Oct 262015
 

The client is an amputee, and needed a pull-out table in his kitchen for crockery etc., prior to washing up.

The client washes up from his wheelchair, but the kitchen layout left little space for the crockery, pans etc.ready for washing.

On the left of the sink there is a washing machine under the worktop, and a microwave on top. Various solutions were discussed including getting a tea trolley which could be positioned as required. This was rejected as the room was very full, and extra furniture was not a good idea.

The solution was to put a pull-out shelf in the 28mm gap between the washing machine top and the underside of the work surface. A pair of heavy duty drawer runners with ball bearings was purchased, with a 40Kg load capacity. A shelf was made from 17mm plywood and finished with varnish. As the runners would have set the shelf too high, fouling the underside of the work surface, the shelf was attached to the runners via steel brackets fitting into recesses in the bottom of the shelf. This gave adequate clearance with the worktop underside and the top of the washing machine.

To limit the amount the shelf could be pulled out, or pushed in. stops were fitted. The RH runner could be fitted to a vertical surface, but the left hand runner was fitted to a baton which was then screwed upwards into the underside of the worktop. 4mm bolts were used to attach the runners to the steel shelf brackets.

A handle was fitted to the front of the shelf..

Refer to photos of the fitted shelf.

The fitted shelf was tested pulled out to it’s maximum limit, and tested under the maximum recommended load. This load was set at 15Kg, far more than the client is likely to load the shelf with. It proved to be very stiff, with no detected deflection. It was considered that a prop was not required.

image

image

Bristol panel case ref. 9\15-05

 October 26, 2015  Posted by at 15:29 Household Equipment No Responses »
Oct 212015
 
Platform in use
Platform in use

Castor & bkt 
Spring-loaded castor and support bracket

The client, who is 4ft 2in, uses boxes to allow her to stand at the kitchen sink to do the washing up and look out over her garden. This was unstable and she had already fallen once.  A stepped platform 25cm high with a hand rail was made.  It is easily moveable so that she and other members of the family can gain access to the cupboards and drawers, and also secure when in use. A set of four spring loaded ball castors were fitted with springs chosen to lift the weight of the platform when unloaded, but to retract as soon as the client stepped on (similar to a kick-step used in libraries).

Berks Panel Job BK2015/46.

BerksRemap@gmail.com

Oct 212015
 
Finished walker
Finished rollator
Unmodified buggy frame
Un-modified buggy frame 
The 6-year-old client is able to walk short distances indoors, but when outdoors, she needs an aid which is manoeuvrable but gives her stability and some protection against bumping into things and able to cope with moving over rough ground.  It will help to improve her stamina, balance skills & confidence and  to join her family when they are out and about.  A child-size off-road rollator is not available to buy.

The family had an off-road buggy which was no longer required.  This was modified to lower the handle bar and move the rear wheels further forward to reduce the overall length and improve stability.  The over-long vertical tubes were not cut down to allow the changes to be reversible.  It still folds for storage and transport.

Berks Panel Job BK2015/48.

BerksRemap@gmail.com

Oct 152015
 

The client’s condition make it difficult for her to get around her home with her 3-wheeled walker. An adaption to the walker is requested, to add gutter supports.

Two options were discussed with the client.

Option 1. Insert and bond close fitting extension tubes into the existing handles, upon which the gutters would be bolted. The client’s forearms would then rest in the padded gutters, whilst her hands could hold the walker handles and operate the brakes if needed.

Option 2. Bolt the gutters directly over the existing handles. This means the walker brakes could not be used, but the client is positioned closer to the walker.

Given that the client only uses the walker to go from room to room, and has poor grip so that braking is not an option, option 2 was chosen. The walker is never used outside of the house.

Two 20cm lengths of 2mm thick plastic gutter were used to make the gutters. Two cushioning pads were made from 25mm thick foam, covered with ‘leatherete’ material. Two holes were drilled through each existing handle, and two 6mm bolts used to secure the gutter assemblies. All corners and edges were radiused. The cushions were secured over the roundhead bolt heads with self adhesive Velcro.

image Bristol panel case ref 10\15-01

Oct 142015
 

The first Remap job ever was for a ramp, for Pat Johnson’s sister. Since then the statutory provision of basic aids has improved considerably but Remap still makes ramps and other simple devices for our clients as well as more complex aids.  However, sometimes we are asked to produce aids when there are readily available and not costly commercial devices which could do the job.

