Tilt in Space Wheelchair

A tilt in space wheelchair is designed to counter the effect of gravity on individuals with reduced or no trunk control. The tilt in space feature allows for weight shifting and pressure redistribution. Especially important for those who cannot reposition themselves. Tilt-In -Space is often specified along with backrest recline and elevated leg rests. This provides a complete change of position and pressure for the individual. This helps to prevent pressure injuries, improves comfort and toleration (extended use) of equipment for those who cannot independently shift their weight and are otherwise in a seated position for extended periods.

Key features.

Tilting Mechanism – Allows the wheelchair to tilt backwards (posterior) and forwards (anterior) as a single unit, typically maintaining the same angle between the seat, backrest and footrest as the entire seating unit tilting angle shifts as it operates.

Angle Retention – As the wheelchair tilts, the angle between the user’s thighs and torso remains consistent, this ensures a proper seating position and prevents sliding or slouching. As opposed to traditional backrest recline that can cause slouching and skin shear. 

Key benefits.

–          Redistributes pressure.

–          Helps maintain and improves posture.

–          Assist individuals with reduced head and trunk control.

–          Assist’s correct positioning of individuals with kyphotic posture.

–          Improves individuals’ ability to sit upright and leads to greater respiratory and digestive support.

–          Reduces potential risk of falls and sliding from the wheelchair.

–          Helps provide easier repositioning and equipment transfer by the individual or their carer.

–           Reduces dependency on peripheral supports required to keep the individual safe and comfortable.

Pressure Redistribution – Extended periods in the one position increases the risk of pressure injuries via reduced blood flow, sustained pressure to vulnerable areas in combination with friction, shearing force and moisture. A tilt in space wheelchair offers an effective way to minimise the risk of seated pressure injuries by redistributing pressure along the body and increasing blood flow and re-oxygenating cells around pressure affected areas. 

The offloading and redistribution of pressure reduces the potential for skin breakdown and minimizes the risk of pressure injuries.

Posture Improvement – Sitting in a poor or hunched (Kyphotic) position can over time cause a detrimental effect on posture. As gravity pushes down on the body, this causes the individual to sit forward causing spinal and positioning issues. When tilting the individual backwards, the effect of gravity is reduced, this eases the pressure that would otherwise cause a forward slumped position. In turn it encourages a midline positioning, countering lateral deviation (scoliosis). 

Head & Trunk Control Assistance – For individuals with reduced muscle strength as a result of a physical or neurological condition, a tilt in space wheelchair will help keep their spine, head and thoracic regions in midline position. Improving body positioning, providing comfort and helping reduce the negative effects of poor posture.

Correct Positioning – For individuals with a fixed or flexible spinal contracture, tilt in space can benefit posture support. Those who sit hunched over with limited or no ability to make eye contact, a tilted position ensures their neck and shoulders are supported and their visual field improves. Leading to better social inclusion, communication and interaction.

Respiratory & Digestive Support – The process of Tilting backwards will often reduce the pressure on the chest and abdomen. Allowing greater lung expansion, increases oxygen intake and is particularly helpful for individuals with respiratory conditions. Maintaining a good posture and preventing slumping can help reduce the risk of respiratory issues associated with compromised breathing from poor posture.

When individuals who have difficulty swallowing (dysphagia), tilt in space will provide the ability to be seated in a prime position to best minimise the risk of food or liquids entering the airway (aspiration). Proper seated positioning can also aid digestion and promote the natural movement of food through the digestive tract. Reducing the risk of complications of gastritis, acid reflux and bowel impaction that poor posture can lead to.

Reduced Fall & Sliding Risk – A change in the centre of gravity that contributes to a better seating position, also translates to a safer seated position and reduces the risk of sliding and falling.

Repositioning & Transfer – With the tilt in space function able to reposition the individual and redistribute pressure, the need for manual repositioning is reduced. The tilt in space function also provides greater flexibility in positioning for transfer in and out of the wheelchair.

Types of tilt in space wheelchairs.

Manual Tilt in Space – These tilt in space wheelchairs have a manual operating system to control the tilting mechanism and can only be tilted by an attendant. 

Power Tilt in Space – A powered tilt in space mechanism allows for a smoother, more controlled action and can be operated by the user or attendant. 

Who benefits from a tilt in space wheelchairs.

A tilt in space wheelchair highly benefits individuals with:

–          Spinal cord injury.

–          A condition that causes postural deviations or instability.

–          Cerebral palsy.

–          Neuromuscular disorders.

–          Limited seating position mobility with increased pressure injury risk.

–          Difficulty swallowing (dysphagia).

–          Limited mobility and/or endurance.

Summary

A tilt in space wheelchair allows the entire seat to tilt backwards or forwards whilst maintaining a consistent hip angle. Resulting in improved pressure distribution, and transferring pressure from the seat to the backrest when tilting. This greatly reduces the risk of pressure injury by increasing blood flow and minimising surface tension between skin and surface. Therefore lowering the risk of shear, skin tear and moisture build up.

Changing the orientation of the seated position can also alleviate pain and discomfort, particularly in the back and hips. This improves postural stability and support for individuals with limited trunk control. The tilt function can also assist to facilitate easier transfer in and out the wheelchair. Optimising body position also provides improved respiratory and digestive functions .

A tilt in space wheelchair increases comfort, promotes health and can often improve social interaction. It allows for more time spent in the chair in comfort for the individual.