Body shapes in wheelchairs

A tall upper body can be a challenge for postural control and sitting tolerance. In combination with an impaired posture, it can lead to wear and tear, on the spine and pelvis, developing rapidly. Stability in the torso is necessary to enable a functional and relevant level of activity.

 

 

A short upper body can limit the range of reach. The cause of a short upper body may be of a deformed spine and then requires a proper adjustment to achieve the best possible support. And in combination with short legs, the seat depth and foot support

 

 

A large upper body can be due to abdominal obesity, tall upper body or leg amputation, and usually moves the center of gravity forward and risks to end up in a forward-leaning position. This will affect breathing and complicate hip flexion. Being able lean against the back support, extension of the torso and breathing is facilitated.

 

Broad hips often leads to a too wide back support, which can affect the stability of the trunk and the mobility of the arms. A well-shaped seat cushion will reduce the enlarged width at the hip/thigh. Using widening parts for the seat can be an option to create space for the hip without affecting the width of the back support.

With broad shoulders, the back support can sometimes be too narrow. An alternative can be to lower the back, but some users need a back support height in level with the shoulder blades or higher, for comfort and stability. If that is the case, you can use widening parts to achieve correct support for broad shoulders.

 

A tilted pelvis is a very common cause of impaired posture and function among wheelchair users, and often leads to the user sliding forward on the seat. If you can create support for a tilted pelvis, at an early stage, you will stabilise the sitting position and thereby reduce the risk of increased back tilting of the pelvis.

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It is important to identify the reason for the leaning posture. Is the pelvis involved and is this the origin of the leaning posture? Or is it caused by lateral flexion of the spine? Can the user correct their leaning posture or is it fixed? Does the user always lean to the same side or does it depend on the activity or time of day? The goal should be to increase sitting tolerance and to help create a comfortable and stable posture while supporting the leaning posture.

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There are many possible reasons for asymmetry. To offer the best solutions it is crucial to establish the cause and the seating goals should be to reduce the asymmetry by supporting the individual in as neutral posture that is achievable for the individual. The goal is to offer postural support that prevents further deterioration in the spine and that allows optimum function for the trunk, arms and head and to ensure that internal organs are not compromised for breathing and digestion.

 

A kyphotic back needs enough back space for the user to sit firmly on an adequate seating area. The back support must follow and be adjusted for the users back curvature. A kyphosis also means a tilted pelvis, and a collapsed torso in combination with normal arm length will also place special demands on the propulsion settings.