Modification of sitting posture of patients with hemiplegia using seat boards and backboards

The purpose of this study was to evaluate and compare the effects of using seat boards only and a combination of seat boards and backboards on wheelchair posture. Forty-one patients with hemiplegia secondary to cerebrovascular accidents were assigned sequentially to 1) a group that used seat boards only (SB Group), 2) a group that used both seat boards and backboards (SBB Group), or 3) a group that used no boards (Control Group). The SB and SBB Groups used the boards throughout rehabilitation. Wheelchair sitting posture was measured at entry to and discharge from the rehabilitation program. The SB and SBB Groups were measured with and without boards. Anterior-posterior pelvic tilt, lumbar lordosis, thoracic kyphosis, lateral flexion, and lateral pelvic tilt were measured using a gravity goniometer, photographs, and calipers. Use of seat boards was associated with a decreased lateral pelvic tilt of 2.3 degrees at discharge while the seat boards were in place. The use of seat boards and backboards combined was associated with decreased lateral pelvic tilt of 3.1 and 1.6 degrees, increased anterior pelvic tilt of 13.1 and 11.1 degrees, and decreased thoracic kyphosis of 13.0 and 14.2 degrees at entry to and at discharge from the rehabilitation program, respectively, while the boards were in place. At the end of rehabilitation when the boards were removed, no long-term postural changes had occurred in the treatment groups compared with the Control Group. This study demonstrated that seat boards and backboards in wheelchairs improve certain postural deviations of patients with hemiplegia, but that these improvements are not maintained when the boards are removed after 5 to 10 weeks of use.