Deformity back system - Patent Review 5407248

What is claimed:

1. A wheelchair back system adapted to support the back of a human, said system being adapted to provide customized fit to a wheelchair user, said system comprising:

a rigid back shell;

mounting means to removably affix said rigid back shell to a wheelchair;

a plurality of foam blocks, said back shell having a front surface and said system further including means for removably attaching said foam blocks to the front surface of said back shell, said foam blocks further having a front surface and providing a substantially continuous layer of foam of substantially uniform depth over the front surface of said back shell, said foam blocks being individually and separately removable from said back shell to provide a recessed area in said substantially continuous layer of foam to provide customized fit to wheelchair users; and

a pad member being sized to overlie the front surface of said foam blocks, said system further including means for attaching said pad member to the front surface of said foam blocks and to the front surface of said rigid back shell in any recessed area formed by the removal of a block.

2. The back system as described in claim 1 having a transition wedge placed in a recessed area formed by the removal of a foam block, said transition wedge providing a sloped surface between the front surface of said rigid back shell in said recessed area and the front surface of an adjacent foam block.

3. The back system as described in claim 1 having a build-up pad and means for attaching said build-up pad to the front surface of a foam block, said build-up pad providing a more customized conformity with the back.

4. The back system as described in claim 1 having at least one adjustable lateral support and means for attaching said lateral support to the front surface of said foam blocks.

5. The back system as described in claim 1 wherein said pad member comprises an envelope containing a flowable fluid material.

6. A wheelchair back system adapted to support the back of a human, said system being adapted to provide customized fit to a wheelchair user, said system comprising:

a rigid back shell;

mounting means to removably affix said rigid back shell to a wheelchair;

a plurality of foam blocks and a thin shim interposed between said rigid shell and said foam blocks, said thin shim having a front surface and said system further including means for removably attaching said foam blocks to the front surface of said thin shim, said foam blocks providing a substantially continuous layer of foam of substantially uniform depth over the front surface of said thin shim, said foam blocks being individually and separately removable from said thin shim to provide a recessed area in said substantially continuous layer of foam to provide customized fit to wheelchair users; and

a pad member being sized to overlie the front surface of said foam blocks, said system further including means for attaching said pad member to the front surface of said foam blocks and to the front surface of said thin shim in any recessed area formed by the removal of a block.

7. The back system as described in claim 6 having a cover, said cover enclosing said thin shim, said foam blocks and said pad member, said cover adapted to maintain said pad in its position with respect to said thin shim and said foam blocks.

8. The back system as described in claim 6 having a transition wedge placed in a recessed area formed by the removal of a foam block, said transition wedge providing a sloped surface between the front surface of said thin shim in said recessed area and the front surface of an adjacent foam block.

9. The back system as described in claim 6 having a build-up pad and means for attaching said build-up pad to the front surface of a foam block, said build-up pad providing a more customized conformity with the back.

10. The back system as described in claim 6 having at least one adjustable lateral support and means for attaching said lateral support to the front surface of said foam blocks.

11. The back system as described in claim 6 wherein said pad member comprises an envelope containing a flowable fluid material.

12. A wheelchair back system adapted to support the back of a human, said system being adapted to provide customized fit to a wheelchair user, said system comprising:

a rigid back shell having lateral edges and a pair of flanges extending forwardly from the lateral edges;

mounting means affixed to said flanges to removably affix said rigid back shell to a wheelchair;

a plurality of foam blocks, said back shell having a front surface and said system further including means for removably attaching said foam blocks to the front surface of said back shell, said foam blocks further having a front surface and providing a substantially continuous layer of foam of substantially uniform depth over the front surface of said rigid back shell, said foam blocks being individually and separately removable from said rigid back shell to provide a recessed area in said substantially continuous layer of foam to provide customized fit to wheelchair users; and

a pad member comprising an envelope containing a flowable fluid being sized to overlie the front surface of said foam blocks, said system further including means for attaching said fluid pad to the front surface of said foam blocks and to said back shell in any recessed area formed by the removal of a block.

