Wheelchair Seating Research Articles

Validation of a data logger for measuring standing time and seat angles for community-based standing devices

Context Little is understood about community-based standing device use and the impact of standing on health outcomes (e.g. pressure injury) in those living with spinal cord injury (SCI). This project reports on the accuracy of a commercially available data logger for measuring standing time and seat angle. Methods A standing frame and a standing manual wheelchair were each instrumented with a commercially available data logger and each was tested by an non-disabled participant. Standing time in the standing frame was calculated from the data logger and compared to a user-recorded standing log over a two-month period in a laboratory environment. The standing wheelchair’s seat angle was calculated using motion capture and compared to the calculated seat angle from the data logger. Average seat interface pressures were also captured during the testing of the standing wheelchair. Results The data logger demonstrated high accuracy (99.99999%) in classifying sitting and standing in the standing frame when compared to a user-recorded standing log. The wheelchair seat angle calculated from the data logger demonstrated a high level of agreement with the motion lab calculations of seat angle (ICC = 0.96 (0.95, 0.97)). The data logger seat angle results also demonstrated strong relationships to average seat pressure and rear dispersion index, measures relevant to pressure injuries. Conclusions The data logger appears to be an appropriate tool for determining standing time and seat angle in standing devices, which may aid clinicians and researchers to better understand the use and impact of standing technologies on health outcomes.

The exploration of the upper body kinematics and kinematic asymmetries during forwards and backwards wheelchair propulsion

The current literature available on the kinematic asymmetries in the upper body during wheelchair propulsion remains limited (Slowick, Requejo, Mulro. & Neptune, 2015, Front Bioeng Biotech, 3, 86-86). This research provides an opportunity to add to this limited area and help provide an understanding of the how the upper body movements change when faced with a change in speed and direction. The present cross-sectional laboratory study aimed to explore the kinematics and kinematic asymmetries during forwards and backwards wheelchair propulsion in able bodied individuals. This study investigated the effect of changes in speed and quantified the upper body kinematics of forwards and backwards wheelchair propulsion. Upon ethical approval, five able bodied participants, 3 male and 2 female (age = 21 ± 1 years, stature = 173 ± 8 cm, mass = 73 ± 7 kg) provided written informed consent and participated in this study. Participants took part in exercise regularly but had no prior wheelchair experience. Individual measurements (Height, weight, weekly exercise levels, injury history, dominant hand and upper body pain via the musculoskeletal pain questionnaire) were taken then participants took part in a series of trials in a wheelchair. Four Inertial Measurement Units (IMeasureU, Blue Trident, VICON, Oxford, UK) were placed on the participant's 7th cervical vertebrae, underneath the wheelchair seat and on the lateral side of each humerus above the elbow joint. Before testing began, participants were given a five-minute familiarisation period on the wheelchair. The testing consisted of ten forwards and ten backwards self-paced wheelchair propulsions on an Invictus Active Trainer (Invictus Active, Wolverhampton, UK), a 20 metre sprint overground on a track (with verbal encouragement throughout the sprint) and a single arm 3 kg medicine ball throw. All tests were performed from a stationary start and shoulder angles were measured to 180° before each test began. This research expects to see a difference in angular velocity between each participant's arms, with a greater level of asymmetry as speed increases. Participants are required to work harder in order to gain speed and as a result their propulsion technique will change to meet the new demands. The other expectation is to see the same side as the participants dominant hand have a higher level of force production during propulsion compared to their arm with the non-dominant hand.

Impact of Wheelchair Seating Systems on Scoliosis Progression for Children With Neurologic and Neuromuscular Disorders: A Retrospective Study of Custom-Contoured Wheelchair Seating and Modular Wheelchair Seating

