Improving seating and positioning in a wheelchair

Some helpful tips to consider when trying to improve upper-body positioning and pressure reduction and relief when sitting in a wheelchair.

• Correct lateral leaning: Lateral leaning increases pressure on the hip area. Lateral body or arm supports can be attached to the wheelchair to help correct this and keep the body properly aligned.
• Control forward leaning: Forward leaning causes improper weight distribution. Products like lap trays, wedged wheelchair cushions can help you from forward leaning.
• Control forward sliding: Forward sliding places increased pressure on the scapula, ischials, and coccyx areas. Cushions with low-rise front barriers like pommel cushions can help prevent the pelvic thrust which causes forward sliding.
• Protect elbows: Using padded wheelchair armrest covers can protect arms and elbows and reduce pressure caused from hard wheelchair armrests.
• Provide proper head positioning: Improper positioning of the head may cause pressure ulcers to develop on the ear lobes. Placing a person in a wheelchair with a high back with head positioning or padded head rest pillows can help prevent left-right head rotation. This also reduces pressure on ear lobes.
• Provide foot support for the wheelchair: Foot support is the foundation for proper positioning and weight distribution. The person in the wheelchair must be able to reach the footrests. If the feet do not align straight forward without leaning to the side, you can use products like footrest cradle, or extender. These products prevent left-right tilting and keep the lower extremities straight.

Pressure Points in a Wheelchair

Bony prominences on the body are particularly susceptible to pressure ulcer development, an ulcer can develop on any soft tissue under prolonged pressure. Friction, shearing force, and excessive moisture may also contribute to the development of pressure ulcers.

What are Pressure Ulcers?

Pressure ulcers are lesions caused by continuous pressure that damages the underlying tissue. Pressure ulcers usually occur over bony prominence areas (pressure points).