Maintaining good posture in your manual wheelchair helps you to carry out tasks and perform activities more effectively. Correct posture differs according to each person and their circumstances, but it is always key to maintaining health and to getting the best out of your wheelchair.
The importance of posture when using a manual wheelchair
Achieving good posture provides comfort to wheelchair users by helping to relieve pressure on different areas of the body such as the spine, neck, thighs and buttocks, as well as helping to optimise the effort required to operate the wheelchair and use less energy.
Good posture is also crucial for propelling the wheelchair in the correct fashion to reduce the risk of repetitive strain injuries in the shoulder tendons.
The aim is to comfortably reach the pushrims and to push with a full movement of the arm, starting at the rear and following right the way around. If the user slides in the seat, the pushrims will be too high to propel from behind, making the movement uncomfortable to perform, as well as shorter and less efficient as a result.
Basic points to keep in mind
When it comes to studying wheelchair functionality, biomechanical factors should be taken into account, such as the height, position and size of the wheels, as well as the distance between and the angle of their axes. It is also important to take into account the:
- Seat height
- Backrest height
All of these features can be adjusted and configured to suit a specific person's requirements and to ensure that the correct positioning and posture is achieved. The provider of your wheelchair will ensure these are adjusted correctly for you during the handover of your wheelchair.
This is the part of the wheelchair that is in permanent contact with the user and therefore it is essential that it achieves the necessary stability for optimal propulsion and function. It also serves to evenly distribute weight and avoid pressure sores.
Ideally the user’s weight should be distributed over the largest area possible. As such, the seat should neither be too wide (causing the user to adopt a non-symmetrical posture) or too narrow (causing the user discomfort and pressure sores). Likewise, the wheelchair's seat must likewise not be too short (forcing pressure onto the buttocks) or too long (where the user has to slide forward to avoid excessive tension in the area behind the knee).
According to experts, the optimal seat length is when the user is able to fit two fingers into the area between the seat and the back of the knee (popliteal fossa) when sitting upright.
The seat itself should have a base that is firm enough that the user does not sink. In most cases it is advisable to place an anatomical cushion at the lower rear of the seat in order to provide a comfortable fit that spreads the pressure evenly. Sunrise Medical provides a wide range of wheelchair cushions through our portfolio of JAY products.
The foot support or footrest must be at an angle comfortable for both ankles and knees. Ergonomically speaking, this would ideally be around 90 degrees. However, in practice this may depend on many factors, as this could impede the free rotation of the front wheels or actions such as climbing a kerb, so it may be slightly lower for very active users, or for sports wheelchairs. It could also be the case that the user is unable to keep their knees at a 90 degree angle.
Likewise, the height of the footrest will also play a part as if it is too low, this may alter the position of the hips, whilst if it is too high, it will create too much pressure on the buttocks.
3. Backrest height
The importance of the backrest height lies in its ability to stabilise the upper body. It depends on the disability and/or injury of each user and is fundamental to the comfort and function of the upper extremities.
A comprehensive range of wheelchair backrests are available through our JAY brand of wheelchair cushions and backrests.
Despite its name, the purpose of the armrest is also to allow the neck muscles to rest, as well as the arms. It is advisable that the elbows be supported at 90 degrees, as having them higher may cause stress upon the neck and shoulders, whilst having them any lower may cause the user to fall to one side. Depending on the user and their lifestyle, the armrests can be replaced by side guards, which do not provide support but do help shield from dirt and splashing when propelling the wheelchair.
Taking measurements to configure, design and buy a wheelchair
The wheelchair is an extension of the user, so taking correct measurements is crucial to determining the degree of independence a person may enjoy. This is why it is necessary for a specialist to evaluate the specific requirements of each individual case, though it is worth being aware of some of the basic aspects.
- Measurements should be taken on a hard surface with a maximum cushioning of 2-3 centimetres.
- The user should try to adopt the same posture that they will use when seated in the wheelchair. The pelvis, knees, ankles and elbows should all be straight, ideally at an angle at or close to 90 degrees.
- It is important to take other factors into account such as the clothes that the user regularly wears so as to help determine the width of the seat.
- Thigh measurements should be taken from both the left and right sides in order to avoid discrepancies. The same should be applied to the calves.
- Obtaining accurate measurements is key when it comes to ensuring comfort and getting the best out of the wheelchair.
At Sunrise Medical we know the importance of using a professional to undertake accurate measurements. All of Sunrise Medical’s authorised wheelchair agents are fully trained in prescribing our products through our STEPS training courses and will carry out detailed wheelchair assessments and handovers to ensure your wheelchair suits you and your lifestyle.
Wondering which wheelchair is right for you? Sunrise Medical offers an extensive range of manual and powered wheelchairs, as well as JAY wheelchair cushions and backrests to ensure you’re sitting comfortably.