The provision in our old constitution which stated we could only make devices when there was no commercial equivalent available was removed when we became an incorporated association.  Whether or not to accept a task is a decision best made at local, not national, level and Panels are free to accept or decline requests as they see fit.  One valid reason for declining a task would be that a commercial device is already on the market and that producing an equivalent would not be an effective use of out volunteers skill or valuable time.  This applies particularly to some request for ramps and furniture raisers.  The converse, that a valid reason for making a device is simply that one of our volunteers wants to do it is of course equally true.

Furniture and Bed Raisers

Requests for furniture (chair/settee/table) raisers and bed raisers are made regularly.  While the jobs are necessary for the comfort of the client for many volunteers they are sometimes not particularly interesting to make and too many such tasks can cause volunteers to become demotivated and leave Remap.  To maintain a sensible balance between the needs of clients and the need to conserve volunteers Panels should be aware of the commercially available products so they can point referrers to more appropriate solutions if they so wish.

The two major manufacturers of furniture raisers are are Langham and Morris & Alexander (M&A) but there are also a number of smaller companies.  The Langham (and similar Medeci Raisers) tend to be the sort which slide over a chair leg or the chair leg sits in a cup type receptacle with a series of spacers or a screw mechanism inside to get it to the required height.

These are usually very simple to install.   The major disadvantages of this type of raiser is that they are visually very obtrusive (often revoltingly ugly!) they only fit a limited range of chair legs and they do not suit electric recliner chairs.  Sometimes chairs fitted with them have to be positioned with their back against a wall to add stability. They do fit spindle leg chairs.

Langhams1

langham chair raised 

langham rased chair

The Morris & Alexander approach is somewhat different.  They use an adjustable steel frame which screws (or attaches using a variety of adapters),  onto the bed or   chair structure.

 

M&A raiserThis gives a very rigid and stable support which is visually less intrusive than the “plant pot” raisers.  It also means they are suitable for a wide range of furniture base types and dimensions and also electric recliner chairs.

MandA1

settee raisers

Should Remap be Making Chair and Bed Raisers?

In most cases before accepting a chair/bed raiser task the referrer, if an OT, local authority or other organisation (as opposed to an individual), should be asked why a commercial device is not being used instead of Remap.  If the reply is that we are cheaper the task should be declined and the referrer told to use a commercial supplier. (However, if a volunteer wants to take the job on because they like that sort of task then of course they should.)

If the reason for Remap being asked is that no ready made device will do (but bear in mind that Morris and Alexander raisers fit far more furniture types than the slightly cheaper and more commonly stocked Langham types  so referrers should be specifically asked why they have not considered M&A) then we should accept the task.

If the referrer is having problems with getting M&A raisers they can be asked if they will reimburse the panel with the cost of purchasing the appropriate M&A fittings and if (and only if) the referrer agrees the panel should obtain the most appropriate M&A raiser and fit it.  The referrer, if a company or organisation, can be billed for the direct cost of the purchase and volunteer travel expenses but no other cost.  If it is an individual no billing must take place.

If the client is distressed by the appearance of either type of chair raiser we should consider making something which would be more acceptable or camouflaging the fitting.  Many clients would like to minimise the intrusion of “medical” devices into their homes and this is perfectly reasonable and understandable.

The above is inevitably very general guidance.  Each case should be considered individually and the aim must always be to best meet the needs of the client, not the budget or policy of the local authority.

Ramps

The need to provide “reasonable access” for wheelchair users to commercial premises has led to the manufacture of a large number of folding aluminium glass fibre and other portable or semi-portable ramps.  As with chair raisers the manufacture of ramps isn’t always challenging and should not be done just because we are cheaper.  Whether advising a referrer to look elsewhere or using a commercial/industrial ramp in a Remap solution the aim as always must be to meet the needs of the client.

