the Mounting Block angle. If the wheelchair widths are different from these sizes or you need to install the Mounting Blocks differently you will also need to make adjustments to the assembly. Also, once the backrest is installed, the positioning of the backrest may require adjustment of the Central Mount/Arm Assembly Remove the Mounting Blocks from their packing and dismantle Install one Mounting Block at the optimum height for the backrest. Ensure that the screw holes are to the outside of the wheelchair and accessible for final positioning. Do not tighten at this stage, allow the Mounting Block to rotate under moderate pressure Install the second Mounting Block on the opposite side approximately 50 mm (2 in) lower than the first block Align the Central Mount/Arm Assembly and insert one Locking Pin into the first Mounting Block Align the second Locking Pin with the opposite Mounting Block Close the first Locking Lever so that the assembly is firmly fixed. Issue 3.1 Page 39 of 52

40 Slide the second (lower) Mounting Block up until the second Locking Pin is fully engaged. Alternatively, slacken the screws on the first Mounting Block and lower the combined mechanism and Mounting Block to mate with the second block to achieve the same result Close the second Locking Lever Check that the mechanism can be removed and replaced easily when both Locking Levers are opened. If it does not do so easily and smoothly, the Mounting Blocks may not be level or the Locking Pins may not be perfectly aligned. Continue adjustments until removal and replacement is smooth and easy Tighten all screws but allow for further positioning after installing the backrest. Locking Cams Figure 59 Assembly of Central Mount/Arms Assembly Issue 3.1 Page 40 of 52

41 CHAPTER 4 - INSTALLATION AND POSITIONAL ADJUSTMENTS 4.1 Introduction The V-Trak mounting system offers a large degree of stepless adjustment and altering one parameter will have an effect on others. Therefore it is advisable to alter each setting individually and move in progression. It is likely to require some repeat adjustment to finely tune the system to the client s requirements. 4.2 Backrest Loosen the Track Screws and slide the Backrest Track over the Sliders (refer to Figure 60) Lower the Backrest into its chosen position and tighten the lower Track Screw. To aid adjustment, the top Track Screw can be left loose until the final height position has been established Adjust the backrest height and angle (refer to Figures 61 and 62). Tighten both screws on completion of adjustment. Backrest Track Track Slider Track Screw Track Slider Track Screw Figure 60 Attaching the Backrest Figure 61 Adjusting the Backrest Height Figure 62 Adjusting the Backrest Angle Issue 3.1 Page 41 of 52

42 4.2.4 When making any adjustment involving rotation of the arms, ensure that the Locking Levers are in the Unlocked position so that they can rotate within the Mounting Block When using the forward/rearward or asymmetrical adjustments, adjust the position of the Locking cams as shown (refer to Figure 63 and 64). For maximum rearward adjustment the cams need to be removed and placed in their storage position When moving the Backrest forward or asymmetrically, the Locking Cams should be moved along the adjustment slot to ensure that in their final position they are in contact with the arms to lock them in position. Cam Storage Locking Cams Figure 63 Backrest Fore/Aft Adjustment Figure 64 Backrest Asymmetric Adjustment For extreme rearward adjustment use the Locking Screws to lock the backrest in the desired position (refer to Figure 65 and 66). Locking Screw Locking Cam Locking Cam Figure 65 Backrest Extreme Rearward Adjustment, Blocks to Rear Figure 66 Backrest Extreme Rearward Adjustment, Blocks to Front Issue 3.1 Page 42 of 52

