Clinical Significance

Contoured Pressure Relieving Cushion

Pelvic tilt: Pelvic tilt is the orientation of the pelvis with respect to the femurs it rests upon and in space.

  • Anterior pelvic tilt is when the front of the pelvis drops and the back of the pelvis rises.
  • Posterior pelvic tilt is the opposite, when the front of the pelvis rises and the back of the pelvis drops.

Examples of technological intervention:

  • Flexible pelvic tilt: A possible solution includes opening the seat angle and provision of a rearward sloping seat along with a padded positioning accessory such as a pelvic belt to prevent the pelvis from tilting forward.
  • Fixed pelvic tilt: The fixed pelvic tilt can be accommodated using a contoured seat cushion along with seat dump and pelvic strap to lock the pelvis and prevent further deterioration. The contoured cushion increases the contact surface helps in pressure distribution there by reducing the risk of developing pressure sores.

Pelvic rotation: Is characterized by one Anterior Superior Illiac Spine (ASIS) positioned in front of the other ASIS.

Examples of technological intervention:

  • Flexible Pelvic rotation: Ensuring correct seating dimensions along with providing a seat dump with appropriate positioning supports will assist with neutral alignment of the pelvis.
  • Fixed pelvic rotation: Providing a contoured cushion can accommodate the fixed pelvic posture (i.e. build up provided under the higher seat bone and thigh). This will provide comfort and prevent further deterioration.

Pelvic obliquity: Is characterized by one side of the pelvis being higher than the other.

  • Left pelvic tilt is when the right side of the pelvis is elevated higher than the left side.
  • Right pelvic tilt is when the left side of the pelvis is elevated higher than the right side.

Examples of technological intervention:

  • Flexible Pelvic Obliquity: Ensure correct seat dimensions with an appropriate cushion that supports both pressure relief and positioning. Hip belts would assist with bringing the pelvis down and back into the seating system along with positioning supports that aid in stabilizing the trunk.
  • Fixed Pelvic Obliquity: The fixed pelvic obliquity can be accommodated by using a contoured cushion with build up under the high side and/or lowering the low side to even out contact area throughout the cushion.


Rigid Backrest

Thoracic Kyphosis: Kyphosis characterised by excessive outward curvature of the spine resulting in a rounded back. It can occur in the cervical, thoracic and scaral regions.

Examples of technological intervention:

  • Flexible kyphosis: Provide a firm back support (tension adjustable/hard backrest) along with stabilizing the pelvis anteriorly and posteriorly. Anterior positioning supports may be required.
  • Fixed kyphosis: Providing a contoured backrest, which with varying depth contours, soft foam and adjustable components that offer stability and comfort, can accommodate the fixed posture. Opening the back angle along with a tilted seat will help with visual orientation.

Lumbar lordosis: Lordosis occurs when there is an exaggeration of the curve at the lumbar spine.

Examples of technological intervention:

  • Flexible lumbar lordosis: can be managed by providing a rigid backrest along with a rearward sloping seat and adjusting the back angle to reduce the tendency of the pelvis to tilt anteriorly. The contouring in the backrest supports the users back. Additionally pelvic positioning is crucial and can be achieved through use of positioning belts.
  • Fixed lumbar lordosis: can be accommodated and further deterioration can be prevented by providing contoured backrest with lumbar support and a chest strap.

Scoliosis: Scoliosis is a condition in which there is an atypical lateral or sideways curve introduced in the spine. These lateral changes are usually related to greater tone or one side of the body or the trunk than the other. The curvature can be moderate to severe.

Examples of technological intervention:

  • Scoliosis can be managed in the early stages with 2-point contact correction symmetrically. Support can be provided using a contoured backrest with adequate lateral support.
  • If the condition of scoliosis is more advanced it may be necessary to use a 3-point contact correction by providing a customized seating system with lateral support at the trunk and pelvis.
  • Fixed and complex scoliosis can be accommodated using a custom molded seating system to prevent further deterioration
Ankle Hugger/Shoe Holder

Normal muscle tone refers to the ability of muscles to maintain optimal amount of tension and elasticity during movements. Irregularities in muscle tone include hypotonicity (floppy), hypertonicity (stiff) and fluctuating tone. Muscle tone variations affect postural control.

Examples of technological intervention:

  • Tilt in space technology: Effects of gravity can be counteracted by using a tilt in space wheelchair
  • Headrest: An appropriate head rest provide support of the head and neck.
  • Lap tray: Provides support for the upper extremities
  • Ankle hugger/shoe holder: Shoe Holders help maintain positioning of the feet and ankles and improving overall posture
Moulded Seating System

Contractures represent a static shortening of muscle and are best supported by adjustbale seating and positioning hardware that can accommodate the fixed positions

Examples of technological intervention:

  • Custom moulded wheelchair-seating system: designed to accommodate and support fixed postures.
  • Angle adjustable footplate: The angle adjustable footplates allow for customized foot positioning and full foot support resulting in improved sitting posture.
Pressure Relieving Cushion

A pressure sore (also called pressure ulcer, bedsore or skin breakdown) is an area of the skin or underlying tissue (muscle, bone) that is damaged due to loss of blood flow to the area. Most often they develop on bony prominences. Pressure sores are commonly seen in the following areas: seat bone, tail bone, base of spine, hip bones, shoulder blades shoulder blade and spine.

Examples of technological intervention:

  • Pressure relieving cushion: Designed to evenly distribute the pressure in buttock region during sitting, shaped with a well for the sit bones and a shelf for the front of the sit bones and supports for the thighs. There are various types of pressure relieving cushions that aid in both pressure relief and pelvic positioning.
  • Tilt in space technology: When an individual is unable to independently shift his/her weight or change positions while seated in an upright position, he is at a very high risk for skin breakdown and sitting tolerance is compromised due to his inability to redistribute pressure. The tilt in space wheelchair helps the user/caregiver to change the seat angle which helps in redistributing pressure.
Pressure Relieving Cushion with Incontinence Cover

Loss of bladder control.

Examples of technological intervention:

  • Incontinence cover: Cushions have a single incontinence cover (water resistant) and is easy to maintain.
  • Dual cover cushion: A cushion which has two covers. The outer cover is made of a mesh/stretch material which is both breathable and washable. The inner cover will be an incontinence cover (water resistant) protecting the inner foam cushion from damage and making it easy to maintain.