SPEX Cushion20170320 Instruction Manual

Cushion
installation & user manual
®
S
User Name:
Serial Number:
User Manual for all Spex Cushions (product code begins with‘110-’)
Revision: Cushion20170320
IMPORTANT CONSUMER INFORMATION NOTICE:
This manual contains important instructions that must
be passed on to the user of this product. Please do not
remove this user manual before delivery to the end user.
SUPPLIER: This manual must be given to the user of this
product.
USER/CAREGIVER: Before using this product, read
entire manual and save for future reference. Transit
Safety section MUST be read before used in a vehicle.

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Introduction
The Spex cushion is a contoured/modular and adjustable cushion for both symmetrical
and asymmetrical sitting postures. It designed for supporting the pelvis and legs correctly
and oering skin protection. The underneath strategic positioning system enables easy
and on-the-spot adjustment.
Note: Check all parts are free from shipping damage. Contact Medifab or your supplier
for further instructions if needed. Medifab recommends that a clinician such as an
Occupational or Physio Therapist that is skilled in wheelchair seating and positioning be
consulted to determine if the Spex Cushion is appropriate for the user. The intended user
of the Spex Cushion is a user with postural support requirements.
Safety Instructions
To avoid injury, read, understand and follow all instructions and warnings in this manual
before installing and using the Spex Cushion. There are hazards associated with the use
of wheelchairs and adaptive equipment. If you misuse your wheelchair or your Cushion
you can be seriously injured. If your Cushion ceases to function as intended, please con-
sult your authorised Spex seating supplier immediately before continuing to use.
Spex Cushion meets the requirements of ISO 7176-16; wheelchairs - resistance to ignition
of postural support devices. The cover and foam meet the ammability requirements of
California Technical Bulletin 117. In rare cases the Lycra fabric may cause a skin irritation
for people with sensitve skin. If you experience any reddening or itching of the skin con-
sult with your health care professional.
Disclaimer: Medifab takes no responsibility as to the therapeutic eectiveness of our
products. Our claims relate to the ability of the products to provide safe and reliable
positioning and seating on the equipment onto which they are installed.
Weight Capacity
• 10-15” cushion maximum user weight: 90 kg (200 lb)
• 16-20” cushion maximum user weight: 160 kg (350 lb)
Warning: Never exceed the weight capacity of your cushion or the wheelchair
as specied by the wheelchair manufacturer. Never perform exercise weight
training that causes the user to exceed the weight capacity of the wheelchair.

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Compatibility
• The Spex Cushion has been designed to be compatible with most wheelchairs.
• The Spex cushion must have a solid base to install to - such as a solid seat base pan
or cushion rigidiser, which provides more stability to the user.
Warning
RISK OF ACCIDENT, INJURY, PAIN OR DEATH IF WARNINGS ARE NOT HEEDED
Seek assistance if you are uncertain about any of the following points
1. Installing a cushion on a wheelchair may disturb the wheelchair’s centre of gravity and cause the wheelchair to tip
backwards and cause harm or death. Check if anti-tippers or other adaptations need to be added to the wheelchair
to help increase stability.
2. Installation and adjustment of your Spex cushion must only be performed by
a) An authorized Spex distributor or technician
b) A qualied healthcare professional who has undergone appropriate biomechanical training
3. The Spex cushion must have a solid base to install to. A solid seat base pan will provide more stability to the user
(the cushion won’t sag).
4. This cushion must be trialled rst to determine it is eective to meet the needs of the user. The clinician must
inspect the user’s skin to ensure that red pressure spots are not developing.
5. The user and/or carers should regularly check for skin redness or tissue breakdown. If redness develops, discontinue
the use of the cushion immediately and consult your doctor or therapist.The cushion can be recongured for better
positioning.
6. With proper set-up and continued maintenance, the Spex cushion is an excellent candidate for people that are at
risk of skin ulcers; however no cushion can completely eliminate sitting pressure or prevent pressure ulcers.
7. Keep the cushion dry. Moisture is a contributing factor to causing pressure ulcers.
8. We recommend the user to have a good diet and have regular pressure relieving exercises/therapy to help prevent
pressure ulcers.
9. Do not leave the Spex cushion outside overnight or at temperatures below 5° C/40° F. The Spex cushion should be
room temperature before sitting on.
10. Avoid sharp objects or exposure to excessive heat or open ame.
11. The Spex cushion has been specically designed as a cushion for users in mobility wheelchairs. Do not use the
cushion in any way not described and never modify the cushion.
12. Never use the cushion without its cover. Care should be exercised near open ame or burning cigarettes. Using the
cushion without its cover increases the risk of ammability and skin damage.
13. Never use the cushion without the incontinence cover. Failure to do so will reduce the life of the cushion.
Environment
Moisture: Keep your Cushion dry at all times, as contact with water or excess moisture
could cause degradation to the functionality of your Cushion, or potential failure. If your
Cushion becomes damp or wet, thoroughly wipe with a dry cloth as soon as possible.
Do not use your Cushion in a showering or pool facility.
Temperature: Your Cushion may not function as intended when used at extreme
temperatures. Keep the Cushion away from sources of extreme heat or extreme cold to
avoid change in functionality of the foam.
Dirt: Small particles such as dust, dirt and sand may restrict optimum functionality.
Regularly wash your Cushion cover to ensure no build-up occurs.