ObjectivesTo retrospectively evaluate the comparative effect of 2 wheelchair seating systems, Custom-Contoured Wheelchair Seating (CCS) and Modular Wheelchair Seating (MWS), on scoliosis progression in children with neuromuscular and neurologic disorders and to determine any predictors for scoliosis progression. DesignLongitudinal, retrospective cohort study. SettingA national health service regional posture and mobility service. ParticipantsNonambulant pediatric wheelchair users with neuromuscular and neurologic disorders (N=75; 36 men, 39 women; mean age at seating intervention, 10.50±3.97y) issued CCS and MWS by the South Wales Posture and Mobility Service from 2012-2022. InterventionsTwo specialized wheelchair seating systems, CCS and MWS. Main Outcome MeasuresA generalized least squares model was used to estimate the effect of seat type on Cobb angle over time. ResultsOf the 75 participants enrolled, 51% had cerebral palsy. Fifty were issued CCS and 25 were issued MWS. Baseline Cobb angle was 32.9±18.9° for the MWS group and 48.0±31.0° for the CCS group. The generalized least squares model demonstrated that time since seating intervention (χ2=122, P<.0001), seating type (χ2=52.5, P<.0001), and baseline scoliosis severity (χ2=41.6, P<.0001) were predictive of scoliosis progression. Condition was not a strong predictor (χ2=9.96, P =.0069), and sex (χ2=5.67, P=.13) and age at intervention (χ2=4.47, P=.35) were not predictive. Estimated contrasts of medical condition with seat type over time demonstrated smaller differences between MWS and CCS over time. Predicted scoliosis velocity was found to attenuate with use of CCS over time compared with MWS, although scoliosis deteriorated regardless of intervention. ConclusionsOur findings showed pediatric wheelchair users with neurologic and neuromuscular disorders prescribed CCS showed greater mitigation of scoliosis progression over time compared with those issued MWS.

A Brain-Controlled and User-Centered Intelligent Wheelchair: A Feasibility Study.

Recently, due to physical aging, diseases, accidents, and other factors, the population with lower limb disabilities has been increasing, and there is consequently a growing demand for wheelchair products. Modern product design tends to be more intelligent and multi-functional than in the past, with the popularization of intelligent concepts. This supports the design of a new, fully functional, intelligent wheelchair that can assist people with lower limb disabilities in their day-to-day life. Based on the UCD (user-centered design) concept, this study focused on the needs of people with lower limb disabilities. Accordingly, the demand for different functions of intelligent wheelchair products was studied through a questionnaire survey, interview survey, literature review, expert consultation, etc., and the function and appearance of the intelligent wheelchair were then defined. A brain-machine interface system was developed for controlling the motion of the intelligent wheelchair, catering to the needs of disabled individuals. Furthermore, ergonomics theory was used as a guide to determine the size of the intelligent wheelchair seat, and eventually, a new intelligent wheelchair with the features of climbing stairs, posture adjustment, seat elevation, easy interaction, etc., was developed. This paper provides a reference for the design upgrade of the subsequently developed intelligent wheelchair products.

Self Operated Ground Lifting Wheelchair for People with Disability

Pro wheelchair users are at a height disadvantage during many function activities, such as transferring or reaching. Retrieving objects from the ground or a higher shelf while seated in the wheelchair can be both difficult and unsafe. Lateral transfers between surfaces at different heights can be hard and unstable. Sit-to-stand transfers are made simpler with a higher seat. This research project seeks to assist reach and transfers by designing a system to raise and lower a wheelchair seat over a 4’’ range. The project followed a multi-step iterative design process that included: needs assessment by conducting interviews and surveys, identify design needs from different stakeholder groups; analysis of stakeholder groups’ feedback and synthesis into design criteria; and creation of design concepts for the adjustable height wheelchair seat; evaluation of the design by setting up heuristic evaluation criteria and performance of user testing; design revision based on user’s test performance and feedback. The design process included fabricating and testing of various concepts, validating design through user testing, and addresses technology transfer of the device.

