Effects of Positioning on Functional Reach

Abstract

This study examined the functional reach of fifty-three elderly persons who use a wheelchair and reside in an extended care facility. Forward, right, and left functional reaches were elicited through a goal-directed activity while the participant sat in a wheelchair with a wedge cushion on a solid-seat insert and on the standard wheelchair sling seat. Participants had a statistically significant greater forward reach when using the wheelchair with a wedge cushion and solid-seat insert compared to the sling seat, but no significant differences in the right and left reaches were found. While the study inclusion criteria did not specifically select individuals with limitations in reach, this difference in forward reach, possibly due to better positioning in a wheelchair, may positively impact the functional ability of elderly persons.

Two approaches to manual wheelchair configuration and effects on function for individuals with acquired brain injury

“…Modified functional reach (MFR) was somewhat better for the P1 group at both the beginning and the end of the observation period which is contrary to the Amos and Brimner (2001) study that found individuals had a significantly greater forward reach with use of a cushion and solid seat insert versus a less supported sling back and seat. MFR improved over time for both groups, suggesting that individuals with hemiplegia functionally accommodate in both seating positions.…”

“…For example, Borello-France, Burdett, and Gee (1988) found that use of a solid board at both the seat and back rest in individuals with hemiplegia resulted in decreased presence of postural deformity while the boards were in use compared to a sling seat and back. Another study by Amos et al (2001) examined functional reach in wheelchairs with a sling seat versus wheelchairs with a solid seat insert and cushion. Individuals had greater forward reach with use of the cushion and solid seat insert (p. 68).…”

Development of Valid and Reliable Measures of Postural Stability

“…Several studies have investigated the effect of wheelchair configurations or seating systems on reach and UE functional tasks. These studies found results differed depending on the task and the configuration used in the study (2,7,15,18,(26)(27)(28).…”

“…While reaching toward targets placed at 458 from the midsagittal plane to the ipsilateral and contralateral sides, sitting balance as measured by COP displacement and COP velocity was significantly improved when subjects sat on a generic contoured foam cushion vs a flat foam or air flotation cushions. Amos et al (27) studied elderly wheelchair users and determined that a solid seat insert with an anterior wedge cushion vs a sling seat improved forward reaching using a goaldirected activity. Lateral reach distance, however, was not improved with a solid seat insert and wedge.…”