Clinical Justification for Tilt-In-Space Positioning Chair
Criteria for Individuals who present with one or more of the following conditions:
A. Decreased postural control
Tilting a seating surface in a posterior direction can reduce the effects of gravity on one’s trunk/upper body, which facilitates a more functional and proper upright posture. Proper postural control also assists with higher and more practical use of the upper extremities. Posterior tilt efficiently opens the diaphragm allowing for more significant thoracic expansion resulting in improved oxygenation, blood flow, and organ function. The tilt-in-space feature facilitates positioning for comfort, pain management, and pain relief.
B. At risk of skin breakdown and/or decreased skin integrity
Tilt seating systems maintain a constant seat to back angle allows for patient repositioning throughout the day without the risk of shear displacement. Tilting the seating surface provides repositioning for those who are unable to independently shift their weight. The posterior tilt of the seating surface moves the weight and pressure away from critical areas under the pelvis. Proper repositioning improves blood flow, oxygenation, and retention of the skin tissue which is vital for maintaining skin integrity. Posterior tilt facilitates position changes associated with pressure relief for individuals with limited range of motion.
C. Musculoskeletal deformities/conditions and other medical conditions which prevent proper positioning when seated in a non-tilting wheelchair (i.e., kyphosis or lordosis)
Tilt-in-space chairs are commonly prescribed for individuals with musculoskeletal deformities or conditions. Posterior tilt reduces the effects of gravity on the trunk and upper body helping to eliminate postural deviations. Tilt-in-space best accommodates conditions such as but not limited to hypertonicity, hypotonicity, kyphosis, and lordosis. Posterior tilt helps decrease fatigue associated with hypertonicity and improves postural support and stability for individuals with hypotonicity.
D. Decreased head/neck control and/or unable to feed themselves or can be feed safely from a non-tilting wheelchair
Clinicians use customized positioning to maximize breathing and speaking ability. This special positioning maintains vital organ capacity and also reduces the risk of aspiration. Posterior tilt provides stability and improved postural support for those who cannot keep an upright posture when seated. Tilting a patient can be used to realign posture and enhance function such as feeding, communication, and completion of activities of daily living. Postural deviations can be decreased with the use of posterior tilt, such as but not limited to; slumping, sliding, falling forward, lateral lean and head drop
E. Individuals who are at risk for falls or injuries from using a non-tilting wheelchair
Tilt provides postural stability and support for those who cannot maintain an upright posture when seated. Tilting the seating surface in a posterior direction maximizes the body’s weight and gravity, allowing the patient to remain seated, perpendicular and engaged in functional activities. Tilting the patient in a posterior direction provides proper seating alignment, decreasing patient fatigue, and postural deviations. With the decrease in postural deviations and improvement of postural support and stability falls can be significantly reduced.