Tips To Prevent a Slouched Posture in Your Wheelchair from an Occupational Therapist, Justin Boulos

For many wheelchair users, maintaining a proper seated posture can be a challenge, leading to what is clinically known as a posterior pelvic tilt or a slouched posture. This position can result in a range of issues, from discomfort and pain to reduced mobility and potential health risks. In this blog, we will explore what a slouched posture looks like, why it's problematic, and practical tips to help you prevent it.

Whether you're a seasoned wheelchair user or new to the experience, these strategies can help you sit more comfortably and maintain better posture.

What Is a Slouched Posture (Posterior Pelvic Tilt)?

A slouched posture in a wheelchair often appears as a rounded back with the pelvis tilting backward, causing the person to sit with a C-shaped curve. Clinically, this is known as a posterior pelvic tilt, and it can lead to various issues, including:

Pressure on the Spine: When you slouch, you place excessive pressure on your spine, especially in the lower back. This can become increasingly uncomfortable over time and lead to extra pressure on spinal discs.

Pressure Injury Risk: Slouching increases the risk of pressure injuries, particularly on the sacrum (tailbone) and the apex of the spine. These painful sores can be challenging to heal.

Reduced Function and Propulsion Efficiency: Maintaining an upright posture is crucial for efficient wheelchair propulsion and functional activities. A slouched position can reduce your independence and mobility.

Difficulty Repositioning: Slouching makes it more challenging to reposition yourself in your wheelchair, which can lead to discomfort and pressure sores.

Visual Field Reduction: In advanced cases, a slouched posture can limit your visual field, making it harder to engage with your surroundings and communicate with others effectively.

Respiratory and Swallowing Issues: A slouched posture can compress your chest and abdominal area, making it more difficult to breathe deeply and potentially impacting your ability to swallow and communicate.

Now, let's explore some strategies to prevent or correct a slouched posture in your wheelchair:

1. Transfer Well: Proper transfers are crucial. For hoist transfers, ensure your caregiver pulls the sling from behind, pushing your bottom as far back into the chair as possible. For standing transfers, make a conscious effort to sit all the way back in your wheelchair. If you didn't transfer perfectly, reposition yourself or ask for assistance. Ensure there is no space between your bottom and the backrest.

2. Use Tilt: If your wheelchair has a tilt feature, use it to your advantage. Tilt your chair back at least 20 degrees, which will help counteract the tendency for your hips to slide forward.

3. Adjust Your Footrests: Ensure your footrests are at the appropriate height. They should be high enough to support your feet and prevent them from sliding forward. Your thighs should make even contact with the cushion, and there should be no space for fingers to fit between your thighs and the cushion.

4. Adjust Your Armrests: Set your armrests to the height of your elbow joint. This will help you sit upright and prevent leaning or sliding forward. Avoid setting them too high, as this can elevate your shoulders.

5. Adjust Your Backrest: If you have a material backrest, tighten the straps at the top of your pelvis to provide support and prevent posterior pelvic tilt. For solid backrests, consider adding foam or a small cushion in the same area to offer additional support.

While these tips can significantly help you maintain a more upright and comfortable posture in your wheelchair, remember that not every solution will work for everyone. It's advisable to consult with an occupational therapist or physiotherapist who specialises in wheelchairs and seating. They can provide personalised guidance to address your specific needs, ensuring that you sit comfortably and upright in your wheelchair.

By following these strategies and seeking professional advice when necessary, you can improve your quality of life and make your wheelchair experience more comfortable and enjoyable.

You can follow Justin on instagram @wheelieworx where he shares an incredible amount of knowledge around choosing and using wheelchairs (as wheel as very entertaining videos!)

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