Page 19 - Mobility Management, April 2019

there is dependent ranging of motion or dependent location
in space can benefit from an E1161 coded tilt-in-space manual wheelchair. Diagnoses range from TBI [traumatic brain injury] to SCI [spinal cord injury] to motor-neural conditions. Patients with ALS, muscular dystrophy, cerebral palsy, CVA [cerebrovascular accident, aka, stroke] can all find benefits from weight shift in space.”
John Frank, Product Manager for Tilt at Ki Mobility, suggested that understanding the patient population that could benefit from E1161 chairs requires first understanding how different the designs of various E1161 chairs can be.
“Recognize that there are a few different design types of manual tilt-in-space wheelchairs on the market,” he said. “Among the designs, a couple of them provide tilt ranges from 45° to 60°. These include rotational tilt and mid-seat frame pivot designs. The most commonly used is the rotational tilt, which rotates through an arced path. There are also front seat frame pivot tilt chairs, often referred to as ‘knee tilt,’ which have their axis of rotation at the front of the seat frame. By virtue of their axis of rotation at the front of the seat frame, they tend to be more limited, having a 20° to 30° range of tilt available.”
The user’s needs and goals are critical in determining which type of E1161 chair is best for a particular individual.
“The intended use or function of the chair can influence which style of tilt in space chair is selected,” said Curt Prewitt, MS,
PT, ATP, Director of Education, Ki Mobility. “For example, the full tilt-in-space provides the greatest range of tilt angles. Due
to its ability to significantly change the loading on the tissue, it is commonly used for individuals who are considered high risk for pressure injury. These full-tilt chairs are also often used to address more complex postural needs as well, such as significant deformities, asymmetries and tonal issues.”
By comparison, “knee-tilt” chairs have less range available, Frank said: “With a pivot point at the front of the seat, the rear of the seat drops down to change seat angle, maintaining the front seat-to-floor height (STFH).” Prewitt added, “This combination of low STFH and varying tilt angles is appropriate for individuals who would benefit from a change of position to promote inde- pendence with MRADLs, such as foot propulsion or hemi-pro- pulsion (foot and hand), transfers and transitions and functional reach.”
Linda Bollinger, PT, DPT, Clinical Education Manager for Sunrise Medical, said she considers ranges of tilt when recommending
one type of E1161 chair over another. “A manual wheelchair that
is coded as E1161 must have the ability to tilt the frame of the wheelchair greater than or equal to 20° from the horizontal while
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