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Sleeping wedge

Nineteen-year-old Dean has quadriplegic cerebral palsy and had surgery five years ago which meant he needed to sleep using an abduction wedge to keep his hips in the correct position.

Now he no longer needs the wedge for orthopaedic reasons, but he has become so accustomed to it that he does not feel comfortable sleeping without it.

Dean has outgrown the original wedge and it has begun to deteriorate with ongoing use. His therapist, Chris, asked TAD’s Port Macquarie Group to make a new, longer wedge that was as moisture-resistant as possible.

When the volunteer team examined the existing wedge, they found that it was asymmetrical – this is a common feature to take variations in body shape into account. Each side therefore had different angles and dimensions, requiring precise measurement and design to reproduce. This was an interesting task for volunteer Detlef Czerniejewski, a retired tool maker, and an opportunity to use his skills with his CAD drafting software.

Detlef designed a new wedge and set about constructing it from EN38 foam, aided by volunteer John Brumby. The foam was in a 100mm-thick sheet, so the design was based on cutting various sections to shape and gluing them together with contact adhesive. A local foam supplier, Ray Atkins, was very supportive, providing both materials and assistance with cutting the various shapes.

A mid-construction check with Dean and Chris showed that Detlef’s design was exactly to requirements. It was then a matter of gluing on the end caps, and placing a layer of moisture-resistant closed cell on the top surface of the wedge. The edges and seams, which would be most exposed to the risk of moisture penetration, were well glued and then sealed with silicone sealant.

There had also been a problem with the previous wedge sliding down the bed, as Dean sleeps in a semi-reclining position and his weight pushes on it. To solve this, John and Detlef made a wooden support which braces against the bottom of the bed and holds the wedge in position.

The new wedge was put into use, and Chris and Dean’s carers felt it was working well for him. However, they realised that it would be useful for it to have a handle, so it would be easier to move, particularly when one person was attending to him on their own.

John and Detlef therefore bored two holes through the wedge and ran a cord through one side, underneath the wedge and back up the other side, then attached a soft webbing handle to each piece of cord at the top. John says it is difficult to get a good anchor point in foam and this approach gave the handle sufficient strength so it would remain in position with use.

The volunteers also added an additional tie strap across the top and a tie running horizontally through the wedge. Both of these support the end-caps against pressure when the wedge is moved.

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