OTCATS: Occupational Therapy Critically Appraised Topics
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When seated in a wheelchair, how many degrees tilt is needed to improve postural stability for function in chidren with a neurological disorder?

Prepared by:

Karen Fermin
Occupational Therapist, Northcott Society, Sydney

Michelle Wellard
Occupational Therapist, Sylvanvale School and Early Learning Service, Sydney

Date:

2 September 2002

Review Date:

September 2004

Clinical Question:

“When seated in a wheelchair, how many degrees tilt is needed to improve postural stability for function in children with a neurological disorder?”

Clinical Scenario:

Occupational therapists working with children with a neurological disorder often prescribe tilt in space wheelchairs to improve postural stability and enhance function. In most situations clinical decision making is based on a therapists’ experience rather than evidence based practice.

Tilt in space is a costly feature to add to a wheelchair. Justifying the need for this feature is an increasingly more difficult task, as available funding does not equate to the equipment needs of people with a disability.

In the current economic climate we as prescribers of equipment must be accountable and able to provide evidence to justify cost /benefits. What is the evidence that the provision of tilt in a child’s wheelchair assists to improve postural stability and function?

Clinical Bottom Line:

Currently available literature does not substantiate the use of tilt to improve postural stability for function in children with a neurological disorder. Each case for tilt in space should be individual and methods as outlined in the research may be a useful starting point for this process.

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