Power tilt-in-space is a seating function that tilts your entire body backward, shifting your weight off your buttocks and onto your back. Permobil power wheelchairs offer up to 50° of posterior tilt-in-space. Unlike recline, which opens your hip angle, posterior tilt-in-space keeps your hip and knee angles the same.
Maintaining the same hip and knee angles can help manage leg spasms and muscle tone abnormalities. It is important to use a headrest to support your head and neck both when tilting and reclining back. Posterior tilt-in-space offers potential benefits to your health and functional activity performance.
Permobil also offers an anterior tilt-in-space function which is described below and can positively impact performing activities related to social engagement.
Potential Health Benefits
Posterior tilt-in-space can help with skin protection, pain management, and reducing lower leg swelling. Posterior tilt offloads pressure from your buttocks and back of thighs, redistributing pressure onto your back. This pressure offloading enables more circulation to the buttock and posterior leg tissues that are compressed during upright sitting. This can help protect your skin from skin breakdown.
Posterior tilt also helps with postural support because it positions the client where the force of gravity contacts the client’s chest, offering passive trunk extension toward an upright posture. When posterior tilt is used with recline and elevating legrests, the feet can be positioned above heart level to help reduce lower leg swelling. Tilting back often alleviates back pain because it alters where the force of gravity is pressing down on the client.
Functional Activity Benefits
Posterior tilt-in-space can help when driving on ramps, into transportation vehicles, for improved line of sight, and repositioning yourself. When driving down an incline like a ramp or a curb cut, tilting the chair back slightly can help stabilize your body in the wheelchair seat. When driving in and out of a modified van, tilting back slightly can help keep you from bumping your head on the van doorway. If you have limited neck range of motion or a kyphosis (forward curvature of the spine), tilting backward could lift up your line of sight, improving your view of the environment.
Tilting back could help to reposition yourself in the wheelchair seat. When tilted back, there is less pressure on the buttocks than when seated upright. This could make it easier to scoot your hips back in the seat. Tilting back can also provide a position of rest. Rather than transferring back to bed for a nap or to rest, one could rest by tilting back in the chair. Having a power seating function that allows you to rest in the chair means you might tolerate more active time in your wheelchair overall.
Anterior Tilt for Social Engagement
Tilt-in-space was originally engineered to move backward only. However, Permobil now offers an anterior tilt power seating function called ActiveReach. ActiveReach can tilt a client forward up to 45 degrees depending on the Permobil power wheelchair model on which it is ordered. ActiveReach can help you reach forward to give someone a hug. If cooking with friends, ActiveReach can help you reach the back burner of the stove or into the freezer for some ice cream. ActiveReach, when used along with power seat elevate, can help you see out your peep hole before letting in guests. It can even help reach elevator buttons if you’re heading out for a social engagement.
Permobil power wheelchairs offer both posterior and anterior tilt-in-space functions. The benefits include those to your health, function, and social engagement.
Eleni Halkiotis, MOT, OTR/L, ATP
Eleni is a graduate of the master’s degree occupational therapy program at the University of the Sciences in Philadelphia. She has been practicing occupational therapy since 2005. Her specialization in seating began in 2009 in New York City at Bellevue Hospital and continued at Independence Care System (ICS). At ICS Eleni was the primary therapist for the multiple sclerosis (MS) team. She provided in-clinic and home visiting treatment in English and Spanish for manual and powered mobility and seating and positioning interventions to members with MS and a vast array of other physical disabilities and chronic conditions. Eleni has participated in clinical research in multiple practice settings and very much enjoys teaching. She served as an adjunct professor in the occupational therapy program at Thomas Jefferson University in 2006 and 2007, and since 2009 continues to teach biannually at New York University. She has presented professionally at the International Seating Symposium in 2013 and 2017, the European Seating Symposium in 2013, and the World Federation of Occupational Therapy Congress in 2018. She holds licenses to practice occupational therapy in the United States of America and in the United Kingdom.