Wheelchair Positioning: The Head
Presented by Michelle L. Lange
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Some wheelchair seating systems do not include any support for the head, and many systems include only a simple posterior head support. Some clients require additional support secondary to impaired head control or asymmetrical head postures. The position of the head must optimize vision, breathing, and swallow, as well as function. This course is applicable to occupational and physical therapists who work with clients using wheelchairs and applies to multiple practice settings.
Learning Objectives
- Implement assessment strategies for a client with a suboptimal head position
- Correlate specific client parameters to posterior head support product features
- Determine when lateral head support is required
- Determine when anterior head support or a collar is indicated
- Implement appropriate wheelchair seating interventions to improve mobility to enhance participation in desired daily occupations and reduce risk for complications such as skin breakdown or contractures
Meet your instructor
Michelle L. Lange
Michelle Lange is an occupational therapist with over 38 years of experience and has been in private practice, Access to Independence, for over 19 years. She is a well-respected lecturer, both nationally and internationally, and has authored numerous texts, chapters, and articles. She is the coeditor of Seating and Wheeled…
Chapters & learning objectives
1. Positioning the Head: Assessment Considerations
Positioning the head involves strong knowledge of where to provide support to achieve postural alignment of the neck and head while respecting vision, breathing, swallow, and functional needs.
2. Positioning the Head: Posterior Head Supports
Head support is typically provided posterior to the head. Some head pads only contact the occiput, while others provide support at the suboccipital area, typically in combination with the occipital pad. Each product offers specific features to match individual client need.
3. Positioning the Head: Lateral Supports
Lateral head support is added to a posterior head support to address lateral neck flexion and/or rotation. Matching specific product features to individual need and understanding optimal lateral pad placement is critical.
4. Positioning the Head: Anterior Supports and Collars
For clients with minimal head control, anterior support at the forehead or a collar under the jaw may be required to maintain an upright head position. Clinical advantages and disadvantages to these options are important to understand and convey to the seating team.
More courses in this series
Wheelchair Positioning: The Pelvis
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Wheelchair Positioning: The Trunk
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Wheelchair Positioning: The Extremities
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Wheelchair Positioning: The Head
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Wheelchair Positioning: Tying It All Together—A Series of Case Studies
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