Design and experimental validation of a new wheelchair seat stabilization system

Purpose Seat tilting wheelchair features can increase the comfort and safety of the user. Although many power wheelchairs have tilting mechanisms, they are often designed with a specific wheelchair model in mind. In this study, a design process for seat tilting mechanisms that can be applied to most rear-wheel drive wheelchair models is developed. Methodology Equations were developed to describe the geometrical and load constraints that were used to size the electric actuator that powers the system and define its position. Finally, the equations were used to create the seat tilting mechanism of a prototype wheelchair, which was then tested. Results The equations yielded coherent results which showed that advantageous actuator positions from a load minimization perspective usually require dimensions that cannot be found in commercial actuators. Also, there are positions in which the load increases exponentially, which should be avoided. The tests showed that the system was able to function properly on the prototype wheelchair and that the actuator position affected the time taken for the actuator to execute different parts of the tilting movement. Conclusions The design process presented here was successful and modelled by general equations that can be applied to most front-wheel drive wheelchairs. It presents a low-cost option for the design of seat tilting systems, which can increase their accessibility.

Identification of wheelchair seating criteria in adults with neuromuscular diseases: A Delphi study.

Adults with neuromuscular diseases like spinal muscular atrophy or Duchenne muscular dystrophy require full-time use of a wheelchair (WC) and perform all activities of daily living in a sitting position. Optimal configuration of the WC and seating system is essential to maintain the health and quality of life of users. However, few recommendations for configuration exist. The aim of this study was to identify and select 10 WC seating criteria that ensure an optimal sitting posture for health and quality of life. A four round Delphi method was used to collect the opinions of WC users and health professionals (HP), separately. First, the HP were asked if they believed that different criteria would apply to each disease. Then the HP and SMA II and DMD WC user experts responded to electronic surveys in 4 rounds. Overall, 74 experts took part: 31 HP, 21 WC users with SMA II and 22 WC users with DMD. In total, 52% of HP believed that different criteria would apply to each disease. Ten criteria were identified by the HP for SMA II and 10 for DMD. Of the 40 criteria selected, 30 (75%) were common to each panel. Six topics were similar across panels: comfort, access to the joystick, prevention of pain, stability, pressure management and power seat functions. However, power seat functions did not reach consensus between HP and WC users (30-33% of agreement for HP and 93-100% for the WC user panels, p < 0.001). Adults with SMA II and DMD had similar WC seating needs. Therefore, the same recommendations can be applied to these groups. Further research is necessary to understand the impact of cost on the prescription of power seat functions by health professionals.

Optimizing frontal impact occupant protection systems for passengers seated in wheelchairs

ObjectiveThe advent of automated vehicles (AVs) provides an opportunity to design integrated wheelchair seating stations that provide an equivalent level of safety for occupants using wheelchairs as those using vehicle seating. This study designed a frontal occupant protection system for an integrated second-row wheelchair seating station that includes optimized airbags and seatbelt systems. MethodsMADYMO models were used to optimize belt geometry for a midsized male ATD seated in a surrogate wheelchair fixture, with and without inclusion of a Self Conforming Rearseat Air Bag (SCaRAB). Sled tests were performed to confirm the benefits of airbag use and optimized belt geometry. Additional modeling was performed with commercial manual and power wheelchairs, to identify the effects of wheelchair design and forward clear space on occupant kinematics and injury measures. Additional sled tests were performed with manual and power wheelchairs to demonstrate effectiveness of the restraint system with commercial products. ResultsSimulations and tests both showed improved kinematics using an optimized seatbelt system geometry compared to a commonly used suboptimal D-ring location that places the shoulder belt at a more outboard location. Use of the SCaRAB helped compensate for suboptimal geometry. Results include specific recommendations for belt geometry relative to the wheelchair seating station and airbag parameters suitable for protecting occupants seated in wheelchairs. Restraint systems initially optimized using the surrogate wheelchair also performed well with the two commercial wheelchairs. The clear space required for maneuvering a wheelchair will likely prevent injurious head contact in frontal crashes. ConclusionsThis study is the first to design a frontal optimal occupant protection system for an integrated second-row wheelchair seating station, demonstrating that it should be feasible once integrated wheelchair seating stations are included in AVs.

