Tilt or recline
Some people use special wheelchairs to distribute pressure and thus reduce the risk of skin sores. These chairs also increase comfort and sitting tolerance.
One type of chair, called “tilt in space,” changes a person's orientation while maintaining fixed hip, knee and ankle angles. In effect, the whole seat tilts. The other chair option is a recline system, which basically changes the seat-to-back angle, flattening out the back of the chair and, in some cases, raising the legs to form a flat surface.
A tilt system redistributes pressure from the buttocks and posterior thighs to the posterior trunk and head. The system maintains posture and prevents sheering (the friction on tissues from dragging across a surface). A drawback: If a user sits at a workstation, for example, the tilt requires that he or she move back from the table to avoid hitting it with the knees or footrests.
Recline systems open the seat-to-back angle and, in combination with elevating leg rests, open the knee angle. There are some advantages to a recline system for eating, making transfers or assisting with bowel or bladder programs, as all are easier when lying down.
Generally speaking, the recline system offers more pressure relief than tilt, but with a higher risk of sheer. Elevating the legs may be beneficial to people with edema. Both tilt and recline must be fitted and prescribed by seating and positioning experts.
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