43 4.3 Adjusting the Backrest Shape - Axxis Range (refer to Figure 67) Each Axxis backrest has five adjustment zones. The Central zone (1) (refer to Figure 67) extends from the top to the bottom and controls the vertical profile of the backrest. Variations in profile (refer to Figure 68) are achieved by adjusting the tension of the four internal horizontal straps. The straps can be adjusted to provide a response which can vary from soft to virtually rigid within the travel of the tensioning mechanism. The patented tensioning mechanism provides extra leverage to make adjustment easy and to facilitate fine adjustments. The additional adjustment zones are two pairs of adjustable wings, two at thoracic level (numbers 2 & 3) and two at pelvic level (numbers 4 & 5). Figure 67 shows the client s right hand thoracic wing (zone 2) adjusted to the maximum inward position and the remaining wings (zones 3, 4 & 5) in their maximum outward positions. These wings are all independently adjustable using a single screw for each wing. The screw adjustment allows easy, fine and precise adjustments to be made and to create symmetrical and/or asymmetrical reductions in width as required. In addition to providing the correct amount of lateral support, the wing adjustment can also be used to reduce the overall width of the backrest and to provide greater depth of support Figure 67 Asymmetrical Adjustment - Axxis Figure 68 Vertical Profiling - Axxis Adjusting Zone Working from the rear of the backrest (refer to Figure 69), open the cover to expose the rear of the backrest shell. Each strap has its own tensioner (P) covered by a hook and loop cover. Remove this cover and pull the end of the tensioner in the direction indicated to achieve the desired result. The tensioner should automatically lock when released To release the strap, first pull the tensioner slightly to aid release of the ratchet, press on the ratchet and allow the tail to travel back through the ratchet When the strap is in its final position replace the hook and loop cover over the tensioner. Note: Because the ratchet is made from Nylon it may take a moment for a released ratchet to become fully reactivated. This is due to the creep characteristics of all plastics and can be overcome very simply by allowing a few seconds for the plastic to recover or by helping recovery by placing a finger under the ratchet lever and pushing back into place while tensioning the strap. Issue 3.1 Page 43 of 52

44 Wing Adjustment Screw Pull to Tension P P P Figure 69 Access to Adjustments - Axxis Adjusting Zone 2 to Working from the rear of the backrest (refer to Figure 69), open the cover to expose the rear of the backrest shell. Locate the adjustment screw for the required zone. Using the long reach 4 mm hex key wrench (as supplied with standard V-Trak mounting assessment kits) turn the key clockwise to increase the lateral support of the backrest in that zone. To cancel the adjustments simply turn the adjustment screw anti-clockwise as required Width adjustments have a fixed range. Movement beyond this range is prevented by mechanical stops. These are effective for reasonable amounts of force. Please observe these limits to ensure the proper deployment and performance of the backrest Note: Please be aware that in common with all thermoplastics some creep is inevitable. A wing adjusted to its maximum inward deflection may not return immediately when released. This will be more evident in a cold environment than in a warm one. We advise that all adjustments should be undertaken in reasonable ambient temperatures. 4.4 Adjusting the Backrest Shape - Comfort (Therapod) Range Adjusting the Vertical Profile All one-piece Therapod (Comfort) backrests are equipped with four elastic straps that control the vertical profile of the backrest (refer to Figure 70). The straps can be individually tensioned to reinforce the required posture. Tensioning will change the shape and extent of the curvature as shown in Figure 71. The internal shell is designed to flex in response to sitting loads and will wrap, centralise and stabilise the occupant. To fully utilise this feature it is recommended that minimum tension required to maintain the desired posture be used. However, the user s postural requirements are paramount and some straps may require significant tensioning. As a guide: the top two straps will be at either end of the thoracic curve; the third in the lumbar region; the lower strap will sit around the pelvis. Therefore, to maintain lumbar curve or to promote pelvic anterior rotation the third strap will be located in the deepest portion of the curve and be tighter than the others. Issue 3.1 Page 44 of 52

45 From the rear of the backrest, open up the Right Hand side of the backrest cover To release the tension in a strap, pull the ring away from the backrest (thereby releasing the Velcro) and set to the desired tension (refer to Figure 72) To maintain tension, re-fasten the Velcro by laying the ring against the shell Re-fix the cover to it s Velcro strip. Figure 70 Strapping Arrangement - Comfort (Therapod) Figure 71 Adjusting the Vertical Profile - Comfort (Therapod) Issue 3.1 Page 45 of 52