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Cushion Contents
Your Cushion contains the following:
Description Quantity
A Outer cover 1
B Incontinence cover 1
C Foam Unit 1
DStrategic Positioning
Base
1
A
B
C
D
Once the user has nished using the Spex Cushion, it must be refurbished if it is issued to
another user. Below are the strict guidelines for refurbishing the Spex Cushion. Medifab
takes no responsibility for contamination, cross infection, or damage.
Reissuing to another user
Part Procedure
Safety check All components to be checked for signs of stress or cracking.
Upholstery covers Both the incontinence cover and outer cover must be replaced
regardless of condition.
Strategic
positioning base
Ensure each contouring pocket has the correct layers of foam
pads.
Foam Foam should be checked for degradation and cleanliness.
Disposal & Recycling
Your Spex Seating System is manufactured using a variety of materials, of which most
can be recycled. Once it reaches the end of its life, if you are the legal owner, do not
dispose of as ordinary household waste but take your Spex system to an approved recy-
cling or collection point, to dispose of according to local laws and regulations.
Separate collection and recycling of the Spex System when disposing ensures protection
of the environment and assists with natural resource conservation.

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Adjusting the Strategic
Positioning Base
Pelvic Obliquity Adjustment
Warning: Adjustments to be done by a certied and experienced clinician
such as a doctor, therapist or rehab engineer who is skilled in seating and
positioning. Adjustments must be done following a proper assessment of
the user’s biomechanical needs.
The Spex cushion can be congured to suit many dierent postures of persons with
disabilities or sitting issues. By adjusting the strategic positioning base, the cushion
surface is contoured to improve overall posture, pelvic alignment, sitting ability, comfort
and pressure reduction. If more contouring or support is needed for asymmetries, the 5º
cushion wedge (accessory) may be required.
Each leg is independently treated
with the strategic positioning base.
Rear corner cells can be added or removed on both sides to correct or accommodate
obliquity. Upper pressure-reducing layers are unaected.
No adjustment Built up under right side

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Images are Indicative only Disclaimer: every outcome must be determined on the
client and based on the clinical evaluation assessment.
Moderate positioning and control
Either both or each side independently of the cushion can be
congured. Cushion can remain at if required.
Tight hamstrings/limited hip exion/posterior pelvic tilt
Cushion can be wedged to slope to front with cells added at
rear and removed at front.
Management and positioning
Build cells up under thighs for enhanced pre-ischial support
and control.
Pelvic rotation
To help control pelvis from rotating, create a build-up under
the aected leg (in front of the ischial).
Need more support/contouring?
Use our 5º cushion wedge for more support if needed. One
can be used or two if needed for both legs. Wedge can be
positioned either sloping to back or front depending on user’s
positioning requirements.
Tilting forward Tilting back
Conguring the Spex Cushion

