Introduction to Wheelchair Seating and Positioning

Course Description: This course systematically reviews wheelchair seating considerations, beginning with evaluation and assessment. A key part of seating assessment is the mat examination, which helps determine where and at what angles a client needs postural support for optimal alignment as well as pressure distribution and relief to prevent the development of pressure injuries. Body positioning is critical; the body should be positioned to support the task that needs to be accomplished. Sitting on the sofa watching TV could accommodate a position of relaxation, but sitting at a desk, signing a report, requires a position of stability to optimize writing. Clients often must find both a position of rest and a position suitable for functional or task performance within the same seating system. This makes the evaluation process all the more challenging. Factors that affect client posture, such as vision and tone management, are also discussed. A 24-hour approach to positioning, specifically sleep positioning, is explored because of the impact sustained postures have on range of motion and orthopedic alignment both within and out of a seating system. The course explores available seating system categories and materials as well as describes specific seating challenges, including causes, goals, and suggested interventions. Dynamic seating systems are reviewed as these provide movement of the seating system and/or wheelchair frame. A review of wheelchair frame components is also provided. Seating for specific populations, including pediatric, bariatric, and geriatric clients, as well as clients with degenerative conditions is provided as seating needs vary by client population. Wheelchair seating and the wheelchair frame are interrelated. (Specific mobility considerations will be presented in a separate course.) This course also provides the practitioner with information regarding the effects of restraint regulations on the provision of appropriate seating interventions.