Introduction
Thank you. I would like to welcome you to seating, positioning and common clinical considerations. I have been doing seating and positioning for 15 years as an occupational therapist. I have worked mostly with a geriatric population, but also a little bit in pediatrics.
Learning Objectives
I hope that you will be able to identify common impairments that influence posture and positioning. We are also going to focus on identifying the common environmental influences on seating in a wheelchair. By the end of this presentation, you should be able to demonstrate an understanding of some restorative and compensatory treatment models for seating and positioning. Lastly, you should be able to define some various common treatment approaches to positioning, and, hopefully, you will go back into your clinic and be able to implement these. Our goal with seating and positioning is to find the right functional posture for an individual. We need to always be mindful that we do not sacrifice function by trying to correct position.
Optimal Seated Position
I am going to discuss what optimal seated position is, but it is important to remember that even though we want to maintain joints in a specific position, we need to keep function in mind. We want to have the head in a neutral position with the gaze going forward, shoulders in a neutral position of equal height, elbows at 90 degrees flexion on armrests and natural spinal curves maintained. A neutral pelvis is very critical with hips at 90 degrees flexion with some slight abduction and alignment in the shoulders and head. There should be equal weight bearing through both ischial tuberosities. The knees should be comfortably flexed, approximately 90 to 100 degrees and in line with the hips, with the back of the knees two inches away from the edge of the seat. The ankles should maintain a neutral position whenever possible with feet having a solid base of support on the ground or on foot pedals.