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Congurations must depend on biomechanical evaluation and assessment.
Anterior pelvic tilt: Leave cushion at or slightly raise front of cushion for neutral
alignment of the pelvis and/or promote weight bearing on ischial tuberosities.
Extensor thrust: Increase hip and knee exion by building more support under front
of thighs.
Pelvic obliquity: Build-up under low side to correct, under high side to accommodate.
Position the cushion about ½”forward of the front edge of the seat base pan to protect
the user’s legs.
Labels on the cushion and covers show the FRONT. The front of the cushion must face
forwards at all times.
Check the size of the cushion. The cushion must fully support the base of the user. If a
cushion is too long it may force the user to sit with a posteriorly tilted pelvis.
The sides of the cushion must always be parallel to the seat rails of the wheelchair
frame.
Proper footrest adjustment may enhance sitting comfort. Adjust the footrests so the
user’s legs rest rmly but comfortably on the cushion.
1.
3.
2.
1.
3.
2.
5.
4.
Other Conguring Tips
Fitting the Cushion

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Maintenance & Cleaning
Monthly cleaning and regular maintenance will help extend the life of the cushion. The
expected lifetime of the Cushion is 5 years; however the cushion needs to be checked
regularly for performance.
Warning
• Fitting the cover after washing must be done correctly. Ensure the back of the cover
matches up to the back of the foam base.
• If used in an institutional setting, write the resident’s name with a permanent marker
on the content label of the covers. This will help to ensure the return of the covers
after washing.
• Use only Spex covers on Spex cushions. Changing the cover or using dierent
materials will alter design and may cause harm or pressure concerns to the user.
Foam
• Keep dry
• Check the foam base regularly to ensure good foam consistency
• If it accidentally becomes wet, dry thoroughly before tting the covers
Incontinence Cover
• Hand wash only
• Do not use bleach or other strong cleaners
• Do not tumble dry
• Failure to use this cover may reduce the life of the cushion
Outer Cover
• Remove the cover from the foam base and turn inside out.
• Machine wash in warm water (40 °C)
• Drip or tumble dry on low heat.
• Do not iron. Do not dry-clean. Do not bleach.
• If chemical cleaners are used, covers must be rinsed thoroughly with water to
remove all chemical residue and left completely to dry before reuse.
• Check the cover for tears and excessive wear and replace if ripped, torn or otherwise
not fully functional.
If you have any additional questions regarding cleaning procedures, please contact your
authorized Spex Seating dealer.

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Once your Spex Cushion is set up in an optimal position, use the below chart to record
the number of contouring cubes in each cell. Mark unused/unavailable cells below
with an ‘X’.
Assessment Date
Clinician Name
Client Name
Notes
Cushion Strategic Base Chart

