Sleeping Wedge

---- CUSTOMIZED ADAPTATION --------- PURPOSE: To create a custom adapted wedge for sleeping for a young adult with quadriplegic cerebral palsy. Initially an abduction wedge was used to assist in keeping the young adult’s hips in correct position after repeated surgeries. However, while the wedge is no longer needed for orthopedic reasons this individual does not feel comfortable sleeping without it but has since outgrown the original wedge. The new design had to account for variations in body measurements as well as be as moisture-resistant as possible. A new wedge set was constructed out of EN38 foam. The foam was in a 100 millimeter thick sheet; therefore the design was based on cutting the foam into various sections to shape the “wedge,” and the pieces were glued together with contact adhesive. The design matched the user's exact requirements, but there were concerns that the edges and seams would be at the most risk of moisture penetration at the end caps; therefore, a layer of moisture-resistant glue was used to close the top surface of the wedge and then sealed with a silicone sealant. There had also been a problem with the previous wedge sliding down the bed, as this individual sleeps in a semi-reclining position and his weight pushes on it. To solve this, a wooden support which braces against the bottom of the bed and holds the wedge in position was made. After the new wedge was put into use, the individual’s caregivers felt that it would be useful for it to have a handle so the wedge would be easier to move, particularly when only one caregiver was attending to the individual. Two holes were bored through the wedge and a cord was run through one side, underneath the wedge and back up the other side, and a soft webbing handle was attached to each piece of cord at the top. Although it was difficult to get a good anchor point in the foam, this approach gave the handle sufficient strength so it would remain in position with use. An additional tie strap across the top and a tie running horizontally through the wedge was added. Both of these support the end-caps against pressure when the wedge is moved. TITLE: Sleeping wedge. JOURNAL: TAD Journal. REF: Volume 31, Number 2, Autumn 2011: p. 13. PAGES: 2 with cover.