Rheumatoid Arthritis: Role Of The Occupational Therapist In Seating - 1

Correct seating for the patient with rheumatoid arthritis is very important, as if the patient has a seat/chair that is not suitable, it will result in pain and/or discomfort aggravation. On top of that, it will also contribute to the worsening of his or her independence when they want to get up to go toilet, answer the phone, have a meal etc.

Very few patients with rheumatoid arthritis have adequate seating support in their chairs. Perhaps it is a financial limitation, or it may be a case of lower priority so the project may have been shelved. For seating clinics, many simply provide a means of elevating the seating itself as an option, which most of the time, unnecessary for the person with rheumatoid arthritis.

When choosing a chair for a patient, the following should be considered

1. Patient is to wear his or her usually worn home shoes to ensure that the correct height is measured using day to day tools and equipment.
2. The fabric needs to be a firm one (vinyl material causes perspiration, which leads to other problems)
3. The adequate seat height for the patient is measured from the bottom of the shoes (soles) to the back of the knees of the patient in sitting, and the knees must be at right angles (90 degrees).
4. Seat depth is measured from the back of the buttocks, to the back of the knees of the seated patient.
5. Seat width needs to be measured with the patient seated in the chair, with 1-1.5 inches extra space on each side from the buttocks. This is for turnings, transfers and overall comfort. It should not be more than a total of extra 3 inches as it will result in a further apart arm rests.
6. There needs to be backrest contours along the entire length of the spine, including the neck, and angled to suit each individual patient.
7. Arm rests are required, and they should support the arms without requiring the patient to hunch their shoulders.
8. Each arm rests for the chair should be level, or inclined slightly at the digits, reaching right to the front of the knees to help the patients in getting to stand.
9. It is best when the arm rests are padded with cushions to make room or accommodate painful flare up of joints and nodules.
10. There should not be any boards or crossbars that brace the front legs of the chair, as this will limit the patient's ability to stand up on their own.