13. The back system as described in claim 12 having a transition wedge placed in a recessed area formed by the removal of a foam block, said transition wedge providing a sloped surface between the front surface of said rigid back shell in said the recessed area and the front surface of an adjacent foam block.

14. The back system as described in claim 12 having a build-up pad and means for attaching said build-up pad to the front surface of a foam block, said build-up pad providing a more customized conformity with the back.

15. The back system as described in claim 12 having at least one adjustable lateral support and means for attaching said lateral support to the front surface of said foam blocks.

16. The back system as described in claim 15 having a suspender and means for attaching said suspender to said adjustable lateral support and said foam blocks to hold said adjustable lateral support secure.

17. The back system as described in claim 12 wherein said pad member comprises an envelope filled with a flowable fluid material.

18. The back system as described in claim 17 wherein one side of said pad member is transparent.

19. The back system as described in claim 12 having an external lateral support and means for movably adjusting said external lateral support up and down relative to said rigid back shell to find a preferred position for the human.

20. The back system as described in claim 19 wherein said external lateral support comprises an extended lateral bracket and a contoured pad.

21. The back system as described in claim 20 further including means for removably attaching said extended lateral bracket to said rigid back shell.

22. The back system as described in claim 19 wherein said external lateral support is permanently affixed to the rigid back shell by a plurality of screws which are placed through a plurality of holes in said extended lateral bracket and into said shell.

23. The back system as described in claim 19 further including a contoured pad wherein said external lateral support has at least one lateral wedge and means for attaching said lateral wedge between the said external lateral support and said contoured pad.

24. The back system as described in claim 19 further including a contoured pad wherein said contoured pad and said external lateral support are covered by a lining fluid pad comprising a flowable fluid material.

25. A wheelchair back system adapted to support the back of a human, said system being adapted to provide customized fit to a wheelchair user, said system comprising:

a rigid back shell-having lateral edges and a pair of flanges extending forwardly from the lateral edges;

mounting means affixed to said flanges to removably affix said rigid back shell to a wheelchair;

a plurality of foam blocks and a thin shim interposed between said rigid back shell and said foam blocks, said thin shim having a front surface and said system further including means for removably attaching said foam blocks to the front surface of said thin shim, said foam blocks providing a substantially continuous layer of foam of substantially uniform depth over the front surface of said thin shim, said foam blocks being individually and separately removable from said thin shim to provide a recessed area in said substantially continuous layer of foam to provide customized to wheelchair users; and

a pad member comprising an envelope containing a flowable fluid being sized to overlie the front surface of said thin shim, said system further including means for attaching said fluid pad to the front surface of said foam blocks and to said thin shim in any recessed area formed by the removal of a block.

26. The back system as described in claim 25 having a cover enclosing said thin shim, said foam blocks and said pad member, said cover adapted to maintain said pad member in its position with respect to said thin shim and said foam blocks.

27. A wheelchair back system adapted to support the back of a human, said system being adapted to provide customized fit to a wheelchair user, said system comprising:

a rigid back shell;

means for mounting said rigid back shell to a wheelchair;

a plurality of foam blocks, said back shell having a front surface facing forward and said system further including means for removably positioning said foam blocks forward of the front surface of said back shell, said foam blocks further having a front surface and providing a substantially continuous layer of foam forward of the front surface of said back shell, said foam blocks being individually and separately removable to provide a recessed area in said substantially continuous layer of foam to provide customized fit to the wheelchair user; and

a pad member sized to overlie the front surface of said foam blocks between the wheelchair user and the foam blocks and forward of the rigid back shell with a portion of the pad member assuming a position extending and received in any recessed area formed by the removal of a block, said system further including means for retaining said portion of said pad member in said position extending and received in said recessed area forward of said rigid back shell and between the wheelchair user and the rigid back shell.

