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If only we lived in an ideal world, all users of high-end rehab power wheelchairs would have access to both power tilt and recline seating when needed. After all, if one can both tilt and recline, it results in foremost pressure relief from one's most susceptible area for pressure sores, the buttocks. However, due to funding limitation, many who need pressure management seating have to choose between power tilt or recline – not both, making for a difficult choice. However, power tilt and recline features aren't only about shifting weight for pressure management, but also meet other clinical needs – and when one understands the full benefits of each technology, choosing between them becomes easier.

The Basics

A power tilt literally tilts the entire seating system – backrest, seat base, and legrests – rearward as a single unit. As the seating system tilts, the user does not change in position – hip and knee angles stay the same – and the user's weight distribution is shifted from the buttocks to the back, thereby providing pressure relief as needed.

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Power Tilt

With a power recline, the backrest reclines while the seat base stays in a fixed position. Much like lying down, a reclined position removes a concentration of weight from the singular area of the buttocks, and redistributes it among one's upper body, reducing seated pressure. Power recline is most often coupled with power elevating legrests for even greater changes in weight distribution, where a closer-to-prone position optimizes weight distribution. It is important to note, however, that power recline alone does not provide as dramatic of pressure relief from one's buttocks as a power tilt.

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Power Recline

Advanced Clinical Benefits
While both power tilt and recline offer pressure management, they have very different additional applications.

For those needing a “fixed” seating position – where hip and knee angles must remain constant – a power tilt is the solution for pressure management, keeping one in-place while still providing pressure relief. Additionally, although one's seated position doesn't change, tilting rearward increases trunk extension for improved respiration and digestion, as well as offers increased trunk stability while decreasing abnormal tone. Commonly, those with cerebral palsy and others with abnormal tone, poor balance, and fixed seating positions require power tilt instead of recline for pressure management.

For those needing a passive range of motion at the hips, a power recline serves as the solution, allowing changes in posture. Specifically, a power recline can reduce the risk of hip contractures (permanent fixation of the hip in one position), and allows for changes in posture throughout the day. What's more, a power recline can increase respiratory capacity, and aids toward catheterization. Power recline is commonly used by those with quadriplegia, multiple sclerosis, and other conditions where dynamic seating posture and movement is needed.

A Tough Choice Made Easier
Indeed, in an ideal circumstance, consumers don't have to weigh some clinical needs against others – and both power tilt and recline combined are funded as the ultimate pressure management solution. Unfortunately, not all consumers are in ideal funding circumstances, and must choose between tilt or recline. In that circumstance, considering one's larger clinical needs, beyond basic pressure management, can create the deciding factor, one that tips the scale – or seat! – toward the best overall clinical solution.

Published 1/2010, Copyright 2010,