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Thread: Permobil tilt wheelchair

  1. #1

    Permobil tilt wheelchair

    Not sure whether anybody can actually answer this question. Feel free to have I guess if you like.

    I have included three photos of me in my permobil tilting wheelchair. Starting from the first photo, tell me in percentage, how much pressure is taken of the ischial (sit bones)






  2. #2
    I can't see the pics, but it's straightforward physics. If you're tilted so your chair seat is at X degrees to the ground, then the pressure is cosine(X)*normal pressure. So a 45 degree angle would result in 71% of normal pressure. 90 degrees would take all the pressure off. This disregards the effect of shear on your skin; also, since your cushion is not perfectly flat (you sink into it), the pressure doesn't decrease quite that fast with increasing tilt angle; some of it is just redirected to a different angle.
    That's why I'm currently investigating a standing chair.
    - Richard

  3. #3
    I'm not sure why you can't see the photos. Anyway, I am using a Permobil which has tilt and recline. What I tend to do is recline the backrest back quite a bit and then tilt the chair as far as it will go. I am then almost parallel to the ground.

  4. #4
    have you checked into a standing chair.
    mine takes almost all pressure off those areas, not to mention i get to stand. i'm sure it didn't cost anymore than any tilt an space

  5. #5
    No I haven't looked into a standing chair, maybe I should. I suppose you have to tie your cushion down to make sure it doesn't fall off? What about your clothing, does it not get all messed up when you keep standing and sitting all day?

  6. #6
    There's a big difference in cost.
    Our tilting chair (Quickie Freestyle M11) cost about $15K.
    We're presently looking into a Redman standing chair; the cost will be somewhat over $26K. I think other makes are roughly the same cost. However, if you can use a chair that requires you to pump a hydraulic handle to stand, you can save a bundle of money.
    Have a look here http://www.newmobility.com/review_ar...&action=browse for some info.
    - Richard

  7. #7
    You will always have some ischial pressure using a tilt in space or reclining wheelchair for weight shifts. Studies indicate that you can get the most effective pressure reduction by reclining so that your back is no greater that a 45 degree angle from the floor. Tilt in space is better because it reduce shear and keeps you properly positioned in your chair while doing this weight shift. Remember not to stay reclined or tilted too long, since when you tilt or recline you are shifting the weight off your ischiums and onto your sacrum, which cannot take prolonged pressure like this.

    (KLD)

  8. #8
    Quote Originally Posted by SCI-Nurse
    You will always have some ischial pressure using a tilt in space or reclining wheelchair for weight shifts. Studies indicate that you can get the most effective pressure reduction by reclining so that your back is no greater that a 45 degree angle from the floor. Tilt in space is better because it reduce shear and keeps you properly positioned in your chair while doing this weight shift. Remember not to stay reclined or tilted too long, since when you tilt or recline you are shifting the weight off your ischiums and onto your sacrum, which cannot take prolonged pressure like this.

    (KLD)
    So, would you say that this photograph indicates the correct tilt and recline? I am also sitting on a roho contour Quattro.


  9. #9
    Senior Member Jeff B's Avatar
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    Take a look at the tilting picture about halfway down the page of this article:

    http://depts.washington.edu/rehab/sci/pressure_map.html

    As you can see in the pictures the tilt and recline works best, at least for him.

    However, even though there is still lots of pressure in the middle picture it is moved from his ischials to his sacrum. So at least it gives his ischial areas a break. That is better than nothing, as long as you don't stay too long in this position, as KLD mentioned. When you think about it you are shaped like an upside down triangle if you are tilted 45 degrees (or a little less) with the most weight/pressure at the point (your sacrum). I saw this when pressure mapping in a powerchair with tilt. The worst pressure was at about 1/4 of the way back. Before knowing this I would often not tilt back far enough. It was quicker and less conspicuous but unknowingly at the time also much less effective.

    You often see people who are always in a bit of a tilt because it is more comfortable but they often get pressure sores on their tailbone areas.

    You should also put a cover on your roho to keep the cells from spreading and letting your ischials sink between them.
    Last edited by Jeff B; 07-15-2006 at 03:28 PM.

  10. #10
    Quote Originally Posted by Ironside
    C5/6 - it is not advisable to dive into a half empty swimming pool
    where was this bit of knowledge 3 years ago?.....LOL
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