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The Spex seating system has been successfully crash tested and complies with RESNA WC-4:2012,
Section 20. The Spex seating system meets the requirements of ISO 16840-4:2009 and is suitable
for use as a motor vehicle seat when used with an appropriate wheelchair base. Please follow all
installation, use and maintenance instructions within this manual as well as the following transit
instructions. If feasible, the wheelchair user should transfer to the vehicle seat and use the vehicle-
installed occupant restraint systems.
Spex seating system has been designed to accommodate the proper use of vehicle-anchored belt
restraints. Spex achieved a rating of Excellent (16 out of 16), for ease of properly positioning a belt
restraint, and the degree to which proper belt restraint can be achieved, based on the methods of
Annex C. The following items of the Spex seating system have been tested and are suitable for use
in a motor vehicle:
• Full height back support range
• Grid-Base Seat Pan
• Cushion Range
• Arm and Thigh Supports
• Trunk Lateral Supports
• Head Supports
Note: Back supports that are lower than the user’s shoulder height are not certied and not
recommended for transport in a vehicle. Eg. Vigour Lo and Vigour Mid back supports.
Assembly, Use, Maintenance & Limitations
• Adjustments to the set up of the wheelchair must only be carried out by a qualied therapist,
professional, or seating technician. Custom contoured/bespoke systems may require a qualied
professional to congure and install the seating system.
• After carrying out any adjustments ensure all bolts, screws and nuts are securely fastened again
to ensure safety when travelling in a vehicle.
• Ensure the top and bottom mounts of the backrest and the front and rear mounts of the seat
pan are installed as far apart from each other as possible to give a stronger 4-point attachment
to the wheelchair frame. Ensure the quick release latches are engaged.
• Do not use the Spex seating system as a means of vehicle seat if seating components which
have not been successfully crash tested are used anywhere on the seating system. Spex seating
is designed and certied using only Spex components. Medifab is not liable in the event where
other manufactured seating systems are used in conjunction with Spex seating.
• At regular intervals check that all the fastenings on the Spex seating system have not become
loose during day to day use and re-tighten if necessary.
• Ensure the swing-away laterals are in their locked position before using the seat as a vehicle seat
in a motor vehicle.
Transit Safety

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Correct Positioning of Belt Restraints
When using the Spex seating system as a vehicle seat, both a pelvic belt restraint and
shoulder belt restraint must always be used. To correctly position the belt restraints on
the wheelchair occupant, the following must be ensured:
• The pelvic-belt restraint should be worn low across the front of the pelvis near the
junctions of the pelvis and thighs
• The angle of the pelvic-belt restraint should be between 30° to 75° relative to the
horizontal and, ideally, between within 45° to 75° to the horizontal (as shown in
Figure 2)
• The belt-restraint buckle of three-point belt restraints should be placed in contact
with the occupant’s body and away from wheelchair components
• The junction of the shoulder belt and pelvic belt of three-point-belt restraints
should be located near the hip opposite the shoulder over which the diagonal
belt crosses and not near the midline of the occupant
• Belt restraints should not be routed outside of the wheelchair wheels or over the
wheelchair armrests, and should not be held away from the body by wheelchair
components or parts
• Upper-torso belt restraints should t directly over, and in contact with, the middle
of the shoulder
• Belt restraints should be adjusted to t as snugly as possible, consistent with user
comfort
• Belt restraints should not be worn twisted in a manner that reduces the area of
contact of the belt webbing with the occupant
Transit Safety
Figure 3a - Improper positioning of pel-
vic-belt restraints over wheelchair armrests
Figure 3b - Proper routing and positioning of
belt restraints on the wheelchair occupant
Figure 1
Figure 2

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1. The distance between the top of the user’s shoulder and the top
of the back should not exceed 16.5 cm (6.5”).
2. The Spex seating system must only be used with wheelchair
basesthataretestedaspartofawheelchairsystemthatconforms
to performance requirements of ISO 7176-19 and RESNA WC-
4:2012, Section 19.
3. The Spex seating system should only be used on wheelchair
frames that provide four securement points and pelvic-belt
anchor points that conform to the requirements of RESNA WC-
4: 2012, Section 19.
4. The wheelchair must be labelled as appropriate for use as a
seat in a motor vehicle, dynamically tested to the performance
requirements of ISO 7176-19 and installed, used and maintained
according to the manufacturer’s instructions.
5. The Spex seating system must only be used as indicated in this
user manual.
6. Both pelvic and shoulder belt restraints as a part of a complete
Wheelchair Tie down and Occupant Restraint System (WTORS)
which meets ISO 10542-1 shall be used to achieve eective
occupant restraint and optimum protection in a vehicle impact;
the belt restraints should be compatible with the specic
wheelchair, and tted to the user in accordance with WTORS
manufacturer’s instructions.
7. Back supports with adjustable reclineangles should not be tilted
back more than 30° to the vertical during travel in vehicles unless
necessary for the medical and postural needs of the occupant.
8. If the back support must be adjusted to an angle that is greater
than 30° to the vertical during travel, the upper shoulder-belt
anchor point should be adjusted rearward to maintain belt
contact with the wheelchair occupant’s shoulder and chest.
Warning