Unlike raisers there are hundreds of manufacturers of ramps both for industrial and disability use.  OT’s tend to be unaware of industrial suppliers even though they may offer better value for money or more flexible solutions.  A Google search for “industrial ramps” and separately for “Wheelchair ramps” will give you more than enough suppliers.  The links below are to a few.

http://www.portableramps.co.uk/contact.php

http://www.theramppeople.co.uk/wheelchair-ramps

http://cpc.farnell.com/1/1/78162-duratool-d01772-ramp-wheelchair-telescopic.html

http://www.wheelchair-ramps.co.uk/

It is common for Remap to be asked to build a ramp where the recommended slope of 1:12 (5° slope, 8% grade, 1 foot of ramp for each inch of rise) cannot be achieved.  Invariably this is because the statutory services (not entirely unreasonably) treat 1:12 (the minimum required for installed ramps by Part M of the Building Regulations) as an absolute limit to be used and assume public access rather than making an assessment of an individuals capability.  We start with the client and try to produce a solution which they can manage. As a starting position a short slope of 1:6 (10°) can be managed by most power chairs or a reasonably fit assistant pushing a manual chair.  A slope of 1:8 (8°) will be usable by most people.

 

 October 14, 2015  Posted by at 22:32 Technical Articles No Responses »
Oct 142015
 

Remap makes many outside objects such as ramps which require a non-slip finish.  This article looks at some of the options available.

Commercial Non-Slip Products

There are a  number of suppliers of non-slip products (as opposed to paints). Two of the better known are Suigeneris and Step-on-Safety.  They make pre-fabricated glass fibre non-slip strips and covers to attach to existing structures.

Fabricated Solutions

Fabricated solutions include mesh attached to surfaces and paints and other finishes.  These are commonly found in Remap jobs.  In the discussion below it is assumed that the substrate is wood unless anything else is mentioned.

Attached N0n-Slip Materials

These include roofing felt, wire mesh and plastic mesh.

Roofing Felt

The use of roofing felt is deprecated.  Although it provides a good non-slip surface it has little tear resistance and once torn rapidly becomes a trip hazard.  It is difficult to maintain in good condition, soon looks shabby and in hot weather and especially direct sunlight becomes soft, fragile and liable to leach semi liquid bitumen which if carried inside on footwear will ruin any carpet it touches.

Chicken Wire

Chicken wire is sometimes used to provide a cheap non-slip surface on riverside jetties and the like.  Small hole chicken wire is nailed to the surface using galvanised or stainless steel staples.  The surface it creates is moderately non-slip but the wire strands are prone to breaking and creating a trip hazard.  Once it starts to break up repairs are usually impractical and the surface has to be re-laid. The staples also allow for rainwater entry into the wood.  On ramps it is not ideal as it looks cheap, hold dirt and debris and is difficult to maintain.

Plastic Mesh

Plastic square mesh with a mesh size of 20-40mm has taken over from chicken wire in New Zealand where it is used to create non-slip surfaces on tourist walkways in temperate jungle.  It is stronger than chicken wire, does not create as much of a trip hazard if broken and has better non slip properties.  Visually it is slightly more acceptable than chicken wire.  It is attached with staples in the same way.

Green garden Mesh

Surface Finishes

These include Polyester Resin (fibreglass resin) and paints, both with non-slip additives.

Polyester Resin

Polyester resin is used in fibreglass manufacture but can also be used as a wood finish.  It is a two part product comprising a resin and hardener.  Once mixed it starts to set and must be applied immediately.  It is usually unusable after about 10 minutes or so depending upon temperature.  It must be applied to a clean dry surface.  Because it sets very quickly it is difficult to paint the surface and then sprinkle on sand or other non slip substances, it has to be done quickly and a bit at a time.  Once down the surface is long lasting hard wearing and easy to repair if required.  Compared with paints it is generally more expensive but longer lasting.  Powders used to provide the non slip surface include dry sand, carborundum grit and Fillite.

