Clinical Benefits of Tilt-in-Space

Provides a change in position for clients who cannot independently shift their body weight and change position
With no means to change position, shift weight and redistribute pressure, these clients are at risk for skin breakdown and sitting tolerance is compromised

• Tilting provides a means for independent weight shifts and position changes
  • Reduces the risk of skin breakdown by redistributing the pressure to the back
  • Provides a safe and easy way for a care-giver assistance to provide a weight shift
• Tilting results in increased sitting tolerance
  • Reduces the need for care-giver to transfer the client in and out of chair periodically throughout the day

Provides a change in position for clients who cannot maintain pelvic, trunk or head position and/or balance against gravity for prolonged periods of time

• Gravity pushes down on the body in the upright position
• If muscle strength or overall endurance is compromised, clients will be unable to hold themselves upright for prolonged time periods
• They will slide forward into a posterior pelvic tilt and thoracic kyphosis (postural collapse) to avoid falling forward and to alleviate fatigue
  • This position requires much less work to maintain against gravity
    
  • They are now at risk for fixed orthopedic deformities and skin breakdown on the sacrum and spine
• Tilting clients when they fatigue helps maintain them in an upright position and facilitates thoracic extension and a neutral pelvis.

Prevents postural collapse in clients who are at risk for respiratory complications
If the client cannot maintain upright and falls into postural collapse as above, the respiratory system can become compromised:

• The diaphragm has less room to drop as it contracts, so lungs do not fully expand
  • Can result in the collapse of lower parts of the lung (atelectasis)
  • Secretions are not mobilized – can result in pneumonia
  • It becomes more difficult to take a deep breath
  • Breathing is shallower and therefore faster
• Tilt can be used to prevent postural collapse, promote thoracic extension and reduce the risk of respiratory complications
  

Prevents postural collapse in clients who are at risk for digestive complications
If the client cannot maintain upright and falls into postural collapse as above, the digestive system can become compromised:

• Food cannot pass as easily down the gastrointestinal tract – this can result in gastritis, gastric reflux, esophagitis and/or bowel impaction
• Head and neck position are not optimal
  • Could cause aspiration with swallowing
  • Could set off primitive reflexes such as the gag reflex or tongue thrust
• Tilt can be used to promote postures that reduce the risk of g.i. complications

Provides appropriate position for clients who are at risk for postural hypotension––
A condition in which the blood pressure drops when client is in the upright position

• Could lead to dizziness or loss of consciousness – a potentially dangerous event
• Dynamic tilt allows client to be re-positioned with the head in a lower position in order to raise the blood pressure

Provides appropriate position for clients who are at risk for autonomic dysreflexia
A condition in which the blood pressure increases due to an event or condition that the body interprets as “noxious”

• This is a warning sign produced by the body to let client know something is wrong
• Could be caused by an overfull bladder (kinked catheter), an impacted bowel, a constriction of blood flow, a change in position, etc.
• The blood pressure can rise so high that it is a potentially life threatening event
• Dynamic tilt allows the client to be brought quickly into the most upright position to try to lower the blood pressure

Provides a change in position and accommodates a fixed hip joint contracture

• Tilt maintains the same hip angle throughout the weight shift

Provides a change in position yet maintains a specific seated posture

• Tilt does not change the client’s joint angles or muscle lengths and maintains the secondary supports and contours in the same position relative to the client
• This is especially significant when the seating system has contours and secondary supports that need to remain in contact with the client at specific points in order to provide optimal support and control

Provides a change in position while minimizing the risk of extensor spasticity

• A slight opening of the hip angle at the beginning of a weight shift can sometimes cause an extensor spasm
• Tilt maintains the optimal hip angle throughout the weight shift

Provides a change in position without the risk of shear forces

• When a client is reclined and then brought back to upright, there is some forward sliding of the pelvis on the seat that occurs (shear displacement)
  
  • This is because the client’s pivot point (hip joint) does not exactly match the pivot point of the chair (seat to back junction).
• In contrast, when the client is tilted and then brought back to upright, there is no movement of the body relative to the chair

ADDITIONAL BENEFITS OF THE QUICKIE IRIS
The curved rocker-arm allows the seat frame to rotate on the base frame, while maintaining the user’s COG in near perfect
alignment with the chair’s center of rotation. This alignment is maintained throughout the tilt and return-to-upright cycle.
Because the user’s COG remains constant and there is virtually no horizontal shift, the IRIS has the following advantages over
other tilt in space systems:

• Can use the shortest wheel base on the market without compromise to stability. This can significantly increase maneuverability for the care-giver and/or for the user capable of independent propulsion
• Since there is no need to position the COG towards the front of the chair to maintain stability, there is no front -loading of the casters and no compromise to maneuverability or safety for the care-giver or client
• Because the user’s COG and the chair’s center of rotation remain in optimal alignment, the care-giver is not lifting or lowering the user’s weight when tilting and un-tilting. With the Quickie IRIS, these movements are smooth and effortless, with no need for mechanical assists
• A constant COG has the potential to eliminate the problems associated with the horizontal shift that occurs in other tilt systems, such as:
  • Triggers or disturbances that could result in spasticity
  • Agitation in clients with cognitive issues
  • Protective extension reactions.