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Basic Requirements of
SeatingTo accurately accommodate the correct amount of required seat width and depth
To facilitate the required level of backrest angle, height and position
To accommodate asymmetry or provide asymmetrical support
To Provide a medically and physically safeenvironment
To assess likely changes in needs, based on prognosis of condition in relationship to diagnosis – 3-5 years
Clinical Decision Making
How much positioning is required?
◦ How, where, why?
◦ Ingress/Egress
◦ Complexity
Accommodation versus Correction
How much stability required for function?
◦ Is there hidden function in current movements and position?
Clinical Decision Making What changes are predicted to occur?
What are the lifestyle considerations?
◦ Transferring and transporting
Client-Caregiver training
◦ Compliance with prescription, pressure relief and maintenance?
Common causes of PPT
• Weak core strength
• Tight hamstrings
• Seat depth too long
• Backrest doesn’t support
posterior pelvis
• Base of support not solid
(sling upholstery)
Pelvic Obliquity
Named for the side that is LOW
(LEFT or RIGHT)
Where is there pressure?
What happens to the spine?
Obliquity- Scoliosis ~Common
causesTrunk Asymmetries
Structural Scoliosis
No solid base of support
Wheelchair too wide
Back does not provide enough
lateral support
Seat cushion does not provide
pelvic stability
Pelvic Rotation
Named for the side that is back
(LEFT or RIGHT)
Where is there pressure?
What happens to the spine and lower
extremities?
Rotation ~ Common causes
Pelvic obliquity
Leg length discrepancy
Unilateral foot propeller
Back support does not support posterior pelvis
Seat and/or backrest contours too narrow
Possible Implications
Posture/Instability
Pain/Discomfort
Self propulsion
Forward reach reduced
Safety
Digestion
Respiration
Start with the Pelvis
The position of the pelvis dictates one’s alignment and ability to function in the seated position.
(c) 1996 Dorling Kindersley Multimedia /Times Mirror International Publishers
Pelvic Total Support
Balance the relationship of the
femurs/pelvis/spine ~ coccyx/sacrum/lumbar
and contain the anatomic shape
to prevent slipping; even asymmetrical
So how do we do it?
TECHNOLOGY
Starting from a flat base we build a modular
system that is always modifiable, composed of
independent pre-moulded inserts which adapt to
any shape and size and morphology
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