What factors are relevant to define the functional sitting position in an activity chair?

Naja Tidemann Jensen, Tina Helle, Erika G. Spaich

Research output: Contribution to conference without a publisher/journalAbstractResearchpeer-review


INTRODUCTION According to the International Standard Organization (ISO), an assistive technology is defined as a product designed to prevent impairments, activity limitations or participation restrictions [1]. Furthermore, assistive technologies promote the ability to live independently and participate in daily activities [2]. In the future, there will be a larger proportion of older people who live longer, which means that an increased use of assistive technologies will be expected [3,4].Activity chairs are an example of an assistive technology designed for people with altered balance, mobility, power, and endurance [5]. Activity chairs, such as the VELA chair, serve to compensate for loss of function and support the citizen in carrying out daily activities at home as for example cooking, cleaning, and doing laundry while seated [5]. Active but controlled sitting is believed to activate muscles and supporting structures and therefore prevent static loads acting on joints, ligaments, and tendons [6]. Furthermore, an alternating sitting position significantly enhances muscular activity, which can be additionally beneficious for the activity chair’s target group [6].Since activity chairs are used to support performing activities of daily living while seated, it is important that they support a functional sitting position. It is however, difficult to find research-based literature that helps to define "the functional sitting position". Therefore, the objective of this study is to identify in the literature factors that can contribute to develop a definition of the functional sitting position with special focus on the relation between the person and the chair, while performing activities.METHODSA literature search was performed in PubMed and Cinahl using search terms like for instance: functional sitting position, chair, office chair, ergonomic, movement, stability, balance, activity, and performing tasks. The search terms were systematically combined. The inclusion criterion was that the articles where published in peer-reviewed scientific journals from 1990 to 2019. No methodological restrictions were applied.The identified publications were screened first based on the title and abstract and then, based on the full paper. Duplicates were removed and the final sample was synthesized to reveal what factors are relevant to consider for developing a definition of the concept of functional sitting position.RESULTSAccording to the literature search and synthesis, the following three factors were found relevant for developing a definition of functional sitting position:a. Body positionForward inclination is important for a functional sitting position because it promotes improved upper extremity function [7, 8, 9], trunk extension [10], and improved postural efficiency [11, 12, 13] and permits engagement in functional tasks [14].Furthermore, forward tilted seating (seating surface inclined 15°) is, in terms of postural activity, a more efficient position for postural efficiency compared to horizontal (0°) and backwards tilted (seating surface reclined 15°) sitting positions [11]. The most efficient posture is that with the least postural muscle activity in postural adjustments [11].b. Mobility Chairs with multiple degrees of freedom provide enhanced spinal mobility, which may be beneficial for the general wellbeing and does it possible to preform different movement and activities [15]. Spinal mobilityincludes twisting, which helps to perform functions in the lateral and posterior space by increasing the area ofreach [16].The functional sitting position requires control in various sitting positions, and multiple movements of the spineand pelvis are needed to maintain the various sitting positions [17].c. BalanceSitting balance is assumed to be essential for obtaining independence in other vital functions such asreaching, sit-to-stand, and sitting down [18-20]. Balance is therefore relevant to consider in particular withregards to reaching tasks that might challenge the users’ postural stability.DISCUSSION AND CONCLUSIONAccording to the results, three factors were identified in the literature as contributing to the development of theconcept of functional sitting position. Collectively, they address body position, mobility, and balance. However,the literature that was included in the synthesis is rather old and sparse. Thais indicates that there is a need towork further in developing the concept of functional sitting position.REFERENCES[1] Hjælpemidler til personer med funktionsnedsættelser- klassifikation og terminologi. DS/EN ISO9999:2007. København: Dansk standard 2007.