Supporting Function and Independence with Specialist Seating
As a Physiotherapist and after many years working closely with fantastic Occupational Therapists colleagues, I have consolidated my knowledge of functional independence and truly appreciate its importance for health and well-being. I thought it a great time to explore how postural care and specialist seating can support three critical areas of function: functional movement, physiological function, and functional engagement.
Function is necessary to participate in the activities important to us. It allows us to access our environment and engage with the world around us. It is critical to independence and important to living a fulfilling life. It is also vital to protect our health and well-being.
Posture underpins our ability to function1; with optimum postural care and a supportive sitting posture, it can be promoted and therefore, individuals are encouraged to maintain their level of independence.
Postural control is critical to enable functional movement; it is the ability to maintain the body’s center of gravity within the base of support. Ensuring proximal stability is a requirement for distal control as freedom of movement in the upper limbs is achieved through effective stabilisation of the pelvis and trunk.2 An individual unable to maintain sitting balance may naturally seek stability through their upper limbs, resulting in the hands being unavailable to perform tasks.
When working with individuals with movement disorders, maintaining mobility and promoting falls prevention can become a priority objective. Falls can be devastating, for the individual and for the wider health and social care system. The human cost includes distress, injury, loss of confidence, and increased morbidity and mortality.3 Reduced postural control can result in individuals sliding out of their chairs or falling during transfers. Generalised weakness from immobility and deconditioning can also increase the risks.
Functional movement is vital in protecting the body structure and reducing the risk of injury; movement is essential for blood flow, activation, and lengthening of muscles. Prolonged postures without regular repositioning can result in pain, soft tissue shortening, and even bony changes.
Individuals who have difficulty supporting their own posture can experience pain, fatigue, dependency, poor physiological function, and even premature death. An inability to maintain an upright sitting posture has been associated with a decline in health.4
Destructive sitting postures can cause organ compaction; for example, head flexion and a rounded shoulder girdle can impact lung expansion and adversely affect eating and drinking, making it potentially unsafe. Individuals may experience pressure injuries, recurrent respiratory infections or digestive problems and be at an increased risk of hospital admission. Therefore, it is critical to their health to promote protective sitting postures to increase the ability of the body’s organs to work more efficiently and facilitate physiological functions such as respiration, swallowing, digestion, and circulation.
An inability to sit out comfortably and efficiently can result in individuals becoming confined to their beds with limited opportunities for socialising. Alarmingly, loneliness and social isolation are twice as harmful as obesity to physical and mental health.5
An unsupported posture can cause fatigue by making inefficient use of the body structure. Gravitational forces can also make sitting effortful for individuals who present with muscle weakness, deconditioning, and abnormal muscle tone. Fatigue can significantly restrict the ability to engage in daily living, as well as having a negative impact psychologically and socially.6 Optimum postural care can enable good energy management, reducing the need for individuals to be confined to the four walls of their bedroom.
Research has shown that a stable sitting posture can also encourage participation in social activities at home, school, or work and as part of the community.7 Head control and positioning is imperative for orientation and interaction.8
How Can Specialist Seating Help?
In summary, specialist seating is critical to an individual’s quality of life. When the ability to achieve optimum posture is affected, it can significantly impact health and well-being. Specialist seating aims to allow individuals who might otherwise have difficulty to achieve their optimum sitting posture. Specialist seating can:
- Promote pelvic stability and postural control.
- Provide security and a stable base of support.
- Encourage the body segments to work efficiently.
- Encourage energy management and conservation.
- Facilitate normal or control abnormal movement patterns.
- Promote optimum positioning of the body segments, including the head and feet.
Specialist seating plays a vital role in supporting the function and independence of individuals with various health conditions and postural presentations. By understanding the benefits and key features of specialist seating, Health and Social Care Professionals can make informed decisions and provide optimal postural care for the individuals they work with. Incorporating specialist seating into clinical practice can lead to improved outcomes by providing the necessary postural support, optimum physiological function to protect health, and the ability to engage more effectively in daily life.9
Please do not hesitate to contact CareFlex to learn about our comprehensive educational programme and how we can support your professional development around postural care. For further reading, please click here to view the Postural Challenge range of handouts.
Crawford S, Stinson M (2015) Management of 24-h-Body PositioningIn Söderback I (Ed) International Handbook of Occupational Therapy InterventionsCham: Springer International Publishing
- Green EM & Nelham RL (1991) Development of sitting ability, assessment of children with a motor handicap and prescription of appropriate seating systems Prosthetics and Orthotics International 15:203-216
- Office for Health Improvement and Disparities (2022) Falls: applying All Our HealthAvailable from: Falls: applying All Our Health – GOV.UK (www.gov.uk)
- Healy A, Ramsey C, Sexsmith E (1997) Postural support systems: their fabrication and functional use Developmental Medicine and Children Neurology 39:706-710
- Holt-Lunstad J, Smith T, Baker M, Harris T, Stephenson D (2015) Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review Perspectives on Psychological Science 10(2):227-237
- NHS (2020) Fatigue Available from: https://www.yourcovidrecovery.nhs.uk/managing-the-effects/effects-on-your-body/fatigue/
- Trefler E, Taylor SJ (1991) Prescription and positioning: evaluating the physically disabled individual for wheelchair seating Prosthetics and Orthotics International 15(3):217-224
- Farley R, Clark J, Davidson C, Evans G, MacLennan K, Michael S, Morrow M, Thorpe S (2003) What is the evidence for the effectiveness of postural management? International Journal of Therapy and Rehabilitation 10(10):449-455
- Janssen-Potten YJM, Seelen HAM, Drukker J, Reulen JPH (2004) The effect of a seating aid provision system on improving body functions in physically disabled children: a longitudinal study Disability and Rehabilitation26(18):1067-1076