pt Health Seating and Mobility Program
Reducing Incidents Of Pressure Ulcers
Seating and mobility assessment is the assessment process to determine appropriate seating devices, wheelchairs and other mobility devices to provide comfort, facilitate function and mobility for residents with physical, cognitive and/psychological impairment. These devices may be manual, powered or adapted.
The development of a pressure ulcer is a common problem for many wheelchair users, and it can significantly hinder a person’s ability to participate in meaningful occupations.
Pressure ulcers are caused by a combination of factors including pressure under bony prominences, shear forces, temperature, moisture, nutrition, seating position and daily life routine (Brienza & Karg, 1998).
The pt Health Approach To Seating And Mobility Assessments
Research shows that a prescription of a proper wheelchair, cushions and back help reduce the likelihood of pressure ulcers as they evenly distribute body weight over a large surface area of the buttocks and decrease undue pressure on bony areas (The Rehabilitation Centre, 2009).
pt Health assessment of a resident for a wheelchair covers a number of areas that must be considered in order to properly prescribe a wheelchair. In order to best suit the unique needs of a resident, pt Health will determine the:
- Amount of time a person sits in a day
- Build of the person (i.e. heavier or thinner)
- Ability to transfer (contour on the back and cushion may make it difficult)
- Tendency to perspire (cloth vs. vinyl cover)
- Urinary control (water resistant cover on the cushion)
- Resident’s or caregiver’s ability to care for and maintain the wheelchair
In order to determine a wheelchair, cushion and back which are the appropriate size for the client, the occupational therapist must take both the seat width and seat depth measurements of the client. The seat width is measured across the widest part of the hips while the client is in sitting so that their weight is distributed over the widest possible surface, while keeping the overall width of the chair as narrow as possible for ease of movement (Bolder, Adler, Tipton-Burton & Lillie, 2005). The seat depth is measured from the posterior buttocks region touching the chair back to the inside of the bent knee, with the seat edge clearance being one to two inches less than this.
The objective of this measurement is to distribute a client’s body weight along the entire sitting surface in order to help prevent pressure ulcers and to optimize muscle tone normalization to assist in the prevention of pressure ulcers (Bolder, Adler, Tipton-Burton & Lillie, 2005).
To speak with a representative about our seating and mobility program, please call us at (877) 696-1620 or email eldercare@pthealth.ca
References
Bolder, D., Adler, C., Tipton-Burton, M., & Lillie, S. (2005). Mobility. In H.M. Pendleton, & W. Schultz-Krohn (Eds.), Pedretti’s Occupational Therapy: Practice skills for physical dysfunction (6th ed.), (pp. 195-247). St Louis, MO: Mosby.
Brienza, D., & Karg, E. (1998). Seat cushion optimization: a comparison of interface pressure and tissue stiffness characteristics for spinal cord injured and elderly patients. Archives of Physical Medicine and Rehabilitation, 79, 388-394.
The Rehabilitation Centre. (2009). Basic principles of wheelchair seating. Retrieved December 12, 2010. Read Source