Tough question!!

In the world of seating and mobility, the first thing to know is if  
the person who needs the lumbar roll is in a fixed position or a  
flexible position at the pelvis. If their pelvis is fixed in  
posterior pelvic tilt, a lumbar roll isn't going to do anything  
except make them slide forward and away from it.  If the position is  
flexible, it's trial and error. Try a small roll and see if the  
person is more comfortable and/or sits more upright. Lumbar rolls  
often help people who have lumbar lordosis since the roll can fill in  
the gap and help the person make full contact with the back of their  
chair.

If you are in the position that most skilled nursing facilities are  
in, you're probably trying to modify a "transport or hospital"  
chair.......the bright silver frame with navy, maroon, etc. naugahyde  
sling seat and back. This type of chair already puts people at a  
disadvantage because the sling effect promotes posterior pelvic tilt  
and rounded shoulders. It is very hard to sit up straight in one of  
those chairs even if you are completely able-bodied with good muscle  
tone/control.

Wow......can you tell that's one of my soapboxes? It's a very  
frustrating situation to try to position everyone adequately when you  
are given very few tools/resources to do it well.

I guess I would say the general rule is if the posture is flexible,  
you can try using external positioning to promote a more midline/ 
upright position. If the posture is not flexible, don't try to change  
it. Just support it.

That's my 2 cents. Since seating and mobility is my passion and also  
most of my practice now, I look forward to hearing the opinions of  
others.

Mary Alice Cafiero, MSOTR, ATP


On Oct 27, 2007, at 8:52 AM, [EMAIL PROTECTED] wrote:

>
>
> I work in a skilled nursing setting. Positioning is a major part of  
> the OT's
> job. We are looking for information regarding possible  
> contraindications with
> use of a lumbar roll. Also, the staff would like to know in what  
> situations
> would you use this roll. We all have our own opinions but would  
> like input
> from others on this matter. thanks for your help!
>
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