28. The wheelchair back system as described in claim 27 wherein a thin shim is interposed between said rigid back shell and said foam blocks.

29. The back system as described in claim 28 having a cover, said cover enclosing said thin shim, said foam blocks, and said pad member.

30. The back system as described in claim 28 further including means for removably attaching said thin shim to said rigid back shell.

31. The back system as described in claim 26 wherein said thin shim has a front surface and said retaining means includes means for attaching said pad member to the front surface of said thin shim in any recessed area formed by the removal of a block.

32. The back system as described in claim 27 having a transition member placed at least in part in a recessed area formed by the removal of a foam block.

33. The back system as described in claim 32 wherein said transition member is a transition wedge having a sloped surface.

34. The back system as described in claim 27 having a build-up pad and means for attaching said build-up pad to the front surface of a foam block.

35. The back system as described in claim 27 having at least one adjustable lateral support attached to the front surface of said foam blocks.

36. The back system as described in claim 35 having a suspender and means for attaching said suspender to said adjustable lateral support and said foam blocks to hold said adjustable lateral support secure.

37. The back system as described in claim 27 wherein said pad member comprises an envelope containing a flowable fluid material.

38. The back system as described in claim 39 wherein said fluid material is a highly viscous liquid.

39. The back system as described in claim 27 having an external lateral support and means for movably adjusting said external lateral support up and down relative to said rigid back shell to find a preferred position for the human.

40. The back system as described in claim 39 wherein said external lateral support comprises an extended lateral bracket and a contoured pad.

41. The back system as described in claim 39 further including a contoured pad wherein said external lateral support has at least one lateral wedge and means for attaching said lateral wedge between the said external lateral support and said contoured pad.

42. The back system as described in claim 39 further including a contoured pad wherein said contoured pad and said external lateral support are covered by a lining fluid pad comprising a flowable fluid material.

43. The back system as described in claim 27 wherein said retaining means includes means for attaching said pad member to the front surface of said rigid back shell in any recessed area formed by the removal of a block.

44. A wheelchair back system adapted to support the back of a human, said system being adapted to provide customized fit to a wheelchair user, said system comprising:

a rigid back shell;

means for mounting said rigid back shell to a wheelchair;

a plurality of foam blocks, said back shell having a front surface facing forward and said system further including means for removably positioning said foam blocks forward of the front surface of said back shell, said foam blocks further having a front surface and providing a substantially continuous layer of said back shell, said foam blocks being individually and separately removable to provide a recessed area in said substantially continuous layer of foam to provide customized fit to wheelchair users; and

a pad member sized to overlie the front surface of said foam blocks wherein a thin shim is interposed between said rigid back shell and said foam blocks, said thin shim having a front surface and said system further including means for attaching said pad member to the front surface of said thin shim in any recessed area formed by the removal of a block.

45. A wheelchair back system adapted to support the back of a human, said system being adapted to provide customized fit to a wheelchair user, said system comprising:

a rigid back shell;

means for mounting said rigid back shell to a wheelchair;

a plurality of foam blocks, said back shell having a front surface facing forward and said system further including means for removably positioning said foam blocks forward of the front surface of said back shell, said foam blocks further having a front surface and providing a substantially continuous layer of foam of substantially uniform depth forward of the front surface of said back shell, said foam blocks being individually and separately removable to provide a recessed area in said substantially continuous layer of foam to provide customized fit to wheelchair users; and

a pad member sized to overlie the front surface of said foam blocks wherein said system further includes means for attaching said pad member to the front surface of said rigid back shell in any recessed area formed by the removal of a block.

Description Submit all comments and votes

BRIEF DESCRIPTION OF THE INVENTION

The present invention relates to a modular back system for use in wheelchairs. More particularly, the modular back system of the present invention includes a mounting means and a rigid back shell which may be fitted with a variety of padding systems.

