My Journey into Complex Rehabilitation

My name is Christie Hamstra, PT, DPT, ATP, and I am a clinical educator for Motion Composites. I interact with clinicians all the time asking, “How did you get into this type of work?” To accurately answer that, we need to travel back a bit, to my first wheelchair. It isn’t pretty, but it will hopefully encourage you on your journey into this remarkable industry of complex rehab.

In my position as a Clinical Education Specialist for Motion Composites, I often have to precisely explain what I do to people inside and outside the world of complex rehabilitation. The long list of letters behind my name does not make it clear, and even my family struggles to fully articulate what exactly I do.

My kids have described the job as “My mom travels and talks about wheelchairs.”; with the global pandemic (I’m sure you’ve heard about it), they have changed their description to “My mom talks on the phone and builds PowerPoints.”  Some of my former clients and co-workers just call me “The Wheelchair Girl.”

My purpose for sharing my story is to encourage clinicians to explore the world of complex rehab and perhaps find their passion.

We ALL start somewhere. No one wakes up and KNOWS how to perform a wheelchair evaluation. It takes dedication, determination, and drive to search out resources to learn and become proficient and skilled. It isn’t taught much in therapy schools, and clinicians often don’t even know this niche specialty exists. I didn’t, until I started in a job I had zero preparation for, and had to learn as I went along. (This is NOT my recommendation).

My journey to my “dream job” started when I became a school physical therapist. I had previously worked at an inpatient rehab, and during my time there, I was introduced to seating and mobility. But, I  was on the fringe of wheelchair evaluation, never completing the process from assessment to delivery myself.  It intrigued me, but it wasn’t until I transitioned to the school setting (kids are my people), that my passionate journey to becoming a seating and mobility specialist truly started.

Excited for my new career path as a school therapist, I relied on a great PT mentor for support but was mostly on my own. I had to step up to the challenges and provide the highest quality of services I could offer, the kids deserved nothing less. The array of seating and mobility needs was not something I was prepared for.  Feeling like I was treading water in a storm, a lifeline was thrown to me by an amazingly knowledgeable ATP (Assistive Technology Provider) that worked for a local supplier. 

The first complex wheelchair I was tasked to complete was with a young lady with severe spastic quadriplegic cerebral palsy with severe cognitive impairment. She had severe rotational scoliosis that could not be corrected, so she needed custom molded seating on a tilting wheelchair frame. It was a perfect storm:  This was my first complex custom manual wheelchair, the parents spoke English as a second language, and had very little interaction with the school.  They believed “The school will provide what she needs.” To top it off, based on insurance contracts, I could not recruit my ATP friend because his company did not service that provider.

The approved supplier did not have an ATP on staff, and I began the assessment with a technician. 

With advice and support from my mentor and the ATP, I made the BEST recommendations I knew how, but what resulted was far from perfect. 

As we lifted the beautiful young lady, with her bright smile and laughter into her “new chair” and began the final fitting process, her excitement and smile dimmed when she sat in the chair, and it was apparent she was NOT comfortable. It did not fit her body shape, and I questioned every component and adjustment made. (Yes I was THAT therapist).  We tried for hours to improve her comfort level, but ultimately, we did not accept the wheelchair's delivery that day.  After months of changes and multiple fittings, the chair was accepted after the fourth “Fitting”, but it never truly fit. No one was happy with the outcome, family, client, therapist, supplier and physician.

I know you are every bit as horrified as me reading this.

Imagine being reminded of this failure every day. It just so happened that the young lady lived in my neighborhood, and I walked by her home almost every single day during my nightly walks with my husband and dogs!

What I envisioned that day of our assessment was NOT what we finally delivered, and that spring day I learned some hard lessons.

  • Insist on an experienced supplier.  Even if you know complex rehab and it is not your first evaluation, it is crucial to have a supplier with the knowledge and history with complex equipment.
  • Insist on the client, the client’s caregiver or parents playing an active role in the process; it will mean more success.
  • Don’t be afraid to make mistakes (we all do), and understand how to fix problems that arise.
  • Reach out for help when you need it and acknowledge your own limitations.

I did not let this experience discourage me, on the contrary, it drove me to become more educated and learn more about this strange area of complex rehabilitation from both the clinical side and the supplier side.

I worked in pediatrics for over 10 years, spent almost 2 years working for a local supplier, and now spend my days encouraging and educating therapists and suppliers to give complex rehabilitation a try.

I share this story to encourage clinicians wading into this sea of CRT (complex rehab technology), knowing that when it is done properly it is life-changing. Yes, the opposite is also true, so we must not be afraid to discuss our failures and use them to educate each other to help make our industry stronger. I encourage clinicians to seek out continuing education, call in clinical experts for mentoring, and read, read, read. Embolden that desire, dedication and drive, so that we can all make recommendations and deliver wheelchairs that don’t make us cringe when we pass by.

Feel free to reach out to our clinical staff, and see our offerings of continuing education in seating and mobility.

About Christie Hamstra, DPT, PT, ATP

Clinical Educator

Christie is a Motion Composites clinical educator. She holds a Master of Physiotherapy from Andrews University and a Transitional Doctor of Physiotherapy degree from Oakland University. Through training and conferences, she actively shares her knowledge with future and current industry professionals.