I was wondering if anyone had any helpful hints, information, or websites they knew of for proper alignment for the lower extremities when in a wheelchair. I am trying to assist a client who is in a manul wheelchair and needs a better setup at their desk. They work on a computer and sit in a manual chair with no armrests. Currently their wheelchair has their lower extremities positioned so their knees are higher than their hips. Any and all information on this subject would be helpful.
You do not mention why the person is in the wheelchair, i.e. diagnosis, however I would not change the way the person is sitting since there is probably is a good reason they are positioned in their chair this way. If they have very little trunk/pelvic control, this position will keep them from sliding out of their chair. If they have neurological issues like spasticity, this position may inhibit some of that spasticity. Many of the sports wheelchairs use this positioning as it makes it easier and more efficient to reach the wheels and maneuver the chair. However you bring up a good point about proper seating for wheelchair users at a desk, since it is very different than non-wheelchair user. I find in my practice that I build the workstation around the person seated in the wheelchair (hopefully comfortably and effectively) by looking at desk height, arm support, and monitor placement. Keyboard placement can best be achieved usually by an adjustable keyboard drawer rather than trying to type on the desktop.
If your client is not comfortable sitting this way, then he needs to be evaluated by a wheelchair seating specialist, usually a PT or OT, and have changes made to the chair and cushion if need be.
Kathleen Shanfield, OTR/L, MS,ATP
The Job Accommodation Network should be able to help you with that information… and should be able to refer to you to a number of different resources within your area. 800-526-7234 to get a live consultant.
Thank you, this is all very helpful.
I too use a wheelchair, if i go out with my husband i use my manual cause we do not have a vehicle or electric
wheelchair carrier on the back of the car, but at home or if i go somewhere that i can roll my chair to i take my
electric. I have Spina Bifida; which means that I was born instead of my spine being straight, it was curved. I
can not walk or bear weight and have no feeling from mid-thigh down to my toes. I am only 4’10 1/2" tall. I can
do pivet when i do my transfers, but i need a stand by assist because i have no balance when transfering. Right
now i do all my computer stuff on my laptop on my apartment /dining kitchen table. The table is just the
right height, but the lighting stinks, and because it is an apartment I can’t change the lighting fixture(s).
Wheelchair wheels can be attached to ergonomic office chairs.
I agree with Kathleen. Don't mess with their wheelchair positioning. You can certainly recommend they contact a seating and mobility specialist if you have concerns. A list of RESNA certified seating and mobility specialists can be found at http://web.resna.org/member_directory/individual/index.dot. That would be a good place to start.
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