Paints and Varnishes

Oil based paints and varnishes have the advantage of an unlimited range of colours and familiarity.  It is worth investing in a good quality oil paint and preparing the surface carefully.  Non slip additives can be premixed with the paint or sprinkled on the surface before it can dry. Powders used to provide the non slip surface include dry sand, carborundum grit and Fillite.

Additives
Sand

Dry sand is cheap and easily available.  It has moderately good non slip properties. It can be sprinkled on wet paint by putting some sand in a fine mesh kitchen sieve and tapping sieve while moving it over the paint surface about 3ft above it.  After the paint has dried excess sand can be brushed away. Because it is a dense material (1.6g/cc) it isn’t easy to pre-mix with paint as it tends to sink to the bottom and creating an even surface finish can be difficult.  It wears moderately well,  is easy to retouch but difficult to obtain an even finish.

Carborundum Grit

Carborundum grit is a more expensive additive and creates a very non-slip surface.  The surface is sufficiently abrasive that if anyone falls on it they can get moderate abrasions.  It is very hard wearing and for extreme conditions is probably the best finish.  As with sand it is dense and doesn’t easily mix with paint.  Probably the best way of applying it is to mix some with paint in a tray and apply with a brush.   Agitating the paint in the tray with the brush will keep the carborundum mixed.  You do not need a large amount to create a non-slip surface.  To apply it to Polyester resin requires quick work, it is best sprinkled on the surface immediately the resin is applied.

If the ramp is to be used by people walking but unsteady on their feet carborundum may not be the best choice as it may cause them to stumble if their walking gait involves dragging or shuffling their feet – it is very non slip and footwear can’t easily slide over it.

Cost is about £15/5kg. and its bulk density is 1.64 to 1.88 g /cc.  SG is 95 g/cc and it is rated 9 on the moh scale of hardness.  There are many suppliers on-line, CFS  have proven to be reliable.

Fillite

Fillite is a powder extracted from pulverised fuel ash from coal-fired power stations.

carborundum and fillite

Top – Fillite                                                                                        Bottom – Carborundum grit

Fillite cenospheres are lightweight, hollow, inert, spherical, low density, very free-flowing, alumino-silicate microspheres. It is used as a filler material in resin cast moulds and also as the non-slip additive for some marine deck paints.  Because of its light weight and ball shaped granules it mixes well with paint or Polyester resin without sinking.  It is usually available as a light grey powder and is inexpensive (typically about £2 to 5/kg or £35/20kg).  bulk density is 0.35 to 0.45g /cc.

Mixed with paint or resin (after the hardener) it has very little effect upon the paint or resin physical characteristics so can be used with roller or brush and goes on evenly leaving a slightly matt finish.  There are many suppliers on-line, CFS  have proven to be reliable.

Conclusion

For most surfaces the best non-slip surface will be obtained by using paint with Fillite mixed into the paint at a ratio of up to 50/50 by volume. It is cheap, easy to apply as it mixes easily with the paint or resin has a good surface finish and gives good non-slip properties (significantly better than sand) combined with ease of repair and cleaning.  Fillite mixed with Polyester resin can be used where very heavy traffic is expected.

For particularly challenging applications Carborundum grit is more difficult to apply but gives a very hard wearing non-slip solution.

Wire mesh and plastic mesh are inferior to both Fillite and Carborundum.  They are more difficult to apply, not as long lasting, often look tatty after a short time, are difficult to repair and not as non-slip.

 

 October 14, 2015  Posted by at 22:27 Technical Articles No Responses »
Oct 142015
 

This section contains 3D printer files for a number of useful devices.   The GCode versions are for the Ultimaker2 printer unless identified otherwise.

Tin Markers for Blind User

With no eyesight all tins feel the same and after a bit beans on custard looses it’s attraction.  These markers are different shapes and have a large raised letter to tell the contents (C = custard etc). A small disc magnet is glued on the back and  when a sighted person puts tins in the cupboard they attach the shape to the top of the tin.

[ddownload id=”4875″ style=”button” text=”tin marker”]

Larger Tin Markers

A larger version of the tin markers described above.

