Contributed by Kathleen Riley PT, ATP
Charlotte-Mecklenburg Schools
Charlotte, North Carolina
I work in a school system with a variety of students with physical needs that require individualized consideration for safety in the restroom. We use a variety of equipment to assist with transfers and managing their personal needs. We’ve recently had success with the Rifton TRAM with several students. Following are two examples.
One of our older students with cerebral palsy and significant full body extensor patterns was being transferred to an adjustable-height changing table using a mechanical lift and a sling with head support. Although the staff was confident that she was safe, it was always a bit unnerving when she did go into full extension when being suspended in the lift mid-transfer. This student did not do a stand pivot transfer but did use a stander routinely and loved being upright.
We used the Rifton TRAM with her and discovered that she could be brought to upright standing with the device which enabled staff to manage her clothing and diaper quickly and easily while she was standing with weight bearing through her legs. Although it still required two people, the entire process was much quicker. When the staff members were finished with her clothing management, they added the thigh straps which placed her in a secure and perfect position to be placed back into her chair with neutral pelvis and fully back in the seating system. The classroom staff love this device as it allows them to change her much quicker especially when she is wearing leggings or her other fashionable wardrobe items! Prior to using the TRAM it took, on average, 25 minutes. Now it generally takes 10 minutes or less. So this has decreased her care needs by almost one hour per day for two staff people, since she is in the restroom four times a day.
We are also using the TRAM with a student in middle school. She has cerebral palsy, spastic and athetoid quadriplegia, and is in the general education setting with exceptional children resource support so she is in multiple locations each day. She drives a power wheelchair with a head array but is dependent for all transfers and mobility related activities of daily living (MRADLs). The classroom assistant was doing a modified pivot transfer with her bearing weight on the footplate of her wheelchair to an adjustable height changing table for clothing and garment management as she is not fully continent. There is only one private restroom location for this activity and it was not on the hallway where she had the majority of her classes. When we used the Rifton TRAM with her we used it in a large modified restroom and transferred her directly to the commode where she is often successful with toileting (no changing table needed). She can have clothing and garments managed in standing and she and the assistant have a great method of elevating her so her feet go back onto the footplates and then she can position herself back in the wheelchair after the TRAM lowers her into the seating system. This is certainly a big boost to her self-esteem and also takes her out of the classroom for less time. Prior to using the TRAM it took 25 minutes for restroom activities and now takes only 10. That means she is in class an extra 30 minutes per day. In addition she uses the TRAM for walking during PE. We love that we can just lower her down to sit on a folding chair or a bench when she needs a rest because the TRAM provides great secure postural support for her in the sitting position.
For these two students the Rifton TRAM has really made a difference in their daily lives.
Back to Top