Tilt In Space Wheelchair

Clinical Benefits of Tilt-In-Space

Provides a change in position for person’s who cannot independently shift their body weight.

When an individual is unable to independently shift his/her weight or change positions while seated in an upright position, he/she is at a very high risk for skin breakdown and sitting tolerance is compromised due to his/her inability to redistribute pressure.

Tilt-In Space manual mobility bases:

Provide a means for weight shifts and position changes.
Reduce the risk of skin breakdown by redistributing pressure from the pelvis to the back.
Provide weight shift/pressure redistribution by increasing the seating surface area and redistributing away
from the critical areas under the pelvis.
Best accommodated position changes for persons with limited hip and/or knee range of motion
Provide a safe and easy way for a caregiver to provide a weight shift for the end user.

Provides a change in position for people who cannot maintain pelvic, thoracic or head position and/or balance against gravity for prolonged periods of time.

While sitting in the upright position, gravity pushes down on the body.
If muscle strength or overall endurance is compromised, he/she will be unable to maintain proper upright posture,
which can lead to postural deviations such as a posterior pelvic tilt, thoracic kyphosis, and/or lateral lean.
Tilt in space helps promote proper seating alignment and decreases potential for postural deviations.

• 
  Upright posture in maintained against with a good back support
• 
  Poor posture results when fatigue occurs over time 

(They are now at risk for fixed orthopedic deformities and skin breakdown on the sacrum and spine)

Tilting him/her whey they fatigue helps maintain them in an upright position, facilitates thoracic extension and
a neutral pelvis.
Tilting him/her allows gravity assisted positioning against the contours and supports of the seating system.
Tilting him/her allows accurate positioning following transfer into the chair by adjustment of posture from
the tilt position.
Changing angle of tilt allows for repositioning in the course of the day.

Tilt in space re-orients the body in space to reduce the effects of gravity and promotes upright posture.

Provide appropriate position for persons who are at risk for respiratory complications.
If the person cannot maintain upright posture and falls into postural collapse as above, the respiratory system can become compromised:

 The diaphragm has less room to drop as it contracts, so lungs do not fully expand
 Can result in the collapse of lower parts of the lung (atelectasis)
 Secretions are not mobilized – can result in pneumonia
 It becomes more difficult to take a deep breath
 Breathing is shallower and therefore faster
 Tilt can often be used to promote thoracic extension and reduce the risk of respiratory complications

Provides appropriate position for the persons who are at risk for digestive complications
If the person cannot maintain upright and falls into postural collapse as above, the digestive system can become compromised:

 Food cannot pass as easily down the gastrointestinal tract – this can result in gastritis, gastric reflux,
esophagitis and/or bowel impaction.
 Head and neck position are not optimal
 Can cause aspiration with swallowing
 Can set off primitive refluxes such as the gag reflex or tongue thrust
Tilt can be used to promote postures that reduce the risk of G.I. complications.

Provide appropriate position for persons who are at risk for postural hypotension –
A condition in which the blood pressure drops when the person is in the upright position, leading to dizziness or loss of consciousness:

 Could lead to dizziness or loss of consciousness – a potentially dangerous event.
 Dynamic tilt encourages blood flow above heart level to assist person if this condition where to occur.

Provides appropriate position for persons who are at risk for autonomic dysreflexia
A condition in which the blood pressure increases due to an event or condition that the body interprets as “noxious”

 This is a potential life threatening warning sign produced by the body to let a person know something is wrong.
 Could be caused by an overfull bladder (kinked catheter), an impacted bowel, a constriction of
blood flow, a change in position, etc.
 Dynamic tilt allows the person to be brought quickly into the most upright position to try to
assist in lowering of the blood pressure.

Provides a change in position while minimizing the risk of extensor spasticity

As slight opening of the hip angle at the beginning of a weight shift can sometimes cause an extensor spasm.
Tilt maintains the optimal hip angle throughout the weight shift.

Provides a change in position without the risk of shear forces

When a person is reclined and then brought back to upright, there is some forward sliding of the pelvis on the seat
that occurs (Shear displacement)
 This is because the person’s pivot point (hip joint) does not exactly match the pivot point
of the chair (seat to back junction)
 Tilting accommodates shear displacement (sliding out of position) during position changes
In contract, when the person is tilted and then brought back to upright there is no movement of the
body relative to the chair.

Additional Benefits of Tilt-in-Space

The curved rocker-arm allows the seat frame to rotate on the base frame, while maintain the persons COG (center of gravity) in near perfect alignment with the chair’s center of rotation. This alignment is maintained throughout the tilt away and return-to-upright cycle. Because the person’s center of gravity remains constant and there is virtually no horizontal shift.

Orthopedic/Neurological Benefits

 Accommodates postural/orthopedic asymmetries and extremity contractures.
 Promotes absent to minimal triggering of abnormal muscle tone or reflex responses during position changes.
 Can minimize some reflexive responses associated with position of the head (ATNR, STNR, TLR’s)
through the increase head control of postural stability

Muscle Tone Management

 Can increase overall endurance for tolerance throughout the day
 Can increase sitting tolerance throughout the course of the day.
 Position for comfort and positioning relief.