A wheelchair is an extraordinary portability solution for any individual who has difficulty moving around on their own. It can provide independence and freedom for many people. Without this supportive device, it would be impossible for somebody with a spinal cord injury or muscle decay to live all alone, provide for themselves, and have the everyday routine they experience today. Life doesn't end in a wheelchair—it simply gets more complicated. If you have spent a lot of your life in a wheelchair, you have it outfitted with all the essential seating and positioning.
The belt or pad can help right common positioning issues like inclining aside or sliding out of the wheelchair. They can also assist with pelvic shifting that makes you lean forward or reverse in the chair. This implies less torment and better constancy for you or your friends and family.
Before we can survey for any strange postures that should be revised or obliged in the wheelchair system, we should initially understand Neutral Position to evaluate any change from "normal".
Neutral Pelvic Position
We are going to start with how you should be situated in a wheelchair. Your pelvis should be level and the Spine is adjusted and upright, with no revolution, no horizontal curvature. Normal lordosis in the cervical and lumbar spine and typical kyphosis in the thoracic spine making the ideal "S" shape.
The Head is practically upright with conceivable mild forward/parallel flexion or rotation.
Issues with Poor Posture
- Urinary tract issues
- Blocks socialization with others
- Issues with gulping and hazard of aspiration
- Difficulty in breathing
Posterior Pelvic Tilt
In a posterior pelvic tilt, the highest point of the pelvis is tipped aft. This rotational progress of the pelvis brings about a flexed or kyphotic trunk.
Problems
The c shape confines breathing and voice projection. Abdominal pressure can prompt clogging, reflux, and risk of UTIs and other bladder issues. Also, the downward head position can make you more powerless to stifling and yearning. It also can meddle with socialization as you can't look upward for exercises or while talking with others.
Solutions
Adequate posterior help to the pelvis will avoid the rearward movement that outcomes in a posterior pelvic tilt. One choice is a biangular back, which keeps the pelvis in an upstanding, impartial tilt while permitting the trunk to stretch out beyond the pelvis.
if the issue is tight hamstrings, you can lighten the pull on the muscle by either opening the seat-to-back point or diminishing the point of the upper leg to the lower leg.
When restricted hip flexion is the issue, flexing the hip drives the pelvis into a posterior tilt. This can be settled by opening the seat-to-back point.
Anterior Pelvic Tilt
An anterior pelvic tilt happens when the highest point of the pelvis moves ahead, straining the lumbar area and making the spine expect a more lordotic position.
Problems
The unreasonable spinal bend makes issues for your processing and bladder leading to constipation and UTIs. The sprained neck can make trouble when swallowing and increase the risk of desire. Additionally, the upward eye stare can make it difficult to connect with others and appreciate imparting.
Solutions
Putting the pelvic positioning belt straightforwardly superior iliac spine (ASIS) pulls the pelvis back into an impartial position. You can do it by mounting a 4-point positioning belt at 30 degrees. A secondary belt positioned between the range of 60 and 90 degrees preserves the essential belt's position, keeping it from moving over the ASIS onto delicate tissue.
Pelvic Obliquity
Pelvic obliquity happens when one side is higher than the other, bringing about a parallel bend of the spine. One basic outcome is pressure ulcers situated under an IT.
Problem
You may shelter one side or appear to be sitting abnormally. Your spine is bent because of the positioning which could cause torment. One side is getting more pressure when situated which can also create torment.
Solutions
In an adaptable obliquity, changing the point of the pelvic belt to 90 degrees might be everything necessary. However, if the customer has a dislocated hip this won't be viable. And if a revolution or a back pelvic tilt is also present, a four-point belt might be indicated.
The other essential intercession for obliquity is wedging. If the obliquity is adaptable, a wedge is put under the seat on the low side to level the pelvis. In a fixed obliquity, a wedge is put under the seat on the high side to more readily appropriate pressure between the ITs. A pressure guide will help decide whether the pressure is well-conveyed.
Pelvic Rotation
Pelvic Rotation with rotation of the neck flexion and spine. Pelvis sits with L or ASIS more forward than the other, creating a rotation in the hips. The neck will go into sidelong flexion as though the individual is dropping the ear to their shoulder.
Problems
This could prompt you to get out of the wheelchair and fall. The forward sliding is regularly because of weakness or self-impetus.
Solutions
If the customer's range of movement is restricted, putting the lower extremities in front of the customer may bring about maneuvering the pelvis into rotation. All things considered, place the legs in a lopsided stance, regularly known as a desolate posture, to permit the pelvis to stay neutral.
You can oblige a leg-length inconsistency with an asymmetrical seat profundity. When pain is the reason, work intimately with your customer's medical team to recognize the pain and settle it, if conceivable. Whenever increased tone or reflexes are adding to pelvic rotation, increasing flexion and abduction may "separate" the tone.