Postural Management for People with Complex Needs

The information in this section about posture management is really concerned with individuals who have serious physical disabilities or injuries and complex needs, though the principles are also more generally applicable.

Everybody knows that if you spend a considerable time sitting or lying in certain positions, it can become uncomfortable or even painful. The automatic reaction is to shift around until you find relief from the discomfort. People with limited mobility may not have that option, and without careful postural management they could spend extended periods in positions that might exacerbate their condition and cause them additional problems.

Forces that cause problems if posture is not managed correctly include gravity, which can pull the head forward if the muscles supporting it are not strong enough to do the job properly; shear, which occurs when the skin is held in one position while the skeleton inside is moving - slipping down in a chair, for example - and the flesh in between is stretched and damaged. Although shear damage often remains invisible for a long time, it can eventually show on the surface as a pressure sore or ulcer.

The surface on which someone is sitting or lying also has a contribution to their comfort and well-being: a flat surface will be less supportive, therefore less comfortable, and will concentrate the weight of the body on those small areas that are in contact with it, increasing the likelihood of pressure damage. A contoured surface, on the other hand, supports the body more effectively, providing more comfort and distributing the weight evenly across a greater surface, so that the risk of pressure damage is reduced.

Another important feature in posture management is helping to prevent the development of contractures (where muscles shorten permanently, causing a deformity) or to try and manage/improve them if they are already present.

In all cases, it is important to have the needs of the individual carefully assessed by a suitably qualified professional, such as an occupational therapist or physiotherapist, to ensure that any products chosen to help with postural management meet their requirements.

Products in this section are divided into these areas:

Task seating

Comfort seating

Wheelchairs and transport seating

Standing support

Night-time sleep systems