Instructions for the comfortable seating exercise

The purpose of the exercise is to increase the participant’s awareness of the importance of suitability of chairs and siting position in increasing independence, comfort and wellbeing.

We suggest you photocopy the pictures and place them around the room. Then give one or two statements to each participant (depending on size of group) and ask them to match the statement to the picture. Then repeat this process with the solutions.

Answers

PICTURE 1:

The chair leans back

Clients back not fully supported, slumping in chair, can lead to back pain

Difficult to stand up from chair leading to decreased independence

Difficult to access nearby tables therefore difficulty with foods / drinks leading to decreased independence

Knees lower than hips – bottom slides forward, knees knock together, increased risk of falling and pressure areas

Solutions

More upright chair needed

Short term fix could be a pillow behind to give a more upright posture and / or a lumbar support to bring the pelvis into neutral

PICTURE 2

Lots of soft, unsupportive cushions, leading to client being in a slumped posture / leaning to one side. Can lead to back pain, breathing problems and digestive problems.

Pillows can restrict movement leading to decreased independence.

Difficult to stand up from chair leading to decreased independence.

Solution

More supportive, narrower chair needed

PICTURE 3

Service user curved forward

Risk of developing / increasing kyphosis (forward curve in spine) which can lead to respiratory and digestive problems, neck and back pain.

Decreased view of room as looking down, risk of social isolation.

Solution

May benefit from a tilt in space chair to support trunk and allow service user to view the room.

Could benefit from referral to a physiotherapist to assess trunk flexibility and see if she may need therapy or specialised seating

PICTURE 4

Chair too small for service user and no arms to chair

Knees higher than hips – can lead to intestinal problems

Chair too low for service user - Difficult to stand up from

Knees falling to one side – leading to a twisted pelvis and increased weight bearing on one side, risk of back pain and pressure areas

Solution

Service user needs a taller chair with arms

PICTURE 5

Chair too tall for service user

Feet dangling can lead to swollen feet, varicose veins and “feet going to sleep”

Difficult for service user to get in and out of chair leading to decreased independence and loss of dignity

Solution

Ideally service user needs a smaller chair

Short term fix may be a footstool

PICTURE 6

Service user slumped to one side – risk of developing a scoliosis (sideways curve in spine) which can lead to respiratory and digestive problems and back pain.

Increased weight bearing on one side can lead to pressure areas

Using left arm for support means that service user can’t use it for other tasks e.g. feeding leading to decreased independence

Solution

Need to provide lateral support for trunk to bring service user into midline e.g. a rolled towel or firm pillow may provide some trunk support

Service user may benefit from referral to physiotherapy to assess trunk and to see if needs therapy or specialised seating.

PICTURE 7

Service user has weak left side (probably had a stroke )

Weak muscles (and possible lack of feeling) means weight of arm is dragging down, risk of causing painful shoulder and stretching weak arm muscles.

Weak leg is leaning in so there is a poor pattern of weight bearing from the knee to the foot can cause strain on ankle

Weight mainly taken through the stronger side so the weak side has not got he chance to build strength

Solution

Need to support arm on possibly on a cushion without pushing the shoulder up

Service user may have better support in more rigid chair

Foot should be placed under the knee

PHOTO COPY AND CUT OUT STATEMENTS AND SOLUTIONS –

The chair leans back

Clients back not fully supported, slumping in chair, can lead to back pain

Difficult to stand up from chair leading to decreased independence

Difficult to access nearby tables therefore difficulty with foods / drinks leading to decreased independence

Knees lower than hips – bottom slides forward, knees knock together, increased risk of falling and pressure areas

Lots of soft, unsupportive cushions, leading to client being in a slumped posture / leaning to one side. Can lead to back pain, breathing problems and

digestive problems.

Pillows can restrict movement leading to decreased independence.

Difficult to stand up from chair leading to decreased independence.

Service user curved forward

Risk of developing / increasing kyphosis (forward curve in spine) which can lead to respiratory and digestive problems, neck and back pain.

Decreased view of room as looking down, risk of social isolation.

Chair too small for service user and no arms to chair

Knees higher than hips – can lead to intestinal problems

Chair too low for service user - Difficult to stand up from

Knees falling to one side – leading to a twisted pelvis and increased weight bearing on one side, risk of back pain and pressure areas

Chair too tall for service user

Feet dangling can lead to swollen feet, varicose veins and “feet going to sleep”

Difficult for service user to get in and out of chair leading to decreased independence and loss of dignity Service user slumped to one side – risk of

developing a scoliosis (sideways curve in spine) which can lead to respiratory and digestive problems and back pain.

Increased weight bearing on one side can lead to pressure areas

Using left arm for support means that service user can’t use it for other tasks e.g. feeding leading to decreased independence

Service user has weak left side (probably had a stroke)

Weak muscles (and possible lack of feeling) means weight of arm is dragging down, risk of causing painful shoulder and stretching weak arm muscles.

Weak leg is leaning in so there is a poor pattern of weight bearing from the knee to the foot can cause strain on ankle

Weight mainly taken through the stronger side so the weak side has not got he chance to build strength

Solution

More upright chair needed

Short term fix could be a pillow behind to give a more upright posture and / or a lumbar support to bring the pelvis into neutral

More supportive, narrower chair needed

May benefit from a tilt in space chair to support trunk and allow service user to view the room.

Could benefit from referral to a physiotherapist to assess trunk flexibility and see if she may need therapy or specialised seating

Service user needs a taller chair with arms

Ideally service user needs a smaller chair

Short term fix may be a footstool

Need to provide lateral support for trunk to bring service user into midline e.g. a rolled towel or firm pillow may provide some trunk support

Service user may benefit from referral to physiotherapy to assess trunk and to see if needs therapy or specialised seating.

Need to support arm on possibly on a cushion without pushing the shoulder up

Service user may have better support in more rigid chair

Foot should be placed under the knee