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Standing vs. tilting wheelchairs

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Does a person benefit more from standing than from being tilted in their wheelchair? Because nothing in rehab medicine is black and white, this is a case by case answer. But usually the main benefits to tilting someone in their wheelchair are: weight shift to alleviate pressure off the ischial tuberosities and aiding in head control and body position and help with fatigue. But the disadvantage can be urine retention, contractures in the lower extremities and a limitation in sensory stimulation.

Standing, on the other hand has many documented medical benefits[1] such as, breaking up the person's sitting posture with passive ROM, this can help maintain a good lordotic curve in the spine resulting in better head control and expanding the chest for greater lung capacity. Also, from looking at pressure images, most people get significantly better pressure relief when standing than when they are tilted back. And when someone is standing, his or her bowel and bladder function is facilitated, pain patterns are sometimes diminished, spasticity in the lower extremities is often improved, and the person is in a good position to interact with their environment.

There are many other documented benefits accredited to standing, but why is tilt prescribed so often? The most common reasons are force of habit, funding and convenience. Because of technology improvements standing for many people, with a variety of disabilities, is becoming easier. And as the importance of position change for the seated person gains acceptance, we will see more money allocated for standing products. Our bodies and mind were not designed to sit in one position for long periods of time. Change is good.


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References

  1. Research Studies on the Benefits of Standing Altimate Medical, Inc.