COLLARS
Persons with
ALS (PALS) often end up needing a collar as their neck muscles become
weaker. Unfortunately, finding a
satisfactory collar is often difficult.
PALS often find wearing a collar to be very “claustrophobic” associated
with having difficulty breathing.
Collars can be
obtained from numerous sources, including medical supply vendors and orthotists
(professionals specializing in making and fitting braces). Your occupational or
physical therapist can help you figure out what your options are.
There is some
Alberta funding available for collars if they are obtained through an
orthotist. AADL will cost-share collars for clients under the age of
65. Blue Cross will assist with funding
collars for seniors.
HEADMASTER COLLAR
This is a
popular collar with PALS as it is very open around the neck while providing
some support. It is available through
some medical supply vendors and orthotists, or it can be ordered directly from
the manufacturer. This model comes in
various sizes so it is important to do the required measurements before
ordering it.
For more
information see www.symmetric-designs.com.
ASPEN COLLAR
This is probably
the collar that orthotists most often provide to PALS. It is made of semi-rigid plastic with foam
inserts to provide comfort. Velcro straps are used to adjust the fit.
For more
information go to www.aspencollar.com.
FOAM COLLAR
This is
probably the most readily available collar, and the least expensive one,
however it is also the least satisfactory collar for most PALS. Although these are “off-the –shelf” items
available in drug stores and medical supply shops, they seldom fit properly
unless cut down to fit the user. They are also quite constrictive and therefore
claustrophobic.
Some PALS find
a foam collar meets their needs for a while.
For instance, if a collar is only needed during transfers or toileting
or while in a vehicle, a foam collar might be adequate.
If a PALS does
choose a foam collar, it is best if the top front edge of the collar is cut
down so that the collar fits snugly under the entire chin rather than allowing
the chin to ride up over the lower chin.
Once the collar is fit to the user, then stockinette (or a tube sock
with its toe cut off and hemmed) can be rolled over the cut portion of the
collar.
CUSTOM COLLAR
These are
available from orthotists (or occupational and physical therapists with a
specialty in collars and splints) and are an option for clients who have not
been able to find any off-the-shelf or semi-fitted collars that worked.
Custom collars
vary greatly depending on the need of the user. One PALS had a collar
consisting of a back piece molded to fit him from his waist to the top of his
head with a head band around his forehead.
This meant that his neck had nothing around it, yet his head and neck
were held in a good position.
ALTERNATIVES TO COLLARS
Some PALS find
ingenious solutions other than collars to keep their head ina comfortable
position. If a PALS is always in a tilted position (e.g. in a tilt wheelchair
or an easy lift chair) then gravity will help keep the head in a comfortable
position and a collar is needed less often. A tilt commode reduces the need to
use a collar when toileting.
Some PALS find
it useful to attach a headband to their wheelchair headrest to keep their head
in a comfortable position. This can work well as long as the headband is positioned
in such a way that the PALS head cannot slip underneath it.
These are just
some of the ideas available to persons with ALS who need some neck support.
Please talk to your occupational or physical therapist for more information, or
contact an orthotist in your area. Your
family doctor or neurologist may also refer you to a physiatrist (a doctor
specializing in rehabilitation medicine).
This information has been prepared by Anne Chapman Heinemeyer, OT, Equipment Program Coordinator for the ALS Society of Alberta. For more information, please call Lyn Skipper at (403) 228-3857 or e-mail at lyn@alsab.ca. Phone toll free in Alberta at 1 (888) 309-1111.