gently recline them back to rest and relax. Rise & recline chairs can assist in

maintaining or improving the general health, and ultimately the quality of life, of users who are sitting for periods of time but require the ability to stand regularly for transfers or mobility throughout the day. The ability to recline the body,

in conjunction with appropriate pelvic stability, can improve energy management for individuals who may experience fatigue. Trunk support and alignment will also promote physiological function, including breathing and digestion, and a range of head supports can offer an improved line of vision to promote social interaction and engagement in activities. The ability to reposition and

redistribute weight away from vulnerable areas regularly to reduce the risk of pressure ulcers is possible too. Using the functions to elevate the lower limbs above hip level may also help improve swelling and encourage circulation, if safe and appropriate. It must be noted that rise & recline

chairs are not suitable for all users. They are generally not suitable for users with significant health conditions. They do not offer the necessary postural support for those with more complex postural challenges.

Top ten hints and tips

1. A comprehensive seating assessment with an experienced seating assessor and health & social care professional is critical and will enable an appropriate seating prescription.

2. Specialist seating should be used as part of a holistic, 24-hour programme that also encourages a regular change of position for the individual to manage both posture and pressure appropriately.

3. During the provision of specialist seating, all body segments should be considered.

4. The chair must be set-up for the individual user; correct seat depth, width and height are critical.

5. The pelvis is the foundation for a good sitting posture as it dictates what happens to the body segments above and below.

6. The position of the thighs helps to

stabilise the pelvis; aim to keep the thighs level and fully supported to reduce the risk of pressure ulcers.

7. Aim to fully support the trunk and align the spine as much as possible to reduce the risk of postural deterioration and promote physiological function.

8. Pelvic stability and trunk functionality are dependent on adequate lower limbs support; aim to align and fully support the lower legs and feet.

9. Upper limbs support is essential to prevent drag and relieve stress on neck and shoulder muscles; however, upper limb support is not there to support the trunk.

10. Head and neck support is vital for breathing and safe eating and drinking; aim to keep upright and in midline to also enable interaction with the environment.

June 2021 • In addition, they do not provide the

robustness needed for those with considerable involuntary movements. Specialist seating offers this enhanced postural management and pressure care for those indicated.

References 1. Age UK, Care homes, 2020 https://www.ageuk. care/care-homes/.

2. Ham R., Aldersea P., Porter D., Wheelchair users and postural seating: a clinical approach, London: Churchill Livingstone, 1998.

3. Pope P.M., Severe and complex neurological disabilities: management of the physical condition, London: Butterworth-Heinmann, 2007.

4. Bartley C., Stephens M., Evaluating the impact of WaterCell Technology on pressure redistribution and comfort/discomfort of adults with limited mobility, Journal of Tissue Viability 26(2):144-149, 2017.

5. Jones M,. Gray S., Assistive technology: positioning and mobility, in SK Effgen (Ed) Meeting the physical therapy needs of children, Philadelphia: FA, 2005.

6. NHS England, After-care needs of inpatients recovering from Covid-19, 2020, https://www. after-care-needs-of-inpatients-recovering- from-covid-19/.

7. Sprigle S., Sonenblum S., Assessing evidence supporting redistribution of pressure for pressure ulcer prevention: A review, Journal of Rehabilitation Research and Development 48(3):203-14, 2011.

8. Waterlow, Pressure Ulcers, 2007 http://www.

9. Moore Z.E., Webster J., Samuriwo R., Wound- care teams for preventing and treating pressure ulcers, Cochrane Database Syst Rev 16(9), 2015.

Rebecca Dunstall

Rebecca Dunstall is a physiotherapist and clinical specialist at CareFlex. Rebecca facilitates training events, develops educational material, and supports health and social care Professionals with their clients’ postural and pressure care needs. As a result of her clinical experience and caring for a profoundly disabled sibling, Rebecca is passionate about postural management and is committed to raising awareness of the vital role of specialist seating in improving individuals’ quality of life.


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