What You Should Know About Wheelchair Lateral-Supports

Lateral trunk supports, are also known as laterals, lateral-supports, lateral-thoracic-supports, trunk-stabilizers or just plain wheelchair stabilizers. They are rectangular-shaped devices that mount to the back-posts of a wheelchair and rest against the user's trunk. Often, they are used in pairs, one on each side of the trunk. The main-purpose for them is to eliminate the "side-to-side" rocking of the chair and lateral leaning. They are part of the wheelchair positioning accessories that provide a comfortable, convenient armrest to facilitate arm-use and rehabilitation.

These supports come in a number of different sizes and padding densities. Size and shape will vary depending on the manufacturer and style. The most common styles are planar (flat) or contoured (shaped). The amount of "contouring" (shaping, fitting) may vary between styles and manufacturers. Many models can be ordered with hardware that allows these supports to "swing-away" from the user and out-of-the-way. This makes getting in-and-out of the chair much easier. They are available from the wheelchair manufacturer or can be purchased from a number of aftermarket sources.

These positioning accessories are most often used to increase the user's trunk-stability and balance. These supports are often used in an effort to control "spinal-scoliosis" ("S-shaped" curvature of the spine). This tactic may work in those cases were the scoliosis is flexible and can easily be reduced. In cases where the scoliosis is rigid, these supports may cause discomfort as well as some tissue damage (wounds). This is especially true if the support is placed on the apex (high-point) of the spinal curvature.

If the user’s trunk can be placed in an upright, neutral, sitting-position but the user cannot maintain this position, the supports can be placed opposite one another, on each side of the trunk. This technique adds the needed external support to hold the user in position. Many users and professionals think that these supports must be placed exactly opposite each other on the trunk. This is not true and, in certain cases, may result in poor performance results and extreme discomfort

to the user.

In those cases where spinal curvature is present, uneven or oblique placement of the supports must be considered. One lateral should be placed just under the apex of the spinal curve. The second lateral should be placed on the opposite side

of the trunk and above the opposing one. This initiates the proper dynamics for reducing the curve (if flexible) and gives

the proper support to the trunk.

In order to work well, these devices must be in contact with the user’s trunk. If they do not make contact, support is not possible. If they are too tight, the user may have a problem with breathing. If they are placed too low, the support is lost and the trunk may "lean" over the supports. If placed too high, they may impinge on the armpit and cause damage to the nerve fibers from the spine to the neck and arm, irritate the surrounding skin and restrict shoulder and arm movement.

PROS

• Aids in trunk support and stability.

• Improves balance and posture.

• Helps maintain the user in a functional position. .

• Prevents further postural decay.

• Diminishes the need for repetitive repositioning of the user during the day.

• Improves appearance. .

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CONS

• If placed too low, they are ineffective.

• If placed too high, they may irritate the armpit, spinal nerves, surrounding tissue limiting shoulder and arm movement.

• May be difficult to mount to the "back-rest" in the proper location.

• When the pad is under pressure, the "swing-away" feature may become difficult to operate.

• Contact of the entire pad against the body is difficult to position since there are no adjustments for angling the pad in or out.

• If the user changes position, the supports will now, most likely, not be aligned, correctly, any more. In addition, they add another layer of complexity to the entire chair.

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