Module 7 - Postural Interventions
Why should we be concerned about posture for SCI clients?
Posture can impact on the client's
- pressure management and weight distribution on support surface. Read more from 'Pressure ulcer prevention and treatment following SCI'.
- movement patterns and efforts required for functional tasks such as reaching and wheelchair propulsion. It is a priority to preserve upper limb function after SCI. Read more from 'Preservation of upper limb function following spinal cord injury: a clinical practice guideline for health-care professionals'.
- balance and stability for safe wheeled mobility
- vision and interaction with the environment
- respiration and digestive systems
- comfort, and
- perception/body image of oneself.
Indications for postural assessment and intervention
- pressure ulcers
- increased pain and discomfort with sitting
- inability to balance during static sitting or a dynamic task, or to perform weight shift for pressure management.
- safety concerns of client or carers
- reduced function
- increased asymmetry and risk of fixed deformity
- replacement of seating and wheeled mobility system
- postural-related aspiration and respiratory restrictions.
Referrals to the Spinal Seating Services are indicated for clients who have
- non-healing, sitting-acquired pressure areas
- history of recurrent pressure ulcers as posture had an interlocking effect on pressure
- significant postural deformities
- custom-fabricated products that require replacements, such as foam on ply backrests, armrests and foot supports
- complex postural and functional needs where commercial products are not able to meet the desired outcome, and/or
- are ventilator-dependant quadriplegics
Referrals for surgical or orthotic interventions for clients who have a severe or extreme postural deformity should also be considered.