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9. The Spex seating system must only be used for forward-facing
seating in motor vehicles.
10. In order to reduce the potential of injury to vehicle occupants,
wheelchair-mounted rigid trays not specically intended for use
during travel in motor vehicles must be:
a. Removed and secured separately in the vehicle or
b. Secured to the wheelchair so they will not break free in a crash
and
• Bepositioned withagap ofatleast75mm betweenthe back
edge of the tray and the wheelchair occupant’s abdomen
and/or chest so as not to interfere with the proper belt-
restraint use, and
• Have energy absorbing padding placed between the back
edge of the tray and the wheelchair occupant.
11. Alterations or substitutions must not be made to the seating
system structure, parts or components, without rst consulting
Medifab.
12. The use of a postural pelvic belt attached to the wheelchair
base or seat frame is encouraged during travel, but these belts
should be positioned so that they don’t interfere with the proper
positioning of crashworthy belt restraints, and they should not
be relied on for occupant protection in crash situations unless
the postural belt has been designed to comply with, and perform
to the requirements of WC19.
13. Postural support devices that are not labelled as conforming
to ISO 16840-4 may be used when in a vehicle, but should not be
relied on for occupant restraint.
Warning

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14. Both pelvic-belt and shoulder-belt restraints that comply with
WC18 and/or WC19 should be used to limit occupant movement
in a crash and reduce the likelihood of occupant ejection from
the vehicle and/or injurious contact of the occupant with the
vehicle interior.
15. Belt restraints should be positioned on the wheelchair occ-
upant in accordance with WTORS manufacturer’s instructions.
16. Backrest mounting hardware must be installed correctly.
Refer to the appropriate section for correct backrest hardware
mounting instructions.
17. If the wheelchair is being transported whilst unoccupied, the
wheelchair must still be secured to the WTORS.
18. Children whose mass is less than 22kg (48.5 lb) should be
transferred from their seating system into appropriate child
restraint systems intended for use in motor vehicles.
19. Sucient forward and rearward clear space should be
provided around the wheelchair occupant. Forward clear-space
zone (FCZ) needs to be larger when a shoulder-belt restraint is
not used.
FAILURETO HEED THESEWARNINGS COULD CAUSE SEVERE INJURY
TO THE WHEELCHAIR USER OR OTHERS.
Warning

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Recommended forward and rearward clear
zones for wheelchair-seated occupants.
(Note: the FCZ may not be achievable for
wheelchair-seated drivers).
Warning
Warranty
Each Spex cushion is carefully inspected to provide peak performance and is guaranteed
to be free from defects in materials and workmanship for a period of 24 months from
the date of purchase, provided normal use. Should a defect in materials or workmanship
occur within 24 months from the original date of purchase, Medifab will, at its option,
repair or replace it without charge. This warranty does not apply to general wear and use,
including punctures, tears or burns, nor to the cushion’s removable outer cover.
Claims and repairs should be processed through the nearest authorized Spex supplier.
Exceptforexpresswarrantiesmadeherein,allotherwarranties,includingimpliedwarranties
of merchantability and warranties of tness for a particular purpose are excluded. There
are not warranties which extend beyond the description on the face hereof. Remedies for
breach of express warranties herein are limited to repair or replacement of the goods. In
no event shall damages for breach of any warranty include any consequential damages
or exceed the cost of non-conforming goods sold.
The serial number of your Cushion can be located at the rear of the Cushion cover.

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EC REP
BEO MedConsulting Berlin GmbH
Helmholtzstr, 2-9
10587 Berlin Germany
Tel: [phone]
Medifab Ltd
Phone [phone]
Fax [phone]
[e-mail]
www.spexseating.com
32 Detroit Drive
Rolleston 7675
New Zealand
US REP
Medicept
200 Homer Ave, Ashland, MA 01721
United States
Tel: [phone]