How Do We Prioritize Seating Challenges During a Wheelchair Evaluation?

Michelle Lange, OTR, ABDA, ATP/SMS

November 2, 2015

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Question

These challenges that we see in seating often are not seen in isolation. We see combinations of them. How do we prioritize them during a wheelchair evaluation?

Answer

It really comes down to what is flexible and what is fixed. For example, if someone has a combination of posterior pelvic tilt and rotation, we are going to look at solutions that address both. An anti-thrust seat, whether it is part of a linear seat or built into a molded seat, has a curb to block the IT's. That can help prevent both posterior pelvic tilt and rotation. We also know that the position or the angle of the pelvic belt is important in limiting posterior pelvic tilt. We would choose probably a 60 degree angle to limit that posterior pelvic tilt but we would make sure it pulled down on the forward side if we were also dealing with rotation. It is keeping in mind all the challenges that we are seeing and trying to create solutions that address all of those. It is very important today to look at how we match individual seating challenges to strategies such as angles of pelvic belts, cushions that are anti-thrust shaped, etc. 


michelle lange

Michelle Lange, OTR, ABDA, ATP/SMS

Michelle is an occupational therapist with over 30 years of experience and has been in private practice, Access to Independence, for over 10 years. She is a well-respected lecturer, both nationally and internationally and has authored numerous texts, chapters, and articles. She is the co-editor of Seating and Wheeled Mobility: a clinical resource guide, editor of Fundamentals in Assistive Technology, 4th ed., NRRTS Continuing Education Curriculum Coordinator and Clinical Editor of NRRTS Directions magazine. Michelle is a RESNA Fellow and member of the Clinician Task Force. Michelle is a certified ATP, certified SMS and is a Senior Disability Analyst of the ABDA. 

 


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