Tilted seat position for non-ambulant individuals with neurological and neuromuscular impairment: a systematic review

OBJECTIVE: To determine the effects of tilt-in-space seating on outcomes for people with neurological or neuromuscular impairment who cannot walk. DATA SOURCES: Search through electronic databases (MEDLINE, Embase, CINAHL, AMED). Discussions with researchers who are active in field. REVIEW METHODS: Selection criteria included interventional studies that investigated the effects of seat tilt on outcome or observational studies that identified outcomes for those who had used tilt-in-space seating in populations with neurological or neuromuscular impairments. Two reviewers independently selected trials for inclusion, assessed quality and extracted data. RESULTS: Nineteen studies were identified which fulfilled the selection criteria. Seventeen of these were essentially before-after studies investigating the immediate effects of tilting the seating. All studies looked at populations with neurological impairment, and most were on children with cerebral palsy (n=8) or adults with spinal cord injury (n=8). REVIEWER'S CONCLUSION: Posterior tilt can reduce pressures at the interface under the pelvis.