Comfort is the top priority for those who spend much of their day in a wheelchair. Wheelchairs can have custom cushioning, plus headrest, backrest, armrest, and footrest options for a perfect fit.
Benefits of the Right Back Support
Here are some benefits of proper support for wheelchair users:
- Supports the spine’s natural curves for trunk stability and balance.
- Promotes pelvic stability and redistributes pressure to minimise peak pressures.
- Reduces the risk or progression of postural abnormalities.
- Lowers pain and increases sitting tolerance.
- Improves connection and responsiveness for better function, safety, and independence in manual wheelchair use.
5 Steps on How to Choose the Wheelchair Backrest
1. Contour Depth
Contour depth is crucial in selecting a wheelchair backrest. A deeper contour offers more support for the spine and increased lateral stability. The choice depends on the user’s comfort and specific postural needs for optimal support and functionality. Models like Sango Advanced often provide customizable contours to suit individual requirements.
2. Level of Support
Consider if the user needs firm or soft support. Firm backrests provide stability and prevent slouching, making them ideal for users with significant postural needs. Soft backrests offer comfort and are often suitable for users with minimal postural requirements.
3. Back Support Height
Choose the backrest height based on the user’s needs. A taller backrest may provide more support for the upper body. However, a lower backrest allows for greater mobility and freedom of movement. Priorities comfort and functionality.
4. Back Width
Select a backrest that matches the user’s shoulder width. Ensure it provides the necessary lateral stability without causing discomfort. A too-wide backrest may not offer adequate support, while a too-narrow one could restrict the user’s movement.
5. Accessories & Additional Supports
Consider supports like lateral trunk supports, lumbar support, or pelvic belts to improve backrest effectiveness. These accessories can provide added comfort and stability, ensuring an optimal seating experience tailored to the user’s specific needs and preferences.
Backrest Supports Are Generally Categorised as:
Sling Back
These are typically standard with basic manual wheelchairs. This type of backrest does not support the pelvis. The pelvis tilts backwards, affecting spinal posture and possibly causing a kyphotic posture. Sling Backs can stretch over time, compromising spinal posture and comfort. They allow easy folding of the wheelchair with the back support in place.
Tension Upholstered Backs
The Tension Adjustable Back supports can be tightened or loosened to match the client’s posture. It may offer more pelvic support than a traditional Sling Back. The tension can be adjusted for some basic postural deviations. It can be re-tightened if your posture or needs change. The wheelchair is easy to fold with the back support in place.
Rigid (solid) Back
Improved support for the pelvis. The angle can be adjusted using the mounting hardware. A low rigid back aids propulsion. When choosing a rigid backrest, consider the height, width, and lateral supports of the backrest.
A seating assessment will determine if the Rigid Backrest is too high, which may affect shoulder movement and limit propulsion, or too low, which may reduce support. Available in different shapes and sizes.
Ways to Choose a Solid Back
Here’s a breakdown of important features:
- Shape of the Shell: The shape of the shell is crucial for comfort. A well-designed shell can reduce pressure points, making it easier to wear for extended periods. It also helps in providing better aerodynamics.
- Medium: This medium size offers a balanced fit for most people. It caters to those who find standard sizes either too big or too small. Medium-sized options often provide versatility in wear.
- Adjustability: Adjustability is key for personalised comfort. It allows you to customise the fit to suit your specific needs. Having adjustable features also increases the usability of different activities.
Functional Considerations when Choosing a Wheelchair Back Support
Consider individual needs, goals, and lifestyles, as these affect the choice of back support. The height of the backrest typically matches the level of support needed based on the severity of the client’s posture issues. Factors influencing this decision include:
Self-Propulsion
If propulsion determines backrest support height, it should sit just below the lowest scapula angle. Backrest supports come in different heights to match your needs and goals. The ideal backrest height offers good postural support and allows arm movement.
Research shows that a backrest height under 40.6 cm (16”) gives wheelchair users more arm freedom, larger stroke angles, and lower cadence, reducing the risk of upper limb overuse injuries. Uphill pushing requires more force and torque, increasing cadence.
Spinal Support & Postural Asymmetries
Tall backs provide strong support and are suitable for clients with significant physical needs, like those with quadriplegia cerebral palsy. They are ideal for tilt-in-space wheelchairs to ensure full support during tilt adjustments.
Features include:
- Lateral stability wedges or swing-away lateral supports
- Pressure-reducing foam to cushion bony areas
- Option to attach a headrest
- Adjustable backrest angle
A Taller Back May Also Offer:
- Lateral stability wedges or swing-away lateral supports are available.
- A foam surface layer reduces pressure and absorbs bony prominences.
- The design allows for headrest support.
- The backrest support can be angle adjusted.
Potential Properties to Consider when choosing a Backrest Support:
- Support for the pelvis
- Angles between seat and back
- Lateral support
- Back height and width sizes
- Removable parts
- Weight considerations
- Comfort level
- Adjustable back support angle
- Height and width adjustments
- Head support mounting
- Shoulder support mounting
- Insert options
- Aesthetic and colour choices
Custom Moulded Backrest Support
Consider a custom-moulded backrest support for clients who cannot change positions independently. These backs provide hold, support, and correct or accommodate postural asymmetry. Consult a specialised technician to ensure the backrest meets a client’s needs.
To choose the right backrest, clients should work closely with their clinical therapy team. The seating assessment will guide the decision, removing any guesswork.
Are you a Wheelchair User Who Wants to Maintain a Good Posture and Position? Call Enhance Mobility Today!
For personalised wheelchair solutions, contact Enhance Mobility. We offer customised options tailored to your needs. Improve comfort and support with expert guidance and achieve an optimal seating experience today. Contact Enhance Mobility for more information.
FAQs
What components make up an effective seating system for wheelchair users?
A seating system may include a cushion, backrest, seat belt, shoulder harness, headrest, lateral supports, chest strap, pommel, and other items.
What role does upholstery play in providing the necessary grip and comfort for efficient propulsion?
Upholstery material affects grip and comfort. A non-slip surface helps keep the user in place while propelling. It offers needed support without compromising comfort. Choose materials wisely, as they contribute significantly to both posture maintenance and propulsion efficiency.
What benefits does a tilt feature provide in maintaining comfort and reducing pressure during propulsion?
The tilt feature shifts body weight, lessening pressure on certain points. This reduces the risk of pressure sores. It aids comfort by alternating pressure areas. Regular tilting can help maintain proper posture throughout long periods of sitting.
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