Occupational Therapy for Posture and Seating

Clinical Specialisms

The field of posture and seating involves a multidisciplinary approach, with several clinical specialisms working together to address the complex needs of individuals requiring support in these areas. These specialisms collaborate to assess, recommend, and implement seating solutions that promote optimal posture, enhance comfort, and prevent secondary complications.

• Occupational Therapy (OT): Occupational therapists focus on assessing the individual's functional needs and daily living activities to recommend seating and positioning strategies that enhance independence and participation in daily tasks. They consider the environmental context and the individual's specific goals to ensure the seating solution facilitates engagement in desired activities.

• Physiotherapy (PT): Physiotherapists evaluate and address the musculoskeletal and neuromuscular aspects of posture and seating. They work on improving strength, flexibility, and endurance related to maintaining optimal posture. PTs are crucial in developing programs to prevent deformities and in recommending exercises that support the individual's posture in their seating system.

• Rehabilitation Engineering: Rehabilitation engineers apply engineering principles to design, adapt, and select customized seating and mobility solutions. They work on creating or modifying equipment to meet the unique postural and seating needs of individuals, ensuring the technology is both functional and appropriate for the user’s lifestyle.

• Orthotists and Prosthetists: Orthotists specialize in the provision of orthoses (braces/supports) that assist in posture correction and support. Prosthetists may also be involved when considering the integration of prosthetic limbs with seating and mobility systems, ensuring that devices are compatible and support optimal posture and function.

• Seating and Mobility Specialists: These specialists have specific expertise in assessing for and providing complex seated mobility solutions, including wheelchairs and specialized seating systems. They focus on matching the technology to the individual’s postural needs, lifestyle, and environmental challenges.

• Neurologists: Neurologists may be involved in cases where neurological conditions affect posture and the ability to sit comfortably or safely. They provide medical management that can influence muscle tone, control, and overall neurological function, which are crucial for effective seating solutions.

• Paediatricians (in paediatric cases): In cases involving children, paediatricians play a key role in monitoring the child’s growth and development, addressing any medical conditions that may impact posture and seating. They work closely with other specialists to ensure that seating solutions support developmental needs.

• Geriatricians (in elderly cases): For older adults, geriatricians address the complex health issues that can affect posture and seating, such as osteoporosis, arthritis, and balance disorders. They ensure that seating solutions accommodate the specific needs of aging individuals to maintain function and quality of life.

How can Occupational Therapy help?

Occupational Therapy (OT) plays a pivotal role in addressing posture and seating needs, especially for individuals with disabilities, injuries, or chronic conditions that affect their ability to sit comfortably and safely. OTs focus on improving an individual's functional independence and quality of life through personalized interventions. 

Comprehensive Assessment

Functional Evaluation: OTs assess the individual's ability to perform daily activities and their current sitting posture, identifying any limitations or areas for improvement.

Posture and Seating Needs: They evaluate the specific posture and seating needs of the individual, considering factors like spinal alignment, pressure distribution, and risk of skin breakdown.

Environmental Context: The assessment also includes evaluating the environments in which the individual will use the seating system, such as home, work, or school, to ensure the recommendations are practical and supportive of the individual's lifestyle.

Customized Seating Solutions

Recommendations: Based on the assessment, OTs recommend specialized seating solutions tailored to the individual's needs. This may include ergonomic chairs, wheelchair cushions, back supports, and other adaptive equipment to promote optimal posture and comfort.

Adaptations and Modifications: OTs can also suggest modifications to existing seating arrangements to improve posture, such as adding lumbar supports, seat wedges, or footrests.

Skill Development and Training

Postural Control: OTs work with individuals to develop and strengthen the skills needed for maintaining proper posture. This may include exercises to enhance core stability, balance, and flexibility.

Proper Use of Equipment: They provide training on how to correctly use and adjust the recommended seating solutions and adaptive equipment, ensuring the individual can achieve and maintain an optimal sitting posture.

Transfer Skills: For individuals using wheelchairs or other mobility devices, OTs teach safe and effective transfer techniques to and from different seating arrangements.

