Wheelchair Positioning – A Therapist’s Role

Positioning and appropriate seating systems are concerns to the Occupational Therapist working with patients in wheelchairs.

Many nursing home residents and elderly patients sit for hours each day, sometimes in wheelchairs designed primarily for transportation. Prolonged periods of sitting in such wheelchairs may not only be uncomfortable but could pose multiple health risks such as difficulty with breathing, swallowing and digestion as well as skin breakdown. Poor positioning limits patients’ ability to socialize and interact with others.

Occupational Therapists have the expertise to evaluate, modify and recommend wheelchair and seating systems that allow patients to achieve optimal positioning to increase comfort, independence and quality of life.

RehabVisions has a formal Wheelchair Positioning program for Occupational Therapists. Sherri and Shelly, two of RehabVisions’ wheelchair positioning experts, have developed a manual to provide our therapists with the knowledge of assessment, intervention, documentation, billing and education for successful wheelchair positioning.

In the manual, Sherri and Shelly describe three keys to a successful positioning program:

Developing a relationship with a good DME (durable medical equipment) vendor.

“They have advanced knowledge of the newest positioning equipment and will often let you trial equipment in order to assess the effectiveness with your patients,” Shelly said.

Completing a quality evaluation with objective measurements.

“It is important during the evaluation process for a therapist to objectively document a patient’s abnormal posture by measuring the deficits.

This allows the therapist to accurately document the skill required in wheelchair positioning. It assists the therapist in developing an appropriate plan of care and measuring the effectiveness of the intervention,” Sherri said.

Providing adequate training to staff and family to ensure carryover of positioning recommendations.

“Wheelchair positioning is one of the most important things we can do for our geriatric patients,” Sherri said. “Improving a patient’s posture and comfort makes such a huge impact on their everyday quality of life.”


As therapists we don’t always see the results of the work we do, however with wheelchair positioning, our efforts are visually obvious. Don’t overlook the impact that proper positioning has on quality of life.

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