June 11, 2024
Can A Reclining Wheelchair Assist with Postural Management?

A reclining wheelchair, apart from meeting the mobility needs of a wheelchair user, is designed to meet those needs that are unique to a user. It provides flexibility over positional change and the sitting angle. The way this is obtained is by increasing the angle between the seat and the backrest.

This is usually done in sync with other features like an adjusted footrest and extra accessories like a sliding backrest that reclines with the user.

In order to support posture, a wheelchair has to allow the user the ability to keep a functional body position in line with their needs. This should include but not be limited to minimized strain on the joints, ligaments and muscles.

The Uses of a Reclining Wheelchair

Reclining wheelchairs are mainly used to give the user the freedom of stretching and changing the position of the body in order to support comfort and pressure care. This can be compared to how a normal person who is not disabled becomes uncomfortable sitting in the same position for far too long.

There is a debate in the medical sphere about the benefits reclining wheelchairs offer. Whether they truly do provide that postural support and other added health benefits.

Reclining wheelchairs, and tilt in space systems do provide pressure relief. They also improve head, neck and trunk control, increase circulation of blood, support safe transfer and minimizes fluctuations in muscular control of the user.

Why The Reclining Wheelchair Debate?

The reclining wheelchair increases the angle between the seat and the backrest when it reclines, and in so doing allows the body to move. This movement of the recliner is good as it allows for the redistribution of your weight from under the bottom to the back reduces pressure whilst increasing comfort.

The bad thing though, occurs if the wheelchair user cannot apply enough pressure on the footplates to support the bottom’s repositioning as the back support is reclining, and thus create shear, which occurs when the skin remains static while connective tissue moves with the body. This process of repeated shearing causes damage to the skin over time.

What this also means is that without the ability to adjust their position the user can slip down the wheelchair and have an impact when the backrest angle is decreased. What is dangerous here is that the wheelchair user can fully slip out of their seat or become trapped by the lap belt.

A tilt system on the other hand allows the wheelchair user to remain in a reclining position while simultaneously maintaining the body’s angle as it orientates in space. This allows posture to be maintained while pressure is distributed.

Neither one of the systems – tilt and recline – are appropriate in the event that the wheelchair user suffers from abnormal movement or uncontrollable reflexes while seated, as these cannot be controlled regardless of the pelvic position.

If the user suffers from spasms, as in the case of cerebral palsy, then the recliner would be inappropriate, posture could still be supported through the tilt-in-space system though. With all aids it is important to think through the tasks that the wheelchair user will perform.

If for instance the user is able to adjust their position and apply pressure on the footplate then the reclining wheelchair would be appropriate if the environment is of a work activity type.

If the user needs to be reclined whilst performing a task and is unable to support themselves, then the recliner might not be appropriate and other modifications are most likely required.