Wheelchair Adaptations & Seating

Wheelchair Adaptations & Seating

Over many years, Bioengineering became increasing involved with making adaptations and providing special seating for wheelchairs. In the early days, this was very much on an ad-hoc basis with therapists, or other clinicians, requesting help with particularly challenging cases. An example, from 1980, was the design and manufacture of an adjustable, tilting wheelchair tray for mounting a Bliss communication board.

During the mid-1980s research funds were obtained to develop special seating and also arm crank wheelchair propulsion. In the late 1980s and early 1990s the service, in collaboration with therapists from a local learning disability hospital, developed a seating harness to maintain the user’s pelvis in the correct position in their wheelchair.

Over time, seating developed into a clinical service for which an increasing number of people have come to rely on. Indeed, from 1999 to 2004, the number of adults using seating provided by the service increased from 400 to 600. Over the past ten years, the equipment provided has gradually moved from being mostly in-house manufactured to being hybrids of commercial equipment with bespoke modifications as required. In 2011, a foam carving machine was purchased with a view to reducing the service’s reliance on external contractors for custom contoured seats.

In 1999, a dedicated bioengineer-led children’s wheelchair and seating service, called Enabling Technology for Children was established. A paediatric physiotherapist was employed to work with the lead bioengineer and an experienced senior technician. The service is now therapy-led with bioengineering support. The Seating service concentrated on adult cases and continues as a bioengineer-led service with therapist support. Both are now part of the Wheelchair & Seating Service that also includes adult wheelchairs.

More recently, bioengineers have once again become involved in research and development in this area with a particular focus on clinical and ISO technical standards, models of service provision and pressure management.

Selected Further Reading.

Rennie J, Flynn M.
A Prototype Seating Harness for People with a Severe Learning Disability and Physical Handicap – An Evaluation of Effectiveness.
Physiotherapy 1992;78(10):740–744.

Farley R, Morris P.
Equipment review: design of a portable wheelchair wheel-clamp.
British Journal of Occupational Therapy 1995;58(3):126.

Dolan MJ.
The redesign of the clinical delivery model of a regional seating service.
Posture and Mobility 2009;26(2):15-18.

Hillman S, Hollington J.
Correlation of interface pressure mapping measures using clinical data.
Proceedings of Posture & Mobility Group National Training Event, Warwick, April 2011, pp68-69.

Dolan MJ.
Clinical standards for National Health Service wheelchair and seating services in Scotland.
Disability and Rehabilitation: Assistive Technology 2013;8(5):363-372.

Dolan MJ, Henderson GI.
An impact assessment and critical appraisal of the ISO standard for wheelchair vocabulary.
Medical Engineering & Physics 2013;35(7):944-948.

Hollington J, Walsh J.
Using 50 Degrees of tilt-in-space to off-load pressure and relieve back pain – A case study.
Engineers Ireland Biomedical Engineering Division and the Irish PMN Seminar ‘Posture & Mobility – Transnational Day of Shared Learning’, Dublin, 31st January 2012.

Hollington J, Hillman SJ.
Can static interface pressure mapping be used to rank pressure-redistributing cushions for active wheelchair users?
Journal of Rehabilitation Research & Development 2013;50(1):53–60.

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Written & compiled by Dr Michael J Dolan, SMART Centre, NHS Lothian, Edinburgh.

First published 15th March 2013. Last updated 24th June 2014. Version 1.1.