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A guide on good seating posture practice

This article is designed to help users and carers in the public domain to learn more about good posture when sitting in a chair or wheelchair. It is not intended for clinicians. This article was put together by BHTA industry expert members.

What is posture?

Posture is the way we hold ourselves or body segments in relation to one another and their orientation in space. Body positioning can be intentional or unintentional.

Body segments (1):

Good seated posture graphic

Posture has two main purposes:

  1. Antigravity – to provide the rigidity needed to maintain an erect posture against gravity
  2. Interface with the outside world – to orientate body segments to interact with the environment

The body structure is a very complex system. It is naturally unstable but highly flexible, which allows for a wide variety of postures but also makes it very vulnerable to damage.

TIP: Posture is influenced by body shape and size, the supporting surface, and even health or emotional state

Seated posture image

Why is good posture important?

  • Enables independence
  • Encourages interaction
  • Promotes physiological function
  • Manages comfort levels and quality of life

When poor seated posture is adopted over prolonged periods of time, a person can experience:

  • Muscle fatigue and associated pains e.g. lower back pain or neck pain
  • Organ dysfunction e.g. breathing and digestion
  • Limitations in activity e.g. difficulty with eating and drinking
  • Limited range of movement in joints and/or altered body shape
  • Other health issues e.g. pressure ulcers, bowel and/or bladder problems

What is good posture?

Good posture (2):

  • Facilitates effective functional performance
  • Is energy efficient
  • Does not harm the body systems

TIP: Failure to manage posture can result in many health complications

What is postural management?

Postural management is the use of any technique to minimise postural problems and enhance health (3). It must be individualised, targeting all body segments. It must also take into consideration the full 24-hour period.

How might someone who is having difficulty with their posture sit?

Seated posture graphic
Seat height being too high results in insufficient foot support, reduced stability, and can increase risk of sliding down the chair.
Seated posture graphic
Seat depth being too long can encourage sliding down the chair and can increase the risk of pressure ulcers.
Seated posture image
Seat width being too wide can make the pelvis move unequally and encourage leaning to the side.

TIP: Select a chair to suit body shape and size

Why might someone have difficulty managing their posture?

  • Neurological impairment
  • Changes in body shape and size
  • Little or no active movement
  • Movements that are difficult to control
  • Lack of body awareness and/or sensory impairments
  • Difficulty communicating discomfort

Where can you get further information or advice?

Contact a healthcare professional for advice on postural management.

Case study:

  • Mr. A, a 35-year-old gentleman diagnosed with cerebral palsy
  • Mr. A has muscle spasms and stiffness
  • He has a curved spine and struggles to sit upright
  • Without a chair that is set up to his body shape and size, he is at risk of pain, not being able to eat or drink safely, and developing pressure ulcers
  • With the appropriate chair, he is more comfortable, and his risk of pressure ulcers is reduced. He has a more stable upright position, making it safer for him to eat, drink and communicate, and manage his muscle problems

References:

  1. Pope PM (2002) Posture management and special seating In Edwards S (Ed) Neurological Physiotherapy London: Churchill Livingstone
  2. Pope PM (2007) Severe and Complex Neurological Disabilities: Management of the Physical Condition London: Butterworth-Heinmann
  3. Farley R, Clark J, Davidson C, Evans G, MacLennan K, Michael S, Morrow M, Thorpe S (2003) What is the evidence for the effectiveness of postural management? International Journal of Therapy and Rehabilitation 10(10):449-455