Healthy, Comfortable, and Functional Positions

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HealthWiki > Disabled Village Children > Chapter 64: Decisions About Special Seats and Wheelchairs > Healthy, Comfortable, and Functional Positions

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In this chapter:

 

In this chapter:

Whether or not a chair has wheels, the position in which it allows a child to sit is very important (see Chapter 65.)

For most children, the chair should help them to sit more or less like this:

back straight

legs at a right angle to the back

hips in straight line with the back, against the back of the chair

looking ahead (not tilted back or down)

knees at a right angle

ankles at a right angle

feet firmly supported

head evenly centered (not tilting to one side)

ankles and feet separated

shoulders even

knees somewhat separated

body straight and centered above hips

hips centered

legs straight down

feet supported at right angles to the body (not tilted in or out)

CAUTION! The seat should be wide enough to allow some free movement and narrow enough to give needed support (see Measurements).

Common seating problems and possible solutions

Problem: Hips tilt back

hips tilt back	In children with spastic cerebral palsy the hips often stiffen backward. This triggers spasms that straighten the legs and cause other muscle tightness with loss of control.		Also, children with weak hips or back, from spinal cord injury, spina bifida, or severe polio, often sit slumped with their hips tilted back and the back severely curved. This can lead to permanent deformity.
		One of the most common causes of backward tilting hips is a chair like this one that is too big for the child.

Other causes of backward tilt and bad position are:		A good position can often be gained through:
a chair back that tilts far back	BAD	a fairly stiff, upright back at a right angle to the seat.	GOOD
and a cloth back that sags.		a chair that fits the child so that his hips reach the chair back.
These let the child lean back and cause the hips to slip forward.
Also, footrests that are far forward so that knees do not bend enough can increase spasticity that tilts hips back		the knees at right angles, and feet firmly supported.
Most children, and especially a child who tends to fall forward in his seat, will sit better and more comfortably if the whole chair tilts back a little. But be sure to keep right angles at hips, knees, and ankles.	BETTER

This page was updated:04 Apr 2024