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Complex Rehab Technology consists of products, equipment and services, including wheelchairs and seating systems needed to meet the unique needs of patients with disabilities, including spinal cord injury, traumatic brain injury, post-polio, cerebral palsy, muscular dystrophy, spina bifida and progressive muscular atrophy.

In order to justify medical necessity to meet insurance coverage criteria, it is best to use a team approach to achieve the best possible outcome when ordering equipment. The team may consist of a physician, physical therapist, occupational therapist, respiratory therapist, an assistive technology professional, care giver and family members as well as the patient.

During the assessment process, the objective is to establish the patient's function level as it relates to mobility, seating and positioning needs. These needs include, but are not limited to, functional mobility, dependent mobility, activities of daily living, positioning, pressure reduction and relief and tone management.

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Some of the common seating and mobility goals is to support the current function level, increase the potential for future function, reduce nonfunctional muscular activity, reduce or prevent the progression of a deformity, accommodate bony prominences and make it comfortable, effective and cost efficient while enhancing appearance.

Often, product demonstration, trial equipment and simulation is required to determine whether the goals have been met. The equipment must meet the patient's medical, physical and functional needs. At times, an in-home assessment is required to be sure the equipment being prescribed allows the individual to access all areas required within the home environment. Transportation needs have to be addressed, especially when utilizing power mobility or when the individual is still able to independently drive with the use of hand controls.

CRT products and equipment must be provided by individuals who are credentialed by a recognized organization in the field of CRT, such as Rehabilitation Engineering and Assistive Technology Society of North America. Once the fitting, programming and training of the equipment has taken place, it is crucial that follow-up occurs for any adjustments required to ensure that the prescribed equipment has met all of the established goals for the individual.

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Kurt Schmidt is a seating a mobility specialist at CHI St. Alexius Health Great Plains Rehabilitation Services.

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