Why are wheelchair footrests essential for posture?
Why are wheelchair footrests essential for posture? Wheelchair footrests are key for good posture. They must be height-adjustable to ensure the right angles in your ankle, knee, hip, and pelvis. This adjustment keeps your pelvic alignment correct and helps you push through your feet to adjust your sitting position when needed. Proper footrest setup is important for comfort and preventing posture problems.
Types of Wheelchair Footrests
Wheelchair footrests come in different types, each offering support for comfort, posture, and mobility. The two main types are standard footrests and elevating legrests. They are designed for different needs, helping with posture and leg positioning.
Standard Footrests
Standard footrests are the most common. They have a fixed angle to support the feet. Here are their key features:
Fixed 70-90 Degree Angle: Provides stable support for the feet.
Swing-Away Design: Makes it easier to transfer in and out of the wheelchair.
Removable for Storage and Transport: Can be taken off for convenience.
Adjustable Length: Fits different leg lengths for comfort.
Flip-Up Footplates: Allows users to easily position their feet.
Elevating Legrests
Elevating legrests are adjustable, offering more flexibility. They are ideal for users needing extra support for both feet and lower legs. Their features include:
Adjustable Angles: Can range from 70 degrees to fully extended for optimal leg positioning.
Calf Pads: Support the lower legs for added comfort.
Length Adjustment: Can be adjusted as the leg is raised.
Swing-Away Design: Easy to remove for transfers.
Optional Articulating Feature: Extends as the leg is raised, providing customized support.
Other Footrest Options
Other footrest choices include:
One-Piece Footboards: Good for users who need to keep their feet together.
Angle-Adjustable Footplates: For customized foot positioning.
Extended or Shortened Hangers: For unique leg lengths.
Heel Loops or Ankle Straps: Help keep feet in place.
Amputee Supports: Designed for users with residual limbs, providing extra support.
Choosing the right footrest is key for maintaining good posture and comfort. The ideal position ensures a 90-degree angle at the hips, knees, and ankles. This helps prevent pressure points and promotes a healthy sitting posture.Wheelchair manufacturers will match the appropriate wheelchair based on the characteristics of each footrest.
Ideal Sitting Position
To maintain good posture in a wheelchair, the ideal sitting position is crucial. Following the 90-90-90 rule ensures proper alignment and comfort:
90° bend in the hips
90° bend in the knees
90° bend in the ankles
Key Elements of Proper Wheelchair Positioning
To maintain this position, keep the following points in mind:
Sit all the way back in the chair for better stability.
Position your pelvis so it’s centered and level.
Keep your trunk centered in the backrest without leaning.
Your head should stay centered, not tilting to either side.
Keep your thighs straight with your knees level with your hips.
Ensure your feet touch the footplates fully.
Leave a two-finger gap (30 mm) between the back of your knee and the seat cushion.
Distribute your weight evenly across both hips.
Keep your feet flat on a stable surface.
Importance of Correct Footrest Height
Correct footrest height is crucial for good posture and comfort for wheelchair users. If the footrest is not adjusted properly, it can cause discomfort, pressure sores, and other problems that affect daily mobility and health.
Effects of Incorrect Footrest Height
| Condition | Description |
|---|---|
| Too short | When the footrest is too low, the knees rise, and the thighs lift off the seat. This creates extra pressure on the buttocks, increasing the risk of pressure sores and causing discomfort. |
| Too long | If the footrest is too high, the feet lose support, and unnecessary pressure is placed on the thighs. This can cause skin irritation or damage where the seat upholstery ends. |
Ideal Footrest Height
For smooth, solid surfaces: 1-2 inches off the ground
For rougher terrain: around 2 inches off the ground
How to Check Footrest Height
- Place your hand under the user’s thigh and pull it forward.
- Make sure there is even pressure from the front to the back of the seat.
- If the pressure under the thighs is too light, lower the footrest.
- If there is too much pressure, raise the footrest.
Adjusting the Footrest Height
- Loosen the screw that holds the footrest plate.
- Adjust the footrest height as needed.
- Tighten the screw to secure the footrest.
- Check the pressure under the user’s thighs again to ensure it is correct.
By setting the footrest at the correct height, the entire length of the thighs will stay in contact with the seat cushion, helping distribute the weight more evenly. Users with different leg lengths may need personalized adjustments to improve comfort and support.
Consequences of Improper Footrest Positioning
Improper positioning of wheelchair footrests can cause several negative effects on the user’s health and mobility.
Pressure and Discomfort
Incorrect footrest positioning can increase pressure on the buttocks, lower back, and thighs, leading to pressure sores and discomfort. Sitting for long periods can become painful and may cause further health problems.
Strain on Body Parts
If footplates are placed incorrectly, they can put strain on the back, lower thighs, and hip bones. This can cause long-term discomfort or even injury. When footrests are too low, they place unnecessary pressure on the upper thighs and behind the knees, creating extra pressure points.
Increased Pressure on Hip Bones
If footrests are set too high, they can cause extra pressure on the hip bones, leading to discomfort and potential hip joint issues over time.
Poor Posture and Reduced Stability
Improper footrest positioning can cause pelvic tilt issues, like posterior pelvic tilt, which affects trunk alignment and reduces stability in the wheelchair. Over time, this can result in poor posture and difficulty maintaining balance.
Circulation and Mobility Issues
Improperly adjusted footrests can lead to reduced blood circulation in the legs, causing numbness or muscle weakness. Also, incorrect positioning of the footrests can hinder mobility and propulsion, making it harder to move the wheelchair effectively.
Risk of Falling
Incorrect footrest positioning may cause users to slide forward in the wheelchair, increasing the risk of falls and creating instability. This can also affect the user’s ability to perform tasks that require a stable seated position.
Long-Term Effects
If left uncorrected, improper footrest positioning can lead to leg contractures or muscle tightness, further limiting movement.
Adjusting Wheelchair Footrests
Adjusting wheelchair footrests properly is important for comfort and good posture. It helps distribute weight evenly, prevent pressure sores, and improve circulation.
Steps for Adjusting Footrests
- Loosen the adjustment bolt or lever on the footrest stem.
- Slide the footrest up or down to the right length, ensuring it is aligned.
- Make sure both footrests are at the same length for balance.
- Tighten the adjustment mechanism firmly to avoid shifting during use.
Common Adjustable Elements of Footrests
Height/Length: Adjust the footrest stem to match the user’s height.
Footplate Angle: It can be set from 0-90 degrees to support different leg positions.
Depth of Footplate: Change it to provide the best foot support and comfort.
Calf Pad Position: In elevating leg rests, adjust the calf pad to position the legs properly.
Indicators for Footrest Adjustment
Adjust the footrests if any of the following occur: – Knees higher than hips: This may mean the footrests are too low. – Feet dangle above footplates: The footrests might need to be raised. – Pressure on the back of thighs: This suggests the footrests are too high. – Footrests hitting the ground or casters: Adjust the height or angle of the footrests.
Frequency of Adjustment
Initial Adjustment: Adjust when the wheelchair is first fitted.
Growth or Weight Changes: Reassess and adjust if the user grows or gains weight.
Routine Check: Make adjustments every 3-6 months to maintain comfort and support.
Regular adjustment of footrests keeps the user’s posture aligned, reduces strain, and improves comfort while using the wheelchair.
Summary
Making small changes to our wheelchair footrests can greatly improve our comfort and well-being. Focusing on good posture and proper alignment helps prevent strain and enhances our mobility. This simple step can lead to a healthier, more independent daily life. I recommend making these adjustments to feel more in control of your comfort.