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General Considerations
Provide the wheelchair user with optimal stability using minimal restraint
Ensure optimal spinal posture and pressure distribution
Minimize discomfort, fatigue, and energy expenditure
Specific areas of concern
Back height
Should support thoracic and lumber regions of the back for relaxation
Should not interfere with are motion for propulsion for function
Should employ higher back heights with scapular cutaways
Seat height
Should not limit the users access to the environment
Should allow for ease of transfers
Seat surface
Should provide a stable setting base
Should include a rigid seat insert
Armrests
Support the upper trunk and contribute to overall sitting stability
Need to be well padded
Need to be set with respect to height, angle of inclination, fore-aft position and width be-
tween (ideally these parameters would be adjustable)
Seat Inclination
Helps prevent the user’s buttocks from sliding forward which can occur secondary to de-
creased friction from seating surfaces designed to decrease surface pressure and enhance
transfers
Forces which occur with sudden acceleration or deceleration
Sliding due to road shock and vibration
Helps keep the user’s back against the backrest and aids in pelvic-sacral support
Back Inclination
Helps with trunk stabilization
Facilitates bimanual hand use in the face of severe weakness
Needs to be 10 to 15 degrees back from vertical
Needs to be greater with high level paralysis
Decreases body weight on sitting area
Back Cushion
Essential to improve the comfort and pressure distribution of the backrest
Should have firm pelvic-sacral and lower thoracic support
Should be softer foam in the upper thoracic support
Solid backs with little padding will push the user’s shoulders and trunk forward,
encouraging kyphosis
Solid backs with little foam can decrease lateral trunk stability
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