The mounting means is adapted to attach the rigid back shell to the vertical posts of the wheelchair and to adjust the wheelchair rigid back at a selected position and attitude. That is, the mounting means is adapted to selectively adjust the attitude of the rigid back shell, i.e., adjust the height of the rigid back shell with respect to the seat of the wheelchair, to adjust the angle of recline of the rigid back shell and to adjust the depth of the rigid back shell (the distance forward or rearward from the vertical posts). Importantly, the mounting means is adapted to maintain the selected attitude adjustments of the rigid back shell when the wheelchair back system is removed from the wheelchair for transportation or storage. Thereafter, when the back is reattached to the wheelchair, the back will resume its desired, selected attitude and position and height.

The rigid back shell is a hard, relatively rigid surface extending between the wheelchair's vertical posts to provide mechanical support to the back and extending forward, at its lateral edges with a pair of forwardly extending flanges to provide lateral support. The padding system is generally mounted between the two forwardly extending flanges.

In a first embodiment, the padding system comprises a contoured foam pad attached to the rigid back shell. In the preferred embodiment, a fluid pad member comprising an envelope containing a flowable fluid material is positioned to overlie the spinal region of the user. This embodiment is particularly useful for persons which do not require extensive customization of the wheelchair back.

In a second embodiment, the padding system comprises a thin shim attached to the front side of the rigid back shell. A plurality of thicker foam blocks are removably attached to the front side of said shim by a hook and loop fastening means. The blocks form a substantially continuous layer of foam of substantially uniform depth over the front of the shim. In order to customize the padding system for a person with extreme back deformities, one or more of the foam blocks may be removed from the shim to create a recessed area. The recessed area can be used to accommodate any protrusions from the back of the user. A pad member is placed over the foam blocks, including the recessed area. The preferred embodiment of this pad comprises an envelope containing a flowable fluid material and sized to overlie the front surface of the shim and over the front surface of the foam blocks.

The present invention also contemplates the use of transition wedges which are used to provide a smooth transition from the foam blocks into the recessed areas. The present invention also contemplates the use of build-up pads or blocks which may be attached to the front side of the foam blocks and/or to the front side of the shim in the recessed area to further customize the fit of the wheelchair back for the needs of users. Alternatively, the build-up pads may be attached to the front side of a contoured foam pad, as used in the first embodiment.

The padding systems, including the contoured foam pad and blocks, transition wedges, build-up pads, fluid pad, and thin shim are all preferably covered by a fabric cover, which may be an outside cover only, or may be an outside cover enclosing an inside cover and attached to a rigid back shell by a hook and loop fastening means.

BACKGROUND OF THE INVENTION

A significant number of people confined to wheelchairs have body deformities which require a customized back. These people require a wheelchair back which conforms to the shape of their bodies so that they will have enough contact with the wheelchair back to be able to sit upright, without falling over. A custom shaped back also provides comfort and avoids skin pressure that may result in decubitus ulcers (pressure sores). Decubitus ulcers are a very serious problem that requires hospitalization, surgery, and extensive rehabilitation. It is estimated that the current cost of caring for a decubitus ulcer is in the $60,000 to $75,000 range. Naturally, while the patient is hospitalized, he is unable to travel, work, or enjoy other pleasures afforded by mobility, and tremendous and devastating psychological trauma can occur.

The people requiring customized wheelchair backs include those affected with cerebral palsy, muscular dystrophy, multiple sclerosis, head injuries, and other similar ailments. Their needs for customized backs can develop because of kyphosis, scoliosis, and lordosis, plus a combination of twisted deformities in varying degrees of severity.

In order to fit those people with back deformities properly in a wheelchair, the back of the wheelchair must be contoured so as to be able to fit closely to the body's shape so as to provide support over the whole back without putting too much pressure on any one point. Currently, there are three approaches used to develop such a contoured wheelchair back.

The first approach is a custom foam system. In this system, an impression is taken of the body. Once the impression is made, it is sent to a factory site. At the factory, foam is either carved by hand or molded to match the impression of the body shape. An upholstery cover is placed over the carved or molded foam.

