The Rifton Advancement Chair:

Measurable Progress for Sitting Skills

by Christina Lopes, PT, DPT
Doctor of Physical Therapy, New York City Department of Education
PS 138 @P30  

It can be difficult to implement measurable progress in children with severe disabilities. As pediatric physical therapists, we are taught to focus on positioning as a means of preventing skin breakdown, and are tempted to choose adaptive equipment that provides the most support.

However, positioning children in adaptive equipment that is completely supportive always seems a bit counterintuitive to me. As a therapist, my goals should be to assist patients in attaining gross motor outcomes that emphasize “progress,” not “maintenance.”

Positioning a child in a supportive device provides little opportunity for muscle activation. Most products that are designed for children with severe disabilities are “passive” in nature. They provide total body support and thereby eliminate any chance of measurable progress.

Fortunately, Rifton has developed the Advancement Chair.

The benefits of the Advancement Chair are numerous. It focuses on “active” sitting by allowing the chair to be anteriorly tilted, thereby promoting trunk and neck muscle activation. For children who cannot sit without upper body assistance, the Advancement Chair provides forearm supports which allow for shoulder girdle muscles to be used in upright sitting. Most importantly, all the accessories can be removed slowly, to provide continual improvement in function and maximize muscle strength.

A more advanced use of this chair is its ability to assist with sit-to-stand activities. The chair can be tilted forward to a point at which sit-to-stand becomes easier for the student and caregiver alike.

In essence, the Advancement Chair has been a gift for my students with severe disabilities. It became very clear to me how effective this chair was when I used it for the first time on a child who could not hold his head upright without a headrest.

In the Advancement Chair, not only was he able to actively hold his head in midline, but I noticed him turning his head to look at me. To see this child turn his head independently was an astonishing moment!

Click to continue…Facilitate Positioning to Develop Sitting Skill: Rifton Anchors