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Seating and Positioning

Seating systems are groups of components that make contact with your body while you’re in your custom wheelchair to support you in a sitting position. These individually prescribed components include the cushion, back support and postural supports.
 
Why is it important to have a good seating system?

Proper seating provides stability and helps you comfortably participate in activities of daily living. Individually configured seats and backs help accommodate spasticity and can also help prevent injuries like pressure injuries.
 
How do I know which seating system is for me?

To effectively match you with the proper seating components, we evaluate your physical and functional needs. Based on the evaluation, your Numotion ATP and full clinical team helps you craft an individually configured seating system.
 
The evaluation generally includes:
  • Your goals and challenges
  • Your current and desired function
  • A hands-on physical evaluation to determine interferences with your ability to sit
  • Pressure mapping, which shows how pressure is distributed across your cushion. This allows our team to identify high-pressure and low-pressure areas on your cushion and make adjustments that provide pressure relief
  • A trial period with the type of equipment the clinical team feels will accomplish your goals

Materials
 

Our cushions, backs and supports are made of a combination of materials — typically foam, fluid, air and gel — that provide a stable, comfortable surface with properly distributed pressure. Some materials, like foam, retain heat more than others. If you have to decrease heat retention because of heat intolerance or increased sweating, then this should be discussed during the evaluation process.
 
All cushions have covers, and many have a choice of covers that are designed to deal with heat build-up and are fluid-resistant for easy cleaning. For those with more severe incontinence issues, we offer heavy-duty fluid-resistant covers.

Additional Resources

NuDigest: Avoiding Pressure Injuries and Other Complications with Proper Seating and WC Systems


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Cushions

Cushions

Cushions support the areas under the pelvis (buttocks) and upper legs — the foundation of support. The position of the pelvis is key, as it dictates the position of the rest of the body. Cushions primarily provide stability or pressure distribution.

There are two ways to deal with pressure areas under the sitting bones: immersion and offloading. With immersion, you sink into the cushion so it distributes pressure under the sitting bones. With offloading, sometimes referred to as “forced isolation,” pressure is removed from the problem area.

Backs

Backs

We offer a variety of back support for chairs that can support many different areas of your back, like the posterior trunk, spine, pelvis and lateral trunk. Back supports are typically attached to chairs with hardware that goes on the back tubes. This allows for easy removal. Some back supports are built into your custom wheelchair system, but are still adjustable. Height, depth and angle adjustments are built in to allow pre-set orientation of the back to match your needs and to allow for change in function over time.

Supports for Posture

Supports for Posture


Certain supports are designed specifically to improve your posture, which also helps to alleviate back pain. Some supports can be detached from your custom wheelchair at any time. Each of these components is individually prescribed based on specific need. The most common components and their benefits include:

Lateral supports (lateral pelvic, thigh, trunk)
  • Enhance the function of the cushion and/or back support
  • Keep the pelvis in one place
  • Guide the upper legs into the desired position
  • More aggressive lateral support than provided by back supports
  • Offset lateral support to accommodate trunk leaning or asymmetry

Medial knee supports (“pommels”)
  • Separate the knees to maintain a certain angle at the hips
  • Alleviate spasticity and increased muscle tone

Arm supports
  • Provide support and/or control of the arms

Foot supports
  • Provide support to maintain foot placement on the wheelchair footplate

Head supports
  • Provide posterior, lateral and/or anterior support

Positioning belts
  • Provide anterior support of the body into the wheelchair
  • Maintain the position of the pelvis/buttocks on the cushion
  • Stabilize the trunk into the back support
  • Keep feet on the wheelchair footplate or alternate foot support