How Can Specialist Seating Help?

CareFlex specialist seating incorporates effective functions and controls that offer a solution for balancing the four key considerations when choosing a chair: comfort, independence, posture control, and pressure relief.


  • Tilt-in-space allows the reclining angle of the chair to be changed without adjusting the user’s hip and knee angle – the whole seating system tilts posteriorly
  • Tilt-in-space can improve pelvic stability without affecting the user’s critical angles for sitting, assist with head control, and promote safety by preventing the user from sliding down the chair
  • It promotes energy management by bringing the user into a tilted resting position for a period of time to recuperate before returning upright to continue with activities of daily living
  • It encourages pressure redistribution as repositioning the user against the forces of gravity in different degrees of tilt can redistribute pressure and ultimately reduce the risk of pressure injury; even a 20° posterior seat tilt can reduce pressure under the pelvis1
  • Tilt-in-space can be effective for the management of the following postural challenges:
  • Tilt-in-space can also assist with hoisting and positioning by utilising gravity to bring the pelvis down into the back of the chair; therefore, reducing the effort required by the user’s support network
  • There are times when tilt-in-space may be contra-indicated, or its use needs to be fully risk assessed and closely monitored, including for users with swallowing difficulties, those who require the use of a tray, or those with catheters; a comprehensive assessment is vital

Back angle recline:

  • Back angle recline adjusts the angle between the chair and seat back, which has an effect on the hip angles
  • Back angle recline promotes comfort, stability, relaxation and energy management for the user
  • It can be adjusted to alleviate pain or discomfort associated with hip joint problems
  • It can reduce abdominal pressure for users with obesity
  • It can also relieve hamstrings muscle tension if the leg rest is elevated
  • Back angle recline can be effective for the management of the following postural challenges:
  • Back angle recline must be used appropriately following a comprehensive assessment due to the risk of increasing friction and shear forces, encouraging an extensor tone thrust, and the user sliding down the chair

Tilt-in-space and back angle recline – what is the difference?

  • The main difference is the effect the functions have: back angle recline opens up the hip angle, while tilt-in-space allows the user to recline without affecting the hip angle
  • Often, the functions are most effective when used in conjunction; tilting the seating system posteriorly before opening up the hip angle will help maintain stability
  • When used together, there can also be a positive effect on pressure redistribution; 25° tilt combined with 120° recline can be effective in providing both muscle and skin perfusion at the pelvis2

Leg rests:

  • Leg rests are important to encourage lower limb alignment and aid pelvic stability; channeled leg rests may be indicated for user’s who find it difficult to keep their lower limbs in midline
  • Elevating leg rests can be used to lift a user’s lower legs to provide a relaxing position
  • Raising the legs above hip level for 30 minutes, three to four times a day, may also help improve swelling and encourage circulation, which can help manage pain3
  • Using tilt-in-space and leg rest elevation in combination to raise the lower legs higher than the hips is more comfortable than elevating the legs with the knees fully extended
  • A negative angle leg rest can accommodate limited knee range of movement allowing a more comfortable seating position for users with tight or shortened hamstrings muscle, facilitate safe standing by allowing optimum foot position, and accommodate oedematous lower legs or large calves for user’s with obesity

Foot rests:

  • 19% of an average person’s bodyweight is distributed through their feet when seated4; therefore, a foot rest is essential to support the feet adequately and reduce the risk of pressure injury
  • Foot support also encourages postural stability to allow movement of the upper limbs for function within and outside the user’s base of support

Manual actuation:

  • Manual actuation allows CareFlex chairs to be adjusted manually with the minimum mechanical help
  • The user’s support network can easily control the movement of tilt-in-space, back angle recline and leg rest elevation, but knowledge and skill is needed to balance all elements together appropriately
  • In multi-user health and care environments, manual actuation is a very cost effective, low-maintenance way of adjusting the position of users in the chairs

Motorised actuation:

  • Motorised actuation is an electrically powered seating system; it uses a battery system meaning that the system keeps working as the chair is moved around
  • It can increase independence allowing the user to adjust of tilt-in-space, back angle recline and leg rest elevation easily
  • It can also assist the user’s support network with repositioning, especially when moving and handling user’s with obesity, easing carer responsibilities and effort
  • There is also the option of pro-control on our HydroFlex, which is an actuation system that allows users to adjust tilt-in-space and leg rest elevation without changing hip angle and risking postural instability; back angle recline remains manually controlled with a small, hidden lever

AutoTilt actuation:

  • AutoTilt enhances the standard pressure management functions already built into the HydroTilt and HydroFlex, moving the chairs through 0.5° of tilt at short intervals to redistribute pressure for those users at an increased risk of pressure injury
  • The AutoTilt cycle starts from a seating angle of 20°, moving through 12° in eight minutes, gently tilting the chair back and returning over the same period of time to its starting position
  • It can promote independence for the user
  • reduce the time needed for manual repositioning

Integral pressure management:

  • All adult CareFlex chairs provide pressure care through specialist seating that is individualised to the user that incorporates pressure relieving materials and pressure redistribution functions and controls
  • CareFlex seating forms part of the user’s pressure care programme when used appropriately following a holistic comprehensive assessment
  • Read about CareFlex WaterCell Technology to find out more

Visit our products  pages for more detailed information on our specialist seating range and to see the options and accessories available for each chair.



Michael SM, Porter D, Pountney TE (2007) Tilted seat position for non-ambulant individuals with neurological and neuromuscular impairment: A systematic review Clinical Rehabilitation 21(12):1063-1074


Jan YK, Crane BA, Liao F, Woods JA, Ennis WJ (2013) Comparison of muscle and skin perfusion over the ischial tuberosities in response to wheelchair tilt-in-space and recline angles in people with spinal cord injury Archives of Physical Medicine and Rehabilitation 94(10):1990-6


Sussman C, Bates-Jensen BM (2007) Wound Care: A Collaborative Practice Manual Baltimore: Lippincott Williams & Wilkins


Collins F (2001) An adequate service? Specialist seating provision in the UK Journal of Wound Care 10(8):333–7