Quantum TRU Balance 4 FAQ's

Currently TB4 is available on the Stretto, Edge® 3, and the 4Front® 2.

The system must be ordered as an entire TB4 power positioning system. This includes power tilt, recline, and AFP, iLevel/seat elevation, anterior tilt, and memory seating. Power tilt, recline, and AFP, and iLevel/seat elevation can only be ordered separately on a TB3 power positioning system.

The TB4 system has been tested and verified as WC19 occupied transit compliant for all units it is available on.

Yes, the memory positions can be added to the basic switchbox, the iAccess box, or any mapped IO system (i.e., keys, mode, etc.)

Any memory number can be latched. When that is done it will latch the forward and reverse positions, they cannot be separated. Therefore, the entire memory seat profile (i.e., memory profile 1) will be latched for forward and reverse commands.

There are up to 8 positions that can be set. There are four memory slots, but each offers a forward and reverse command, which allows for a total of 8 memory functions.

Anterior tilt limits the footplates from hitting the ground. Programming a transfer position will allow the consumer to have a dedicated position for transfers so the footplates can go all the way to the floor. We recommend the footplates not be placed on the floor, and that there is a space between the footplate and the floor.

The system will include a complimentary 10° of anterior tilt that is not required for use by the consumer if it is not wanted/needed. There are seat presets in the system that do not include the anterior tilt functions that can be activated through programming and will allow anterior tilt not to show up in the system, yet memory seating will still function.

TB3 will be the power positioning system to order if the team wants tilt and recline only.

Yes, the attendant control will operate all power seat functions, including the memory seating positions. When the attendant control is active, the seating screen on the QL3 display will show the seat function and/or the attendantcan look at the lights on the attendant joystick for seat function. The memory seating functions are displayed on the attendant control via the number of blinking seat functions (i.e., one for memory one, two for memory two, etc.).

No, not at this time. The seating system must elevate in order to prevent the AFP from striking the floor.

Memory seating is only available on the TB4 seating system at this time.

Yes, they can potentially hit the floor. It is recommended that the Teach Elevate vs AFP Articulation parameter be retaught after those changes are made. Follow the prompts of the programming and it is easily set. Once set, the footplate will no longer hit the floor in any of the taught positions.  

Anterior tilt is a power seating function that changes the angle of the wheelchair seat in the sagittal (anteroposterior) plane where the rear aspect of the seat is higher than the front. This facilitates an anterior pelvic position and places the person in a partial weightbearing stance. This position may benefit the consumer medically/physiologically, psychologically, and/or functionally.

Anterior tilt of the pelvis can elongate the spine, open up the rib cage and may have a positive impact on respiratory capacity/health, the ability to take a deep breath and achieve a productive cough to clear secretions. Anterior tilt may aid in effective chewing (alignment of the mandible), swallowing, digestion, and bowel function, as it can minimize compression of the internal organs often found when sitting with a posterior pelvic tilt. For some individuals, an anterior pelvic tilt may promote pelvic floor relaxation and allow the vagus nerve and bladder to do their jobs. With increasing anterior tilt angle, there is greater weight bearing on the long bones of the legs (tibia and femur), which may help slow bone loss.

A neutral to anterior pelvic tilt position facilitates spinal alignment, allowing the head to sit naturally on the cervical spine and minimizing the amount of energy expended to maintain a horizontal eye gaze, which may promote social interaction. An upright seated posture can maintain self-esteem, promote a positive mood, and help build resilience to stress. Alternating between sitting and standing positions increases the release of hormones like serotonin, which is a mood booster.

The “ready to work” position occurs when the pelvis shifts anteriorly, facilitating trunk and lower extremity extension, or co-activation for increased stability and weight bearing proximally to promote movement and function distally. Anterior tilt shifts the individual to the front edge of the wheelchair base, which may allow them to get closer to the tasks they need to carry out. Anterior tilt may facilitate safer and/or more independent sit-to-stand and sit/squat-pivot transfers due to the biomechanical position of the individual with the shoulders over the knees over the feet position.

The person would benefit from assistance due to impaired trunk control to complete reach needed to perform functional activities they want/need to perform (with appropriate positioning straps as needed). The person has the necessary range of motion in their lower extremities in order to utilize anterior tilt safely and properly.The person can tolerate the more upright body posture the anterior tilt seating function places them into. The person can tolerate the partial weight bearing the position will place them in. The person has the functional need for the position to achieve mobility related ADL’s.

Yes, since the anterior tilt is increasing weight bearing through the lower extremities and increased pressure from the potential secondary devices (knee blocks), a medical professional should make the judgement call as to whether anterior tilt is appropriate. If someone has not done any weight bearing for a long time, they could have bone density issues. This could lead to a fracture or broken bone occurring with use of anterior tilt, so clearance by a qualified healthcare professional should be sought out before trying anterior tilt.

If an individual has not achieved a more upright posture since their diagnosis, injury or in a long time, then their blood pressure should be monitored while using anterior tilt. Anterior tilt could potentially cause a drop in blood pressure which can cause an individual to pass out. If their blood pressure starts to drop and they get lightheaded, then the team should lower them into a posteriorly tilted posture as quick as possible until their blood pressure is stable again, then bring them back to an upright seated posture again.

If a consumer has restrictions in lower extremity range of motion (tight hamstrings, tight heel cords in particular) then a clinician should check that the individual has the range of motion needed to properly utilize anterior tilt.

For individuals that do not have the accessory muscles for respiration, and use a diaphragmatic breathing method, anterior tilt may be contraindicated as it could reduce abdominal pressure. An abdominal binder may minimize this risk.

You can set positions in memory and hide the anterior tilt seat function but hiding anterior tilt will also hide the posterior tilt function as well. Posterior tilt and anterior tilt are the same function and cannot be separated. When coming out of posterior tilt the system will stop once 0° (the neutral position) is achieved. An additional command is required to go into anterior tilt. The user must return the input device to a neutral position, then provide another forward command (on the tilt screen) to go into anterior tilt. This prevents the individual from going into anterior tilt accidentally while coming out of posterior tilt.

Reference the TB4 setup guide included in each TB4 order.