Altering Sitting Posture through the Lumbar Spine

MAUREEN T. NAHORNIAK, RPTA


The effects of gravity, tone, and structural deformity often complicate postural control of individuals who use wheelchairs. Seating systems usually address control of the pelvis, hips, and frontal plane motions of the spine. Too often, however, the lumbar spine is neglected. Altering the lumbar spine in the sagittal plane changes alignment and stability and affects tone.

Stability of the lumbar spine requires the facet joints to be in a close packed position, maintaining the normal lordotic curve. This can be done through the use of orthoses, Warm 'N Form devices, or lumbar rolls. Usually a lumbar roll provides the necessary support for patients with cerebral palsy, spinal cord injury, muscular dystrophy, and myelodysplasia. The lumbar roll can be a simple and effective adjunct to the management of posture for selected patients.

Shriners Hospital for Crippled Children, 516 Carew Street, Springfield, MA 01104