Prevention and Management of Secondary Complications

Pressure Ulcer Prevention: By promoting proper seating and posture, OTs help prevent pressure ulcers and other skin integrity issues that can arise from prolonged sitting in incorrect positions.

Ergonomic Education: OTs educate individuals on ergonomic principles to apply in various settings, reducing the risk of musculoskeletal injuries and enhancing overall comfort during seated activities.

Collaborative Care

Interdisciplinary Collaboration: OTs often work as part of a multidisciplinary team, collaborating with physical therapists, rehabilitation engineers, and other healthcare professionals to provide a cohesive approach to posture and seating.

Family and Caregiver Involvement: They also involve family members and caregivers in the process, providing education and training to support the individual’s posture and seating needs.

Follow-Up and Adjustment

Monitoring and Reassessment: OTs conduct follow-up assessments to monitor the effectiveness of the seating and posture interventions, making necessary adjustments to accommodate changes in the individual's condition or needs.

Adaptive Strategies: As part of ongoing care, OTs continually adapt strategies and interventions to ensure that the individual maintains optimal posture and seating comfort over time.

What does an Occupational Therapist do ?

When assessing posture and seating, an Occupational Therapist (OT) undertakes a detailed and systematic process to ensure that any recommendations or interventions provided are tailored to the individual's specific needs. 

Initial Consultation:

• Gathering Information: The OT begins by collecting comprehensive information about the individual's medical history, lifestyle, daily activities, and any specific challenges they face related to sitting, posture, or mobility.

• Understanding Goals: Understanding the individual’s personal goals, preferences, and what they hope to achieve through improved posture and seating is crucial for tailoring the assessment and subsequent recommendations.

Physical Assessment:

• Posture Analysis: The OT assesses the individual's posture in various seating positions and during different activities to identify any deviations or areas of concern, such as poor spinal alignment or asymmetrical sitting.

• Musculoskeletal Examination: Examining muscle strength, flexibility, range of motion, and any musculoskeletal abnormalities that might impact the individual's ability to maintain an optimal posture.

• Sensory and Skin Integrity Evaluation: Assessing sensory function and checking for any signs of skin breakdown or pressure ulcers, which are critical considerations in selecting appropriate seating solutions.

Functional Assessment:

• Daily Living Activities: Observing and evaluating how posture and seating impact the individual's ability to perform daily living activities, including eating, working, and engaging in leisure activities.

• Mobility and Transfers: Assessing the individual’s ability to move in and out of the seat, including transfers to and from wheelchairs, beds, and other surfaces.

Environmental Assessment:

• Home and Workplace Evaluation: The OT may conduct assessments in the individual’s living and working environments to identify potential challenges and opportunities for improving seating and posture within these contexts.

• Equipment and Furniture Use: Reviewing the current seating arrangements, furniture, and any assistive devices being used to determine their suitability and effectiveness.

Recommendations and Trial of Equipment:

• Seating Solutions: Based on the assessment, the OT recommends specific seating solutions, which may include specialized cushions, back supports, ergonomic chairs, or custom-made seating systems.

• Trial Period: Whenever possible, the OT arranges for the individual to trial recommended seating solutions to ensure they meet the person's needs and preferences before making a final decision.

Education and Training:

• Instruction on Proper Use: Providing education and training on how to use and adjust the recommended seating solutions effectively to maintain optimal posture.

• Postural Exercises: Teaching exercises and strategies to strengthen postural muscles and improve overall sitting posture.

Implementation and Follow-Up:

• Implementation Support: Assisting with the acquisition and setup of the recommended seating solutions, ensuring they are correctly adjusted to the individual’s specifications.

• Ongoing Monitoring: The OT schedules follow-up sessions to monitor the effectiveness of the seating and posture interventions, making adjustments as needed based on feedback and any changes in the individual's condition or needs.

Diagnoses & Conditions treated with Occupational Therapy for Posture and Seating

Neurological Conditions such as Stroke, Traumatic Brain Injury, Cerebral Palsy and Multiple Sclerosis

Musculoskeletal Conditions such as Scoliosis

Developmental Disorders such as Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).

Age related conditions such as Parkinson's Disease

Paediatric conditions such as Global Developmental Delay (GDD)