46 Figure 72 Vertical Profiling - Comfort (Therapod) Issue 3.1 Page 46 of 52

47 CHAPTER 5 - REMOVING AND REPLACING THE V-TRAK BACKREST 5.1 Introduction To remove or replace the backrest, when folding the wheelchair for transportation, or to change between wheelchairs fitted with identical mounting blocks, observe the following procedures. 5.2 Removing the Backrest Raise the Locking Lever, at the end of each V-Trak Arm, past the vertical position to the Unlocked position as shown in Figure With a hand under the outer end of each V-Trak Arm, lift the system evenly upwards and clear of the Mounting Blocks. The system is now fully detached. 5.3 Replacing the Backrest Ensure both Locking Levers are in the Unlocked position With both hands under the outer ends of the V-Trak Arms, lower the system evenly into the Mounting Blocks on the wheelchair When the Pins are located in the holes in the Mounting Blocks, push down firmly. Ensure that the pins are fully located before pressing the Locking Levers downwards until fully horizontal, in the Locked position. The system is now firmly attached to the wheelchair Check the security of the backrest before sitting in the wheelchair It may be necessary to adjust the force required to lock and unlock the system to suit the strength and/ or dexterity of the user or to maximise the retention of the backrest. This is achieved by adjusting the Securing Nut until the required setting is achieved. Unlocked Locking Lever Pin Securing Nut Locked Mounting Block Figure 73 Backrest Removal and Replacement Issue 3.1 Page 47 of 52

48 Intentionally Blank Issue 3.1 Page 48 of 52

49 CHAPTER 6 - MAINTENANCE, WARRANTY AND ORDERING 6.1 Maintenance After installation and adjustment have been completed, and at regular intervals, check the following: All screws are fully tightened All washers and locking nuts are installed correctly All locking nuts are correctly tightened without loosening the main screw Removal and installation of the backrest can be accomplished smoothly and easily Washing Instructions Standard covers are made from a foam-backed fabric and are not waterproof. Any spillage should be removed immediately with a moist cloth. Further cleaning may be carried out with an upholstery spray cleaner (follow the manufacturer s instructions) Standard covers may be machine-washed (replacement covers are also available); observe the washing instruction symbols (refer to Figure 74). 40 o 6.2 Warranty Figure 74 Standard Cover Washing Instructions Performance Health Products Ltd (PHP) fully guarantees the V-Trak range of products against faulty materials or workmanship for a period of 24 months from the date of invoice subject to the following conditions: Goods must have been purchased from an authorised Supplier/Distributor In the event of a claim the supplier must notify PHP immediately Faulty goods must be retained for inspection by PHP Defective products will be repaired or replaced free of charge at PHP s option Products must be installed in accordance with the manufacturer s instructions Products must be used for the purpose for which they were designed This Warranty does not cover: Fair wear and tear Abuse or inappropriate use Unauthorised alterations or adjustments Failure to maintain the product as directed. Issue 3.1 Page 49 of 52

50 6.3 Ordering Using the Prescription Forms - UK Only Use the prescription form shown in Appendix 3, 4 and 5 to order parts. Please ensure that a copy of the prescription form accompanies every order as this allows your Supplier to check for any conflicts in size and configuration. Should they identify any conflict, they can contact you to clarify the requirements before processing your order. Please remember that, carriage is added at cost as shown on the current price list and VAT at the applicable rate will be charged on all goods and carriage. Fax or post the completed prescription form to: Performance Health Products Limited Unit 32, Village Farm Road Pyle, Mid Glamorgan CF33 6BL UK Tel: +44 (0) Fax: +44 (0) php@talk21.com 6.4 Ordering from your Dealers - Outside the UK Use the order/prescription form and price list provided by your dealer. This will allow the dealer to check for conflicts etc. Treatment of shipping costs may vary between dealers. Issue 3.1 Page 50 of 52

51 6.5 List of Appendices Appendix 1 Standard Assessment Kits - Contents 2 Mounting Block Packs - Contents 3 The V-Trak Axxis Prescription Order Form 4 The V-Trak Comfort Prescription Order Form 5 The V-Trak Classic Prescription Order Form 6 Crash Test Certificate Issue 3.1 Page 51 of 52

52 Designed and made in Wales by Performance Health Products Limited Unit 32 Village Farm Road Village Farm Industrial Estate Pyle, Mid Glamorgan CF33 6BL UK Tel: +44 (0) Fax: +44 (0)