[ddownload id=”4878″ style=”button” text=”Large Tin Markers”]

Laser Holder for Parkinsonism

A common problem with Parkinsons Disease is that of freezing, people can’t get moving once they are up. Some describe it as having their feet glued to the ground. North Herts developed a simple laser pointer which projects a bright line on the floor ahead of theuser.  If they then attempt to stand on the line this will often get them moving again.  This design is for the laser holder which attaches to a finger with Velcro.

[ddownload id=”4882″ style=”button” text=”Parkinsons Aid”]

Base for Raspberry Pi

A base for a Raspberry Pi.   [ddownload id=”4883″ style=”button” text=”Rasperry Pi base”]

 

 October 14, 2015  Posted by at 18:29 Technical Articles, Useful Software No Responses »
Oct 082015
 

The client cannot move her legs to pedal, and relies on the electric exerciser to pull her feet around, hence moving her leg muscles. This means the pedals are trying to pull away from her feet, and the only friction between foot and pedal is due to the weight of her leg. (i.e. no downward force from pedalling effort.

It was decided to replace the plastic exerciser pedals with normal bicycle pedals, and to fit toe clips with a tensioning strap. In addition, the rear of the pedals were modified to accept 5mm plastic plates though which a Velcro fastened strap could be threaded, which could be fastened around the heel of the client’s shoe.

This combination proved to be successful in keeping the clients feet on the pedals, allowing her to exercise her leg muscles.

See attached photos, of the plastic plates made for the heel straps, and of the new pedal and toe clip installation.

The client paid for the pedals, toe clips and Velcro straps.

The client, who has M.S., has a mini electric exercise bike, of the type that is placed on the floor in front of the user’s chair. Whilst the pedals do have a single strap across them, the client’s feet keep coming off the pedals.

image image

Bristol panel case ref 9\15-06

 October 8, 2015  Posted by at 15:25 Leisure Activities No Responses »
Oct 082015
 

Physiotherapist working for South Glos community learning difficulties team, looking for a solution for a client who’s feet do not rest on his current foot plate on his wheelchair. It is his own electric powered wheelchair with a single footplate. However, because of his deformities, the way he sits in his mould in his chair and the fact his legs are different lengths, his feet therefore do not rest on the footplate.

Separate foot plates cannot be fitted to the chair after contacting the wheelchair company-‘Elite’ Can REMAP be able to help in making some sort of adaptation/block onto his existing footplate to accommodate the difference in his feet position and so each foot could rest and therefore be supported

Assessment of the client found that his position in the chair meant that his left leg fell along the centreline of the chair with his right leg further to the right than would be expected. Additionally his legs failed to reach low enough for him to be able to use the foot plate.

A provisional experiment found that he was considerably more comfortable when the footplate support was displaced by transferring it to the right side of the support bracket.

A temporary footplate was fabricated for use whilst the changes were made to the original plate and support.

The changes made were:

· to move the plate mounting/pivot point from the centre to the left hand corner of the foot plate – cutting and welding by a local fabricator;

· to drill further holes in the support to enable further adjustment to become available;

· all metal affected repainted with black Hammerite paint;

· leg rests previously fitted to the chair were and remain redundant, and were removed on consultation with client and specialist.

The changes resulted in the footplate moving 3” right and up 2” which means that both feet are now supported by the footplate, and client indicated he is now comfortable.

No special instructions or instructions were considered necessary for this modification.

See attached photos.

 

Bristol Panel case ref. 7\15-08

clip_image002

Before

clip_image002[4]After
Oct 052015
 

A referral for remote control of TV by a client suffering from advanced MS resulted in the development of a cheap Sip and Puff device.

It is acknowledged that for intensive use commercial products are available, but in some cases these are deemed prohibitively expensive.

Accessibility software is often built in by manufacturers (certainly in iPhones and iPads) but the hardware required to make use of this is not available cheaply and therefore can put a user off experimenting with something that could considerably enhance their quality of life.

A solution utilising Arduino components and 3D printing provides a low cost device which can be easily replicated.

 

GooseneckSnP BT-IR