Dropped Head Support
The client, Irene, has dropped head syndrome whereby her neck muscles are unable to support the weight of her head. Without support, her chin rests on her chest which results in breathing difficulties. With help from Occupational Therapy, Physiotherapy and Orthotics, various neck collars were tried but she is unable to tolerate them due to her Kyphoscoliosis.
The only solution which had been found to work was to support Irene’s head with a piece of memory foam inserted inside a fabric bandage strap across her forehead which is tied to the back of her reclining chair. The constant pressure from this over many months had resulted in severe pressure sores across the forehead. To relieve the pain from both the pressure sores and the constant pressure exerted on the forehead, the head support bandage was being repositioned typically 244 times over a 12 hour day (every 3 minutes!)
The Occupational Therapist contacted REMAP to ask if we could help.
The Challenge
The requirement is to relieve the pressure on Irene’s forehead from the support bandage which holds her head up and allows her to breathe. The constant pressure causes pain and pressure sores. The family, in conjunction with the NHS, have tried all the commercially available solutions without success.
The solution
In an attempt to relieve the pressure on the forehead a headrest was constructed to help support the head by letting Irene rest her forehead on the headrest without having the constant pressure of the bandage. This solution would also allow Irene some limited head movement to relieve the pressure herself without needing someone else to pull the support strap away from her forehead. Unfortunately this solution did not work as Irene’s head simply slipped down below the headrest. A chin support was added to try to overcome this issue, but this was not successful as it resulted in a claustrophobic arrangement which also made speaking, eating and drinking very difficult.
On-line research into pressure sores identified two solutions based on passive and active support surfaces. These solutions are used in medical grade mattresses to reduce the risk of pressure sores for patients. Following a phone call with Essential Healthcare Solutions (www.essential-healthcare.com) about both passive and active support, they kindly donated samples of the specialised foams they use in their passive support mattresses and the fabric they use for their active support solutions. The memory foam used in the forehead strap was replaced with the specialised foam to see if this would provide better pressure relief on the forehead. Whilst this initially provided some relief, the foam soon compressed to the point where it wasn’t helping to reduce the pressure experienced.
An active support solution was then designed and constructed. This comprised a multi-chamber inflatable cushion with an associated control unit. The cushion was made using the fabric donated by Essential Healthcare Solutions. The control unit comprises an air pump, electric valves and an electronic circuit to control everything. The control unit inflates the cushion chambers in an alternating sequence to help relieve the constant pressure on the forehead. The inflation pressure and the rate of alternating inflation between the cushion chambers can be adjusted on the control unit. Several different cushion designs were tried until a workable solution was found in terms of the number and size of the inflatable chambers.
The benefit
This solution has proved to be effective in relieving the constant pain from the original foam and bandage strap. Following two months of daily use, the pressure sores now show significant signs of healing. The head support bandage can now be left in position for 30 minutes or more without needing any adjustment. The reduction in constant disturbance of the skin is believed to have helped with the healing process, together with the reduction of the overall pressure felt on the forehead.
Quote from Irene’s daughter:
“We appreciate all your efforts and just wish this project was easier for you. What has been achieved is amazing.”
- Skills involved:
- Issues Addressed:
- Activities Helped:
- Location:
- Solution:
