positioning in w/c Flashcards Preview

Assessment and Intervention > positioning in w/c > Flashcards

Flashcards in positioning in w/c Deck (22):


Lateral bending of the spinal column
Rotation of the spinal column
Can be flexible or fixed



Excessive inward curvature of the spine
Usually at the lumbar area (lower back)


Kyphosis (hunchback)

Excessive rounding of the spine
Usually at the thoracic area (neck)


Orthopedic conditions

Often occur in children with neuromuscular disorders such as cerebral palsy, muscular dystrophy and spina bifida

Due to an imbalance in muscle tone surrounding the vertebral column

Can cause problems with posture, digestion, breathing and motor control


Pelvic and Hip Deformities

Dislocated hips
Pelvic obliquity
Pelvic rotation
Pelvic tilt
Windswept deformity


Hip dislocation

Head of the femur does not articulate with the acetabulum (hip socket)
In those with neuromuscular disorders, caused by excessive tone or lax ligaments


Pelvic obliquity

One side of the pelvis is higher than the other side


Pelvic rotation

One side of the pelvis is rotated forward of the other side


Pelvic tilt

Posterior: Top of pelvis is tipped backward
Anterior: Top of Pelvis is tipped forward


Windswept deformity

One hip is adducted and one hip is abducted


3 categories of seating intervention

Management of deformities and postural control
Pressure management (prevention of skin breakdown)


outcomes of proper seating

Normalization of tone and reflexes
Control or prevention of deformity or contractures
Enhanced function through maximized stability
Enhanced organ function
Increased comfort and decreased fatigue


Evaluation: physical skills

Range of motion
Skeletal condition


Evaluation: neuromotor skills

Muscle tone
Postural control


seating and positioning rules

Alignment and stabilization of pelvis is first area to be addressed

Neutral position is ideal: hips flexed at 90 degrees, pelvic is level side to side and front to back

Modifications to the seating surface may be necessary to accommodate deformities to allow for a level pelvis


modifications for LE positioning

Shorten the seat depth or undercut front of seat to allow legs to come under the seat
Support legs in position they are fixed in
For leg length discrepancies provide foot rests of different heights
Angle footrests to accommodate ankle contractures
Straps across the top of the feet, behind the heels or across the ankles can help


modifications for trunk positioning

Lateral supports – greater control when placed high on trunk and close to the body
Tilt – placing a person with poor trunk control at a slight backward tilt eliminates gravity slightly and helps the person maintain a more symmetrical posture
Anterior Supports – help person maintain upright position (straps, panels, rigid shoulder supports)


trunk positioning rule

it is important to attempt to support the individual in their natural position instead of forcing them into a more “normal” position


head and neck positioning

Position of head is important in inhibiting reflexes and promoting visual skills
important to support person in a functional position to foster use of vision and engagement in environment


head and neck modifications

Head rests
Headbands that provide anterior support
Lateral supports applied at temporal area, neck or side of face (May be useful in inhibiting the ATNR)
May need support for fatigue, travel or for changes in position only


UE positioning

Lack of support can affect head and neck positioning
Injury to arms that are left to hang can occur
Desired position allows elbows to bend at 90° angle
Use trays or individual arm troughs to provide support for the arms


skin integrity positioning

Important to note areas of increased pressure
Many types of materials are available
Important that positioning provides ways for pressure relief (tilt, recline, etc.)