This method suffers from a number of disadvantages. For one, it takes a long time to construct the system (typically several weeks). It is also a labor-intensive method and, therefore, expensive. Further, when completed, the system cannot be changed even if it was done incorrectly. Systems on the average take three to six weeks to deliver and three to six weeks to remake if done improperly. The system also cannot be changed if the user's body changes over a period of time. This is especially a problem with children whose bodies quickly and continually change. It is also not possible to fit the user in his own wheelchair which increases the probability of an improper fit at the time of delivery. Rather, the fitting must be done in a fitting frame. Further, there is no opportunity to assess or evaluate the system's effectiveness by the user prior to purchasing it since the system is custom made. In addition, if the foam or cover wears out, the entire system needs to be replaced. Finally, problems with decubitus ulcers are often encountered because of shearing, improper fit, and the user moving and not sitting in the molded position.

The second common approach is a foam-in-place system. With this system, a flexible plastic bag is put between the user and a rigid surface. Liquid foam is then injected into the bag. The liquid foam expands into a rigid foam which takes the shape of the user's body. This system also has a number of disadvantages including the fact that it is messy, and that one cannot control the volume of the foam. In addition, the foam-in-place system has all of the above disadvantages of the custom carved molded products.

The third system is marketed under the trade name MATRIX. It allows custom fit to the individual by adjusting a series of metal parts that form to virtually any body contour. The hard matrix is then covered by foam and a fabric cover. This system takes an average of 4-8 hours to fit and is very difficult to refit should someone desire to change the system.

The back system of the present invention overcomes the foregoing problems as is more fully described below.

SUMMARY OF THE INVENTION

The present invention relates to a modular wheelchair back system.

The wheelchair system of the present invention comprises a rigid back shell and a mounting means adapted to removably affix the rigid back shell to the vertical posts of a wheelchair at a selected position in a selected attitude. The rigid back shell is fitted with one of several padding systems.

The Mounting Means

The mounting means is preferably a 4 point mounting means adapted to removably attach the modular back to the wheelchair in a selected position and attitude. In its preferred embodiment, the mounting means includes means to adjust (and maintain in the adjusted position) the back in the desired depth and angle mounted on the rigid back shell and the means to adjust and lock the height mounted on the vertical posts of the wheelchair. The mounting means preferably comprises a pair of post brackets, which are mounted on the vertical posts in a selected position, to accommodate the user's needs. A pair of rods, adjustably affixed to the rigid back shell, engage the vertical post brackets. A pair of U brackets, adjustably affixed to said rigid back shell, engage the wheelchair posts at a location spaced apart from said post brackets. The depth and angle of the back is controlled by adjustment of the position of the rods (which engage the post brackets) and adjustment of the position of the U bracket. Using these adjustments, the depth of the back may be adjusted forward or backwards in the chair, and the angle of the back may be adjusted. The selected back position is maintained by the mounting means even after removal from the wheelchair and later replacement on the wheelchair. The mounting means also does not normally interfere with the arm rest or the folding mechanism of the chair. This allows for easy folding of the wheelchair for transportation.

The ability to recess the back is important to lengthen or shorten seat depth for different users, to adjust backward over time to accommodate growth, and to keep feet in footrests. The ability to recline the rigid back shell is important to accommodate a hip angle of more than 90.degree., to allow users with severe kyphotic deformity to look straight ahead rather than at their lap which results in fatigue to the neck, and to increase stability by allowing the head to rest against a headrest.

These adjustments generally are made one time during fitting, and then do not need to be changed, even when the back system may be removed at a later date to transport it, and is then replaced back in the chair for use. Further, if a change from the initial position is required for example, to accommodate the user's growth, the back may be readjusted in height and forward or backwards in the chair and the angle of the back may also be adjusted and re-set in the new position.

