Distinct tilting behaviours with power tilt-in-space systems

Abstract

Purpose. To characterise the use of tilt-in-space systems and to form recommendations for tilt prescription and training based upon its use.

Method. Wheelchair occupancy and seat position of 45 full-time power wheelchair users were monitored for 1–2 weeks using an accelerometer, occupancy switch and data logger. Demographics, pressure ulcer history, functional and physical presentations of their disability, and sensation were also documented.

Results. Participants spent 12.1 h in their wheelchairs daily, with a median typical position of 8° (0°–47°). The median participant tilted every 27 min (0.1–16.6 tilts per occupancy hour). Pressure-relieving tilts (i.e. a tilt ≥30° for ≥1 min) were performed, on average, once every 10 h (0–2.2/h). Participants spent 19% of their seated time tilted past 15°. Seventeen participants utilised the tilt feature frequently and spent >20% of the time in multiple positions. The remaining participants sat in a single tilt range for >80% of the time.

Conclusions. Given the limited pressure relief compliance, alternative approaches to pressure relief and improved training may be needed for some clients. Wheelchair design and prescriptions may also need to reflect participants' preferences for sitting in small and medium tilts and changing position frequently.

Keywords:

• Wheelchair
• tilt-in-space
• monitoring
• pressure relief
• seating
• behaviour

Acknowledgements

The authors would also like to gratefully acknowledge Michelle Nemeth, PT, CCRP, and Chris Maurer, MPT, ATP, for their support and involvement with subject recruitment and data collection, as well as the subjects whose participation made the study possible.

Declaration of interest:

This work was completed as part of the Mobility RERC, which is funded by the National Institute on Disability and Rehabilitation Research of the US Department of Education under grant number H133E080003. The opinions contained in this article are those of the grantee, and do not necessarily reflect those of the US Department of Education. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.