53 Appendix 1 Page 1 of 2 STANDARD ASSESSMENT KITS - CONTENTS Mounting Assessment Kit (KIT-M) Item Description Quantity MB R 20 Clamp band... Clamp band for 20 mm dia round tubes... 2 MB R 22 Clamp band... Clamp band for 22 mm dia round tubes... 4 MB R 25 Clamp band... Clamp band for 25 mm dia round tubes... 2 MB R 32 complete pair... Mounting blocks for 32 mm dia (Netti) round tubes... 1 MB S 22 Clamp band... Clamp band for 22 mm square tubes (parallel mount)... 2 MB D 22 Clamp band... Clamp band for 22 mm square tubes (diagonal mount)... 2 MB DD 16 spacers... Reduces 22 mm dia to 16 mm dia for specific model... 2 MB R 16 spacers... Reduces 22 mm dia to 16 mm dia... 2 MB ET Clamp band... Clamp band for fixing to Etac telescopic handle... 2 Pin blocks... Mounting block components... 2 Plain wedges... Mounting block components... 4 Threaded wedges... Mounting block components... 4 M6 X 20 Socket cap screws... Mounting block components... 8 M6 X 25 Socket cap screws... Mounting block components /16 UNF x 1 1/4 in Bolt... Arm components /16 UNF Type T Nylock Nut... Arm components... 4 M8 Form A Washer... Arm components... 8 CMA Universal central mount with 125 mm arms... 1 AM 100 pair... Arms 100 mm long... 1 AM 150 pair... Arms 150 mm long... 1 AM 175 pair... Arms 175 mm long... 1 AM 200 pair... Arms 200 mm long... 1 AM 225 pair... Arms 225 mm long... 1 SH SD... Segmented hinge... 3 HA Headrest adapter up to 14 mm... 1 HA Headrest adapter up to 17 mm... 1 HA Headrest adapter up to 20 mm... 1 Tools... Complete set of wrenches and keys... 1 Case... Plastic briefcase style case... 1 CMU... Universal Central Mount (packed as separate item)... 1 Axxis Backrest Kit (KIT-AX-B) Item Description Quantity AXS-S...AXXIS low backrest 330 mm (13 in) wide, 305 mm (12 in) high... 1 AXS-M...AXXIS low backrest 380 mm (15 in) wide, 405 mm (16 in) high... 1 AXS-L...AXXIS low backrest 430 mm (17 in) wide, 405 mm (16 in) high... 1 AXS-XL...AXXIS low backrest 500 mm (20 in) wide, 405 mm (16 in) high... 1 AXSB-SF...AXXIS segmented backrest section 330 mm (13 in) wide, 170 mm (6.75 in) high. 1 AXSB-MF...AXXIS segmented backrest section 380 mm (15 in) wide, 205 mm (8 in) high... 1 AXSB-LF...AXXIS segmented backrest section 430 mm (17 in) wide, 205 mm (8 in) high... 1 AXSB-XLF...AXXIS segmented backrest section 500 mm (20 in) wide, 205 mm (8 in) high... 1 AXSB-SR...AXXIS segmented backrest section 330 mm (13 in) wide, 145 mm (5.75 in) high. 1 AXSB-MR...AXXIS segmented backrest section 380 mm (15 in) wide, 150 mm (6 in) high... 1 AXSB-LR...AXXIS segmented backrest section 430 mm (17 in) wide, 160 mm (6.25 in) high. 1 AXSB-XLR...AXXIS segmented backrest section 500 mm (20 in) wide, 170 mm (6.75 in) high. 1 BKXT-M...Backrest extension medium... 1 BKXT-L...Backrest extension large... 1 Holdall...Large flexible case - holdall style... 1 Sep 2004

54 Appendix 1 Page 2 of 2 Comfort Backrest Kit (KIT-CO-B) Item Description Quantity BM H Therapod High Backrest 380 mm (15 in) wide, 760 mm (30 in) high... 1 BM L 15...Therapod Standard Backrest 380 mm (15 in ) wide, 610 mm (24 in) high... 1 BM L Therapod Standard Backrest 430 mm (17 in) wide, 610 mm (24 in) high... 1 BM S Therapod Sports Backrest 380 mm (15 in) wide, 410 mm (16 in) high... 1 Holdall... Large flexible case - holdall style... 1 Accessory Kit (KIT-A) Item Description Quantity TS 2 RH... Thoracic support right hand... 1 TS 2 LH... Thoracic support left hand... 1 TS 2 MP...Thoracic pad - medium... 2 TS 2 LP...Thoracic pad - large... 2 HS AC... Head support - cushion style fully adjustable... 1 HS AW... Winged head support - standard size... 1 BM HX... Track extension... 1 BM SAS 15...Secondary arm... 1 BM STA...Shell stabiliser... 1 BM STX...Extended shell stabiliser... 1 BM AHC... Harness carrier... 1 BM AHK...Harness attachment kit for secondary arm... 1 Holdall... Medium flexible case - holdall style... 1 Sep 2004