Rigid Back Shell

The rigid back shell includes a monolithic, rigid surface, which is generally contoured with the vertical center line being somewhat to the rear of the lateral edges in a manner to generally conform to the shape of a human back. Attached to the lateral edges are a pair of forwardly extending flanges. The mounting means is attached to the forwardly extending flanges. While whatever type of padding system used is generally mounted within the volume defined by the forward extending flanges.

The Padding System

A first embodiment of the padding system of the present invention relates to contoured backs for wheelchairs for people who do not require extensive customization of the back. More particularly, this embodiment relates to a wheelchair back system comprising a contoured foam pad. In the preferred embodiment a fluid pad member is attached by a hook and loop fastening means such as is commonly available under the tradename VELCRO to overlie the front surface of the contoured foam pad along the length of the spinal region of the user and is attached to the contoured foam pad so that it runs down the middle of the contoured foam pad.

The second embodiment of the padding system of the present invention relates to custom shaped backs for wheelchairs for people confined to a wheelchair and who require an extensively customized wheelchair back. This embodiment comprises removable foam blocks, transition wedges and build-up pads which are attached to a thin shim. The foam blocks provide a substantially continuous layer of foam having a substantially uniform depth of the entire front surface of the shell. Individual blocks can be removed in order to create a padding system surface conforming to the shape of the person's back deformity. The thin shim may be placed in the rigid back shell between the rigid back shell and the foam blocks. Alternatively, build-up pads cam be added to the front surface of the layer of blocks in the second embodiment or to the front surface of a contoured foam pad in the first embodiment to further customize the padding system and can be removed or added to the shim so as to create a padding system surface conforming to the shape of the person's deformed back. In addition, a pad member is attached by VELCRO to the shim, the build-up pads, and the foam blocks. The pad member overlies the front surface of the shim and the foam blocks and build-up pads.

To form a proper contour for the shape of the user's back, the foam blocks can be removed from the shim to form a recessed area to provide a customized fit for the user's back with a possible depth of as much as 4 inches behind the original surface of the blocks. The edges of these blocks are preferably beveled so that they do not present a sharp edge to the person's body and generally do not require modification by the person setting up the system. While the preferred embodiment uses blocks which do not generally require modification by the therapist or person doing the fitting, it is understood that another embodiment could employ blocks which generally may be modified for a substantially perfect fit. Foam transition wedges are provided to achieve a smooth transition from the front plane of the removable blocks to the front surface of the thin shim or rigid back shell. Various size transition wedges allow a more custom fit. Additional conformity to the user's back shape is achieved by filling in spaces or voids in areas forward of the front plane of the removable blocks or the contoured foam pad by placement of build-up pads on the front plane of the removable blocks or contoured foam pad. These build-up pads contour to the body shape in order to fill in around the body. The build-up pads can also be used in the recessed area (where the blocks were removed) to build up that area since removing the blocks may create too much of a recessed area.

Foam lateral supports with optional reinforcing VELCRO suspender may be attached to the front surface of the foam blocks or the contoured foam pad with VELCRO.

The Pad Member

The pad member, which overlies the foam blocks, may be a thin foam pad or a flexible envelope containing a flowable fluid material, adapted to smooth out the contour of the back over the blocks, recessed areas and add-on pads.

In the first embodiment, a fluid pad member generally is used to overlie the spinal region of the user, but may be sized to overlie the entire surface of the padding system.

In the second embodiment, a fluid pad member is used to make the customizable padding system have a substantially perfect contoured fit to the user's back. Further, the pad member allows the person to be able to move a little while still maintaining a substantially perfect contoured fit to his body. The pad member covers the whole front surface of the padding system. It is oversized by a significant amount so that it can be draped into any recesses and easily fill in over the build-ups from the build-up pads while overlying the surface of the thin shim. The pad member will also generally smooth out the edges of all the components (i.e. foam blocks, foam lateral supports, build-up pads, transition wedges) underneath it. The pad member is held in its proper position by having VELCRO on the back side of the pad member, which attaches to the foam blocks, build-up pads and transition wedges and to the thin shim in the recessed area. In addition, the pad member has flaps which fold over the back of the thin shim and attach to the back of the shim by VELCRO. The plastic film of either side of the pad member may be transparent so that the therapist or fitter may observe where the fluid has displaced during the fitting process, and thus adjust the fitting to provide substantially uniform pressure on contact areas of the user's back.

