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Sunrise Medical SMA User Manual

Page 13

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Compensate for limited trunk stability – even a slight tilt may utilize gravity to help
extend the trunk and maintain a more extended position

Reduce shear as much as possible, as compared to recline

Maintain proper position related to AAC (Alternative and Augmentative
Communication) devices, computer, even when tilted

Safer negotiation of inclines – can increase ground clearance by slight tilt

Improved respiration and digestion through more trunk extension

Utilize gravity for postural control, prevention of typical secondary complications such
as posterior pelvic tilt, kyphosis, scoliosis, pressure on the internal organs and
compromised vital organ capacity

Some control of edema, if combined with elevating legs


However, tilted is not a very functional position (line of sight is upwards) so if tilt-in-
space is used on the wheelchair, there needs to be dynamic variation between upright and
tilted positions. Since the seated angles are maintained, other means are to be utilized to
help prevent contractures.


Recline

Recline refers to opening (or closing) the backrest angle relative to
the seat. Various angles provide different benefits, and they may be
available with shear reduction. Shearing is an unfavorable force
that develops due to the body and the seat moving relative to each
other and friction arising between the two. Some shearing is good
to maintain position and prevent sliding, but extensive shearing may lead to compromised
skin or pressure sores. Shear reduction means that the mechanical component of the
backrest and the actual user interface of the backrest moves relative to each other while
reclining, thus reducing shearing on the user’s back.

Benefits:

Provides passive range of motion – helps prevent contractures at the hip

Distributes pressure over largest surface of body

Increases tolerance to staying in wheelchair

Allows multiple functional positions

Improves trunk stability, postural stability

Allows supine transfers

Allows better trunk position to accommodate kyphosis

Can decrease fatigue

Can facilitate bladder emptying, better catheter or urinal use

Allows positioning for diapering without transfer