55 Appendix 2 Page 1 of 1 MOUNTING BLOCK PACKS - CONTENTS Mounting Block Pack (MB-R-UE) - Configured for Europe Description Quantity Clamp Bands for 22 mm (7/8 in) diameter wheelchair uprights mm (1 in) diameter Clamp Bands for 25 mm (1 in) diameter wheelchair uprights... 2 Spacer Shells use with 25 mm (1 in) Clamp Band on 19/20 mm (3/4 in) diameter uprights... 2 Pin Blocks... 2 Plain Wedges... 2 Threaded Wedges... 2 Clamping Screws... 4 Mounting Block Pack (MB-R-US) - Configured for USA Description Quantity Clamp Bands for 25 mm (1 in) diameter wheelchair uprights... 2 Thin Spacer Shells use with 25 mm (1 in) Clamp Band on 22 mm (7/8 in) diameter uprights... 2 Thick Spacer Shells use with 25 mm (1 in) Clamp Band on 19/20 mm (3/4 in) diameter uprights... 2 Pin Blocks... 2 Plain Wedges... 2 Threaded Wedges... 2 Clamping Screws... 4 Mounting Block Pack (MB-UN) - for NETTI and ETAC Wheelchairs Description Quantity Clamp Bands for NETTI Mk I wheelchair uprights... 2 Clamp Bands for NETTI Mk II and III wheelchair uprights... 2 Tube inserts (sleeves) for ETAC wheelchair uprights mm x 4 mm high tensile socket countersink screws... 2 Pin Blocks... 2 Plain Wedges... 2 Threaded Wedges... 2 Screws mm Allen Key... 1 Sep 2004

56

57 DELIVERY ADDRESS: POSTCODE:... TEL:... Fax:... CONTACT:... ORDER FORM - It is NOT necessary to fill in this portion, but these details would allow the supplier to double check the prescription. The Service will be contacted if there are anomalies. Client Details Name :... Condition :... Date of Assessment :... Wheelchair Details Appendix 3 Page 1 of 2 Client Ref No:... Model :... Seat Width :... Seat Depth :... The V-Trak Axxis Backrest is supplied complete as a boxed system with all the necessary components to fit onto a wheelchair with round backrest tubes of diameters between 19 mm and 25 mm (3/4 in and 1 in). For other sizes/sections of backrest tubes (or to purchase items separately), refer to the V-Trak Order Form - Classic. Accessories are indicated on the reverse of this Form. 405 mm (16 in) 405 mm (16 in) 405 mm (16 in) 305 mm (12 in) AXS-XL-UE AXS-L-UE AXS-M-UE AXS-S-UE Includes all mounting hardware Includes all mounting hardware Includes all mounting hardware Includes all mounting hardware Max Width: 500 mm (20 in) Max Width: 430 mm (17 in) Max Width: 380 mm (15 in) Max Width: 330 mm (13 in) Min Width: 400 mm (16 in) Min Width: 350 mm (14 in) Min Width: 300 mm (12 in) Min Width: 260 mm (10 in) 610 mm (24 in) 610 mm (24 in) 610 mm (24 in) AXH-XL-UE AXH-L-UE AXH-M-UE Includes all mounting hardware Includes all mounting hardware Includes all mounting hardware Max Width: 500 mm (20 in) Max Width: 430 mm (17 in) Max Width: 380 mm (15 in) Min Width: 400 mm (16 in) Min Width: 350 mm (14 in) Min Width: 300 mm (12 in) Performance Health Products Ltd Tel: (0) , Fax: (0) V-Trak Backrest Order Form -Axxis v1.0 April 2004