Call 1300 499 282 or email sales@hiaus.net.au to speak to our specialist team

Pelvic Positioning

Sitting is an activity which should ideally allow for dynamic and smooth movement of the pelvis, excellent forward and lateral functional reach, and pelvic stability in order to maximise potential functionality.

It is very important to position and support the pelvic region correctly since, as a badly positioned pelvis can lead to the development of spinal deformities, and vice versa.

For individuals with muscle weakness or low tone, through getting into a reach position might not be a challenge, getting back into a neutral position could prove to be difficult. Dynamic support systems and pelvic positioning devices act as valuable aids in this respect, where a degree of elasticity will assist the torso to return into a neutral position.

BES offers a range of secondary support devices for better
pelvic positioning, including lightweight cushions, laterals, the dynamic HipGrip®, and the Evoflex™, the ultimate evolution in pelvic positioning. It is time to move on from just Pelvic Stabilisation to Pelvic Positioning, and understand that seating is all about dynamic movement and not restraints.

Posterior Pelvic Tilt

Posterior Pelvic Tilt

Assessment

Sacral sitting - most common tendency. ASIS (Anterior Superior Iliac Spine) higher than the PSIS (Posterior Superior Iliac Spine). Tendency to slide out of chair. Flexed lumbar spine, and thoracic kyphosis seen. Shoulders protracted with Increased cervical extension. ‘C’ type posture. 

Causes

Wheelchair Issues: Canvas back, no PSIS block, seat depth too long, back support too short, footplates too low.

Physical Conditions: Tight hamstrings, muscle weakness, kyphosis.

Pelvic Support

One of the options is to use a pelvic positioning belt. The objective of the belt is to prevent sliding hence a two-point padded centre pull belt, or a two-point padded dual pull belt would prevent sliding. 

Attachment

Position the padded belt anterior and inferior to the ASIS across the thighs and attach at an angle that brings it anterior to the greater trochanters.

Solutions

Pelvic Obliquity

Pelvic Obliquity

Assessment

One ASIS is higher than the other along with a compensatory C-shaped curve in the lumbar and thoracic spine seen.  Lateral tendency and a shoulder tends to be elevated. May involve rotation.

Causes

Wheelchair Issues: Sling back/seat upholstery, wheelchair too wide, seat too short.

Physical Conditions: Irregular trunk muscle tone, muscle imbalance, scoliosis.

Pelvic Supports

The objective of the pelvic support is to bring the pelvis down and back into the seating system. In this situation a two-point rear-pull pelvic positioning belt will help. 

Attachment

Position the padded belt anterior and inferior to the ASIS across the thighs and attach at an angle that brings it anterior to the greater trochanters.

Note: a block at the level of the PSIS is required.

Solutions

Anterior Pelvic Tilt

Anterior Pelvic Tilt

Assessment

The ASIS is usually lower than PSIS. Thoracic kyphosis is reduced or reversed. Increased lumbar lordosis is seen along with retracted shoulders, and trunk extension.

Causes

Wheelchair Issues: Seat to back angle too is small.

Physical Conditions: Tight hip flexors, weak abdominal muscles, and lordosis.

Pelvic Support Options

Pelvic Positioning Belts can be used when an individual shows charecteristics of Anterior Pelvic Tilt. The objective of the belt is to resist forward tilt of the pelvis.

In this case 4-point centre pull pelvic belt and 4-point dual pull pelvic belt are ideal.

Attachment

Position the padded belt over the ASIS and attach directly back to the wheelchair back posts. Anchor the secondary straps to the seat as illustrated to stop the padded belt from rising up into the soft tissues of the abdomen.

Solutions

Pelvic Rotation

Pelvic Rotation

Assessment

In Pelvic Rotation, one ASIS is more forward than the other. One side of the hip is abducted and the other adducted. Appears to have leg length discrepancy or a ‘wind-swept’ appearance. 

Causes

Wheelchair Issues: Seat depth too short or too wide.

Physical Conditions: Irregular trunk muscle tone, muscle imbalance, spinal deformities, varying leg length.

Hip Belt Options

The objective of the belt is to bring the pelvis back into position and hold it there. Four-Point Rear-Pull Hip Belt

Attachment

Position the padded belt over the ASIS and attach directly back to the wheelchair back posts. Anchor the secondary straps to the seat as illustrated to stop the padded belt from rising up into the soft tissues of the abdomen.

Solutions

Relevant Articles

Other Resources

Other Resources

© 2018 HIA Ltd