Taking the Pressure out of Specialist Seating

We rarely sit still for a minute. We make postural changes to get comfortable and remain stable so that we can do other things, maintaining and maximizing functionality. After all, sitting is a dynamic activity.

We instinctively make changes to our posture but when our abilities are reduced or compromised by illness or disability we need to pay closer attention to how our seating helps to maintain comfort and stability.

Providing the right seating system can help maintain independence and promote social inclusion. It can also help reduce deterioration and the risk of developing complications such as increased muscle tone, skeletal deformity and pressure damage.

Identifying when a client is in need of specialist seating can be difficult. However, specialist seating should be considered as soon as the client's abilities can no longer compensate for problems caused when their chair is the wrong shape and size, if their chair does not have features which improve functionality and is not made from materials which maximise pressure relief.

The chair must fit the client
Correct seat depth supports the pelvis and prevents the client sacral sitting. It also distributes the majority of the client’s body weight over as large an area as possible		Correct seat height gives good foot support to stabilize the upper trunk		Correct seat width centralizes the posture, keeping the client ‘midline’		Correct arm height facilitates good sit-to-stand, maintaining independence
Seat depth too long encourages client into sacral sitting		Seat height too high reduces upper trunk stability		Seat width too wide encourages leaning		When the chair is correctly set up the client’s feet, pelvis, arms and back are fully supported
The chair can improve functionality
Correct chair sizing will help maintain independence, encouraging the client to stand and carry out different functions		The addition of support for the trunk and head provides stability to allow the client to carry out other tasks and neuro-rehab exercises		Movement options such as Tilt-in-Space and back angle recline can give a range of positions from upright for feeding to reclined for watching TV
		The addition of lateral support can stabilize trunk and head position		TiS: changing position without affecting postu		Back angle recline with TiS, giving a restful position without destabilizing the pelvis
The chair has to manage posture and pressure
Maximizing the contact area between client and chair will stabilize posture and distribute pressure effectively		The position of feet, legs, pelvis, trunk, head and arms are interdependent and need to be viewed in relation to each other		Tilt-in-Space allows position to be adjusted without destabilizing posture		Pressure relief materials such as Reflexions® foam, WaterCell technology and multi-stretch fabrics reduce peak pressures
The correct fit between client and chair will distribute pressure over the maximum surface area						Pressure relief materials conform to body shape, distributing body weight over as large a surface area as possible
The chair needs to integrate
The seat height needs to be appropriate for safe and simple transfer		The position of the chair in relation to room layout, the position of the TV, environmental controls and other people need to be considered so that the client does not feel isolated or feel the need to re-position to better interact		All those involved in the use and care of the chair need to be aware of its features, benefits and limitations		The chair needs to be kept clean and maintained to ensure all aspects of pressure care work to the benefit of the client
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