Head Support
The Suffolk East group was asked by an occupational therapist to provide some head support for use when walking. Neck collars and chin supports are available by they tend to be very uncomfortable.
A support was not required when sitting back in a lounge chair or on a mobility scooter. In fact a support would probably hold the head too far back when sitting.
The client had already adapted a baseball cap with a strap to a waist belt but this was proving to be inadequate.
The solution
It was decided to see if a neck roll would give a better angle of pull. It was hoped this would result in less webbing strap tension and therefore less pressure on the forehead. Initially a neck roll formed by a small rolled-up towel was tried and found to work well.
A travel pillow was modified by the client’s partner. The pillow had a zip to allow the cover to be removed for washing. This allowed the central part of the cushion’s filling to be replaced by some rolled-up towelling to make it firmer and with some foam over the top for comfort.
Two designs of support were tried. One utilised the ‘harness’ extracted from a builder’s hard hat while the other was made from webbing. Another option would have been to use a harness from a face visor. A towelling headband, as used in beauty salons, made wearing the harness option more comfortable. For the webbing version some closed-cell foam was used around the forehead part to give more comfort. It was considered that ordinary firm foam may compress too much but the closed-cell foam tends to be too firm. The foam is held in place by towelling with Velcro fastening so it can be removed for washing. This also allows the foam to be removed so a hat can be worn over the webbing.
To avoid the tendency of the back of the trousers being pulled up by the webbing strap, the head support was tried with the webbing going under the arms and around the chest instead. This was found to be unsatisfactory.
It should be noted that support prevents almost all rotation of the head.
Hard hat harness version
The benefit
The use of a neck roll or modified travel cushion was found to be transformational: allowing our client to walk to shops and to go on country walks.
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Hi Ian,
Thank you for your comments. When seeking permission to publish the photo I said to our client that I hoped we would be able to help others by publishing this. I would say that the use of a neck roll or travel cushion is transformational.
I would advise against trying to allow a small amount of lateral head movement. I think it is quite likely that clients having difficulty keeping their heads up are likely to have weakened strength to keep their heads from falling laterally. Anyway, I do not see that anything significant is to be gained by allowing some lateral movement. Our client had some difficulty stopping lateral head movement when using a mobility scooter on uneven surfaces.
In considering allowing some head rotation, I refer you the ‘Axion Rotating Wheelchair Headrest’. For something like this to work when not fixed to a wheelchair I think you would need a support system like the ‘Head Support System Plus’.
Since publishing this on MakeAbility, our client has asked for a quick release mechanism. He now has a small device which attaches to his belt with a ‘rip cord’ to pull to release the head support. It has spring tension which can be adjusted so it does not release unexpectedly, nor too difficult to pull the cord.
Peter (Remap Suffolk East)
congratulations on your very simple & effective solution to this difficult problem. I have now had two clients in six months with the identical challenge. The first was fitted with a baseball cap tensioned with a velcro strap (as per the original design) to the back of his dining room chair and greatly fascilitated eating/drinking & talking . Today’s case-the family had already fitted a soft webbing strap around his forehead attached to a metal post anchored to the back of his riser-recliner chair with some success. (in the absence of any discernible practical help from the DHS) . We plan to upgrade to using your safety helmet device with an adjustable strap as maintaining maximum extension will be tiring & will need to be relaxed after a while. Possibly building in a small degree of head lateral & vertical movement as well, to permit “normal head movement”. The “rolled hand towell” behind his neck, helping to re-establish the normal cervical curvature proved an instant success .