[2] Socialstyrelsen. Hansen E. M. Mobilitetshjælpemidler til voksne – Hjælpemidler, der virker. December2014. Available at: https://socialstyrelsen.dk/udgivelser/mobilitetshjaelpemidler-til-voksne-aktuelforskningsbaseret-viden-til-udvikling-og-planlaegning-af-den-kommunale-indsats-hjaelpemidler-dervirker.Accessed 27-02-2019.[3] Brandt Å. & Stapelfeldt C. Forbrug af mobilitetshjælpemidler 2002-2006 – på basis af data fra ZealandCare. Hjælpemiddelinstituttet. 2009.[4] Hjälpmedelsinstitutet. Äldrestatistik 2010. Äldres hälsa funktionsnedsättning, boende och hjälpmedel.Vällingby: Hjälpmedelsinstitutet).[5] VELA Vermund Larsen A/S. Arbejdsstole. Available at:https://www.vela.dk/produkter/arbejdsstole. Accessed 03-02-2019.[6] Horton SJ, Johnson GM, Skinner MA. Changes in head and neck posture using an office chair withand without lumbar roll support. Spine (Phila Pa 1976). 2010 May 20;35(12):E542-8. doi:10.1097/BRS.0b013e3181cb8f82.[7] Myhr U & von Wendt. Improvement of functional sitting position for children with cerebral palsy. DevMed Child Neurol. 1991 Mar;33(3):246-56.[8] Myhr U, von Wendt L, Norrlin S & Radell U. Five year follow-up of functional sitting position in childrenwith cerebral palsy. Dev Med Child Neurol. 1995 Jul;37(7):587-96.[9] Reid DT. The effects of the saddle seat on seated postural control and upper extremity movement inchildren with cerebral palsy. Dev Med Child Neurol. 1996 Sep;38(9):805-15.[10] Miedaner JA. The effects of sitting positions on trunk extension for children with motor impairment.Pediatric Physical Therapy: Spring 1990.[11] Van der Heide JC, Oten B, van Eykern LA & Hadders-Algra. Development of postural adjustmentsduring reaching in sitting children. Exp Brain Res. 2003 Jul;151(1):32-45. Epub 2003 May 10.[12] Myhr U & von Wendt. Reducing spasticity and enhancing postural control for the creation of afunctional sitting position in children with cerebral palsy: a pilot study. Pages 65-76 | Accepted 01 Nov1989, Published online: 10 Jul 2009.[13] Myhr U & von Wendt. Improvement of functional sitting position for children with cerebral palsy. DevMed Child Neurol. 1991 Mar;33(3):246-56.[14] Pain H, McLellan L & Gore S. Choosing Assistive Devices A Guide For Users and Professionals.(2003) London: Jessica Kinsley Publishers. Learning Disability Practice. 6, 6, 24-24. doi:10.7748/ldp.6.6.24.s18.[15] Baumgartner D, Zemp R, Liste R, Stoop M, Naxera J, Elsig JP, Lorenzetti S. The spinal curvature ofthree different sitting positions analysed in an open MRI scanner. Scientific WorldJ ournal. 2012;2012: 184.016. doi: 10.1100 / 2012/184016.[16] Lengsfeld, M., van Deursen, D.L., Rohlmann, A., van Deursen, L.l., L.l., and Griss, P. Spinal Loadchanges during rotatory dynamic sitting. Clinical Biomechanics (Bristol, Avon). 15(4), 295-297.[17] Clinical Physical Therapy . Asai, H. Pelvic Movemnet in Agign Individuals and stroke patients. May31st 2017. DOI: 10.5772/67510. Available at: https://www.intechopen.com/books/clinical-physicaltherapy/pelvic-movement-in-aging-individuals-and-stroke-patients) Accessed 01-03 -2019.[18] Franchignoni FP, Tesio L, Ricupero C, Martino MT: Trunk control test as an early predictor of strokerehabilitation outcome. Stroke. 1997;28:1382–1385.[19] Pollock AS, Durward BR, Rowe PJ, Paul JP: The effect of independent practice of motor tasks bystroke patients: A pilot randomized controlled trial. Clin Rehabil. 2002;16:473–480.[20] Tessem S, Hagstrøm N, Fallang B: Weight distribution in standing and sitting positions, and weighttransfer during reaching tasks, in seated stroke subjects and healthy subjects. Physiother Res Int.2007;12:82–94.
Original languageDanish
Publication date2019
Publication statusPublished - 2019
Externally publishedYes

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