Editor's Note

CRT's Evolution

• By Laurie Watanabe
• Apr 01, 2022

In 2002, in one of our very first issues, we featured a story on “early” intervention. An absolutely adorable 5-year-old had just received his first power chair — and his first opportunity for independent mobility — in time to don a powder blue tux and roll down the aisle as ring bearer in a relative’s wedding. Not surprisingly, he stole the show.

That success story would now be considered archaic. Waiting until age 5 to introduce independent mobility? Wasting all those precious years of cognitive, physical, social and emotional development? Noooooo!

I also remember hearing in our early days that the industry of Complex Rehab Technology (CRT) — referred to as rehab or re/hab back then — was, leaving childhood and entering its adolescence. If that’s true, then 20 years later, CRT is a young adult.

This issue supports that metaphor. We set out to demystify seat cushion standards (page 10): Kara Kopplin and Tom Hetzel explain what standards mean, what they don’t mean, and why we can’t just say, “Cut to the end and just tell me the best three cushions that I should prescribe/supply to all my wheelchair clients.”

We also take a look at the importance of a thorough home assessment, thanks to Cindi Petito, who explains why it’s just as important to accurately measure the wheelchair environment as it is to measure clients for their wheelchairs (a truth that could be the tagline for home assessments).

We wouldn’t have written about either subject 20 years ago, and it’s telling that both topics are what I (as an unscientific English major) consider science or evidence based. Cushion standards seek to bring a common language and understanding to the field, so seating teams can use measurements and testing results to narrow their product choices. Accurate home assessments provide additional data that can also be used in the equipment selection process to improve the chances of ultimate success.

Cushion standards and home assessments both work to support the clinical expertise and experience of the seating team. And developing these methodologies are examples of how CRT has evolved and continues to establish itself within healthcare.

On the flip side, Medicare’s “in the home” policy of covering only CRT and DME used in the client’s home was short-sighted in 2002, but still lives on. So does (at press time) Medicare’s non-coverage for seat elevation on power wheelchairs — although the CRT industry has formally requested coverage from the Centers for Medicare & Medicaid Services.

It can be frustrating to see antiquated thinking still be the rule decades later. But it’s also good to occasionally look back over our shoulders to see how far we’ve come… before turning back to face the road ahead.

This article originally appeared in the Mar/Apr 2022 issue of Mobility Management.