How to Choose the Right Specialist Chair for Your Client: An OT’s Guide
Prescribing a specialist chair is never a one-size-fits-all task. It requires careful clinical assessment, functional understanding, and an awareness of the client’s environment and support network.
Whether you’re working with someone recovering from a stroke, living with Parkinson’s, or at risk of pressure injuries, this guide will help you choose a care chair that matches your client’s evolving needs.
Why Specialist Seating Requires Specialist Thinking
Unlike standard recliners or wheelchairs, specialist chairs are purpose-built for clinical support, offering features like tilt-in-space, postural supports, pressure care cushions, and modular adjustability.
These chairs are designed to:
- Support proper posture and spinal alignment
- Minimise pressure injury risk
- Enable safer hoist or assisted transfers
- Conserve user energy during long periods of sitting
- Increase participation in daily activities
Step 1: Conduct a Clinical Seating Assessment
A thorough seating assessment is the foundation of correct prescription. It should be led by an occupational therapist, physiotherapist, or experienced seating specialist.
Physical Evaluation
- Posture Analysis: Look for postural issues such as pelvic obliquity, kyphosis, scoliosis, or lateral lean.
- Skin Integrity: Check the sacrum, ischial tuberosities, and heels for pressure injuries or redness.
- Range of Motion (ROM): Assess for limitations in hip flexion, knee extension, or ankle dorsiflexion, as these can significantly impact seated positioning and comfort. Identifying these limitations helps guide decisions about chair configuration — such as the need for a negative angle footplate, elevating leg rest, or fixed positions to accommodate reduced lower limb range.
Step 2: Understand Functional Needs
Transfer Abilities
How does the client transfer—independently, with assistance, or via hoist?
This influences your choice of features such as:
- Drop-down or removable arms (essential for hoisting)
- Forward tilt function (helps with standing transfers)
- Wheeled base for mobility within a room
Our Care Chairs can be configured to assist with side transfers, stand transfers and support hoist transfers, reducing manual handling strain for carers. For stand transfers we can enable forward tilt, lower the seat-to-floor height and remove the footplate.
Cognitive Considerations
Clients with cognitive impairment may be unable to reposition themselves or operate powered functions safely. In such cases:
- Manual tilt or recline mechanisms should be carer-controlled
- Recline angles can often be locked out to prevent shear risks
Did you know? Tilt-in-space preserves joint angles and is preferred for pressure relief, while recline changes the seat-to-back angle and may increase shear risk if misused.
Learn more: Tilt or Not to Tilt
Step 3: Evaluate Daily Function and Sitting Time
Duration of Sitting
If your client remains seated for hours each day, standard seating options may cause:
- Fatigue
- Static loading
- Pressure injuries
- Decreased engagement
To manage this:
- Use high-performance cushions (e.g., viscoelastic or alternating air)
- Prescribe tilt-in-space to vary pressure points
- Include accessories like tray tables for activities
Step 4: Assess the Environment
- Space constraints: Measure doorways, corners, and turning areas.
- Flooring: Chairs that are wheeled must move easily over carpet, tile, or vinyl.
- Caregiver capacity: Can the caregiver safely assist with repositioning, tilt, or hoist transfers?
Choose a chair that aligns with both client and caregiver capabilities to avoid daily friction or safety risks.
Step 5: Match the Chair’s Features to the Client’s Clinical Picture
| Clinical Indicator | Linked Feature or Seating Consideration |
|---|---|
| Postural Instability (leaning, collapse) | Tilt-in-space, lateral supports, contoured backrest |
| Pressure Injury Risk (skin breakdown) | Pressure-relieving cushions, tilt-in-space, alternating air options |
| Hoist Transfers Required | Care chairs with drop-down arms, raised wheeled bases, hoist compatibility |
| Pain or Fatigue When Sitting | Recline or tilt functions, adjustable lumbar/thoracic support |
| Reduced Trunk/Head Control | Profiled headrests, lateral supports, cocoon backrest, postural backrest |
| Involuntary Movements or Spasticity | Stable base, padded supports, secure pelvic positioning |
| Sliding Forward in Chair | Tilt-in-space function, anti-slide cushions, pelvic positioning belts |
| Cognitive Impairment | Manual controls only, recline lockouts, simplified adjustment options |
| Short vs Long-Term Use | Hire chairs vs. modular/customised seating with growth and adjustability built-in |
| Stand Transfers Possible | Forward tilt, riser recliners, removable footplate, adjustable floor-to-seat height |
| Environmentally Constrained Settings | Narrower armrests, directional and pivot castor brakes/locks, push handles |
Visit our Care Chair collection to see options tailored to clinical needs.
What Happens After Prescription?
- Caregivers must be trained on how to adjust the chair correctly (especially tilt vs. recline)
- Monitor for signs of poor fit or new pressure risks
- Reassess every 6–12 months, or sooner if the client’s condition changes
Regular reassessment prevents complications like postural deterioration or pressure injuries.
Use tools like Seating Passports to track usage, comfort, and caregiver feedback.
Conclusion: Thoughtful Chair Prescription Leads to Better Outcomes
When you match the right features to the right person, you empower users to:
- Sit more comfortably and safely
- Engage in daily activities
- Reduce fatigue and pressure risks
- Experience higher quality of life
At Enable Lifecare, we make it easy for therapists to find intelligent, adaptable, and carer-friendly seating solutions.
Ready to prescribe with confidence?
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Or download our full Clinical Guide to Specialist Seating
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