Views: 3 Author: Site Editor Publish Time: 2021-07-07 Origin: Site
While today's wheelchairs are lighter and more comfortable and maneuverable than ever before, it's estimated that 80 to 90-percent of wheelchair users are using a chair that doesn't fit their body. Choosing the right wheelchair can maximize your mobility and posture and prevent chronic discomfort or other medical problems. The proper fit will improve swallowing, breathing, and digestion while preventing pressure wounds, pelvic and hip problems, and general discomfort and fatigue.
The ideal wheelchair sitting position follows the 90-90-90 rule, which creates a 90-degree bend in the hips, a 90-degree bend in the knees, and a 90-degree bend in the ankles. The user should sit all the way back in the seat, with their buttocks making contact with the wheelchair back. Knees should be in line with the hips, and not above or below, and the thighs should be parallel to the ground.
Seat width - The width of the seat should be wide enough to accommodate the hips without pinching or being too snug, but not so wide that you have to stretch to reach the wheels when you're self-propelling. When it's too wide, the user tends to fall/slouch to either side in an unhealthy posture, and it may also be much harder to turn and/or get through doorways and other smaller spaces.
Seat depth - Generally, to avoid blood vessel constriction in the legs, the seat depth should be two inches away from the back of the knee.
Seat height - If the wheelchair user needs to use their feet to propel or turn, the height of the seat should enable them to reach the floor with their heels. Wheelchairs with footrests often have a higher seat height and will not permit this, but can be better suited for pulling up to a dining table to eat or play games with others.
Back height - For users who need the support, a full-length backrest is recommended, along with a headrest. Other wheelchair users may prefer a shorter back that enables more movement within the chair.
Armrest height - The user's arms should be comfortably supported in a natural, resting position. Other positioning devices and adjustable armrests can provide the right fit for various needs.
Footrest length and style - The wheelchair user's legs should never be allowed to dangle, nor should they be pushed too high, which leads to pelvic tilt. Leg-rests and footrests can be adjusted for different kinds of shoes, along with adjusting for comfort for swollen or painful legs. Additional accessories, such as calf supports can also be employed for stay-in-place reclining.
Are you at risk for pressure ulcers or skin breakdown?
Skin shear refers to the force of gravity that pushes down on the body with resistance between the user and their wheelchair, while pressure sores or wounds form from repetitive, irritating pressure to the same place on the body, usually the more bony prominence. Both conditions are painful, hard to treat, can lead to more severe problems, and best to prevent whenever possible.
Like anyone who sits excessively, wheelchair users are often more susceptible to developing pressure wounds and skin shearing. One of the best ways to prevent this is by selecting an ergonomic or tilt-in-space wheelchair that's specifically designed to offload pressure, friction, and shear. Tilt-in-space wheelchairs help to shift the weight from the buttocks to the back, reducing pressure.
Ergonomically-designed wheelchairs are specially constructed to provide comfort to patients more prone to developing these pressure and shear problems. Ergonomic wheelchairs typically include a unique, cushioned seat to prevent patients from getting sores, which can appear after extended time spent in the wheelchair. If you or your loved one will be spending long amounts of time in the chair, it's worth considering an ergonomic wheelchair design.
Stand-up wheelchairs also offer tremendous help in the prevention and treatment of pressure ulcers and skin shear, as they help users retain standing positions and break up that sitting throughout the day.
Incorporating the right positioning devices is another great way to reduce the risk of pressure ulcer development. While most wheelchairs offer patients a soft, comfortable seat during transportation, many models provide their users with additional comfort through the use of padded cushions and seat cushions which help to distribute weight more evenly.
This padding also serves as an added safety measure, helping to prevent any injury from a collision in the wheelchair. Depending on the patient's needs and the amount of time they'll be using the wheelchair, padding can provide a supplemental degree of comfort, and can prevent heat and moisture buildup as well.
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