Wheelchair Positioning: The Pelvis

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Video Runtime: 59 Minutes; Learning Assessment Time: 52 Minutes

What is the cornerstone of wheelchair positioning? The pelvis. The position of the pelvis very much determines the position of the trunk and lower extremities, so achieving and maintaining the optimal position is critical. This course will present common pelvic asymmetries, with suggested strategies to address each challenge. Providing as neutral a pelvic position as possible improves overall posture, stability, and function. This course is applicable to occupational and physical therapists who work with clients using wheelchairs and applies to multiple practice settings.

Learning Objectives

Apply appropriate wheelchair seating interventions to a client sitting in posterior pelvic tilt
Apply appropriate wheelchair seating interventions to a client sitting in anterior pelvic tilt
Apply appropriate wheelchair seating interventions to a client sitting in pelvic rotation
Apply appropriate wheelchair seating interventions to a client sitting in pelvic obliquity
Implement appropriate wheelchair seating interventions to improve mobility to enhance participation in desired daily occupations and reduce risk for complications such as skin breakdown or limb contractures

Meet your instructor

Michelle L. Lange

Michelle Lange is an occupational therapist with over 38 years of experience and has been in private practice, Access to Independence, for over 19 years. She is a well-respected lecturer, both nationally and internationally, and has authored numerous texts, chapters, and articles. She is the coeditor of Seating and Wheeled…

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Chapters & learning objectives

1. Positioning the Pelvis: Posterior Pelvic Tilt

A posterior pelvic tilt is typically seen in combination with a kyphotic trunk and can lead to weight-bearing on the sacral area. Strategies for reducing a posterior tilt include preventing forward movement of the ischial tuberosities (ITs), posterior movement of the upper pelvis, and an appropriately angled pelvic positioning belt.

2. Positioning the Pelvis: Anterior Pelvic Tilt

An anterior pelvic tilt is typically seen in combination with lumbar lordosis. Strategies for reducing an anterior pelvic tilt include an appropriately angled pelvic positioning belt and reducing the lordosis, as possible.

3. Positioning the Pelvis: Pelvic Rotation

Pelvic rotation occurs when one anterior superior iliac spine (ASIS) is forward of the other and can be seen in conjunction with spinal rotation. Strategies for reducing pelvic rotation include direction of pull of the pelvic positioning belt and limiting movement of the IT on the forward side and movement of the posterior pelvis on the rearward side.

4. Positioning the Pelvis: Pelvic Obliquity

Pelvic obliquity occurs when one side of the pelvis is higher than the other and is often seen in conjunction with lateral spinal flexion. Strategies focus on pressure distribution and are highly dependent on whether the obliquity can be reduced.

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