A further reason for the pad member to be oversized is to prevent hammocking. Hammocking is defined as a suspension of the bony prominences of the user on the surface of the padding system, thereby preventing substantial conformity of the padding system to the user's body and preventing substantially complete pressure equalization. By having an oversized pad member, the surface will easily yield in response to pressure from the bony prominences and therefore distribute the pressure over a larger area.

The Cover

The shim, foam blocks, build-up pads, foam lateral supports, and pad member all fit inside the covering system which may be of two embodiments. One embodiment employs an inside protective cover and an outside washable cover. The inside cover is incontinent and protects the whole system from any tampering with the positions of the internal components, while the outside cover may be easily removed for washing. Further, the zipper of the inside cover can be partially unzipped while the user is still sitting against the system so that the therapist can make adjustments to better fit the user's body immediately. This is especially important when there have been changes in the user's body shape, and if the system is not adjusted, a substantially perfect fit will no longer exist, and a decubitus ulcer can quickly form. The inside cover is a full-zip enclosed cover which is attached to the pad member. The inside cover contains VELCRO attachment points. The front of the cover is oversized to avoid a hammocking effect when covering the recesses in the padding system surface. The covering system may have VELCRO points that are attached to VELCRO points on the foam blocks and the thin shim. The outside cover is a removable washable cover and includes extra material so that there is no hammocking effect creating pressure on the user's body. Tear out seams allow for adjustment of the cover shape depending on the deformity, to provide enhanced cosmetic appearance.

A second embodiment of covering is an outside stretch cover, stretching over the front of the foam parts, but leaving the back of the thin shim or contoured foam pad exposed. Either style of covering is intended to provide at least one cover that will protect the internal components.

The Customization

Because the customizable back system of the present invention uses removable foam blocks, transition wedges, build-up pads, and pad member, the system can be quickly set up for a user by a therapist or training fitter. Accordingly, a lot of the labor expense of producing the system that was required in the prior systems is eliminated. Further, a user can have the system the day he is fitted for it. It can even be fit into the user's own wheelchair. Even if a substantially perfect fit is not initially achieved, the components of the system can be easily changed so as to achieve a substantially perfect fit. Also it may be necessary to change the contour later if the person's body changes due to gravity, growth, etc. In addition, because the components of the system can be so easily set-up, the user has an opportunity to assess and evaluate the system prior to purchasing it. Further, if some of the components of the system wear out, they can be replaced without having to have the entire system replaced. Furthermore, because a substantially perfect fit to the user's body can be achieved and because the system can allow for movement by the user, the probability of decubitus ulcers is greatly decreased over that which occurred in the prior systems. Furthermore, this system permits the concept of progressive fitting, meaning the fitter can choose to become more aggressive with successive fittings, thus allowing gradual correction of deformities or postural tendencies, much the same as when a dentist tightens teeth braces as the teeth start to straighten.

External Lateral Supports

Lateral supports attached to the rigid back shell, external to the padding system, may be used to provide side-to-side positioning and support of the user's body. These external lateral supports may be needed instead of or in conjunction with the previously described foam lateral supports to provide more aggressive support to the user if necessary. External lateral supports generally include a rigid bracket, foam pad, optional wedges, and optional lining fluid pad with a cover. The external lateral support fits onto the adjustable rigid back shell with VELCRO for assessment, and with bolts for permanent mounting. The rigid bracket fits between the side guards on the rigid back shell and the padding system, and is curved on one end to allow attachment to the rigid back shell between the rigid back shell and the thin shim. The external lateral support may be