Pressure injuries, care and prevention: the case of wheelchair users

The objective of this study was to understand the interference of pressure injuries on wheelchair users' lives and to verify the care and prevention strategies. This research is characterized as descriptive observational, with analysis and discussion of data under the qualitative paradigm. A semi-structured interview was conducted with 31 wheelchair users from the Spinal Injuries Association of Rio Grande do Sul. The qualitative analysis was performed by the data categorization and triangulation method. It was found that pressure injuries develop while users are hospitalized in hospital beds, due to the use of the wheelchair without the care of frequent seat pressure relief and the inappropriate cushions use. It was also observed that the injuries affect the health and interfere users’ quality of life, and the long treatment period for the healing of the injuries implies into the removal of social life. It’s concluded that the best solution is prevention, which should occur early through the use of products and practices that relieve pressure in certain places of the body on the wheelchair seat and in hospital beds.

Therapeutic positioning to address neuromuscular scoliosis on an adolescent child with Aicardi syndrome: a case study

ABSTRACT Among persons with neuromuscular mobility limitations, therapeutic positioning has been implemented to improve body function, avoid secondary complications such as contractures and body shape distortions, and optimize body energy through restorative sleep. This case study describes the application of a 24-hour posture care management intervention for a preadolescent girl with Aicardi syndrome. The intervention was administered by adding therapeutic bed positioning to use of a custom molded wheelchair seating system. Over the 6-year intervention period overlapping with the subject’s adolescent years (age 11–17), marked improvement was observed in thoracic shape and symmetry. Moreover, the subject’s mother reported regular full-nights of uninterrupted sleep, relaxed muscle tone upon waking, a stronger cough with less audible congestion, more efficient swallowing and zero hospitalizations. The 24-hour posture care management intervention offers an alternative option for families and caregivers of persons with neuromuscular mobility impairments who wish to use a low-risk, noninvasive, locally available approach to improve body symmetry, increase hours of restorative sleep, and ease caregiving routines. Further research in 24-hour posture care management, including positioning for sleep and rest, should be explored in individuals with complex movement limiting disabilities who are at risk of developing neuromuscular scoliosis.

Psychometric properties of the Iranian version of the wheelchair seating discomfort assessment tool (WcS-DAT) – section II: a revised two-dimensional structure of comfort and discomfort to improve inclusive design practice

Purpose The objectives of the study were to: 1) validate the Wheelchair Seating Discomfort Assessment Tool (WcS-DAT – section II) in Iran, and 2) to determine whether or not the items on the scale address just one dimension (e.g., discomfort). Methods A descriptive-methodological study was performed among 109 (76 males and 33 females) full-time wheelchair users, aged 12–70 years in Tabriz, Iran. To develop the revised Iranian version of the WcS-DAT – section II, a standard “forward-backward” method was in the first step. Then, the content validity and construct validity of the tool was assessed based on feedback from an expert panel and factor analyses (exploratory and confirmatory), respectively. Sensitivity (using ceiling/floor effect), internal consistency (using Cronbach’s α), and test–retest reliability (using Intraclass Correlation Coefficient – ICC) were also evaluated. Results Results established content validity, sensitivity, internal consistency (values of Cornbrash’s α: 0.79–0.82), and test–retest reliability (values of ICC: 0.79–0.93) of the Iranian WcS-DAT – section II. Factor analyses revealed a two-factor structure (comfort and discomfort), for the scale, and thus confirmed its construct validity. Conclusions The findings suggest that the Iranian version of WcS-DAT– section II is a reliable and valid tool for the evaluation of wheelchair seating comfort and discomfort in the Iranian population. The revised two-factor model of comfort/discomfort has potential implications for inclusive design research and practice.

Experimental study of the influence of using polyurethane cushion to reduce vibration received by a wheelchair user

Purpose Experimental studies on comparing the ability of polyurethane cushions of three arbitrary selected thicknesses to minimize vibrations transmitted from the wheelchair to its user. Methods Measurements were made during passive motion on five different surfaces often found in public spaces. Two tests were carried out during the measurements. In the first test, the sensor was located directly on the surface of the wheelchair seat. In the second test, a polyurethane cushion was placed on the seat, on which the measuring sensor was then placed. Results The study showed that regardless of the surface on which the wheelchair user moves, the threshold defined in the ISO standard for frequencies in the range from 4 to 40 Hz is exceeded. However, thanks to the use of polyurethane cushions, vibration damping is visible for frequencies ranging from 10 to 40 Hz. The impact of the user’s weight on the magnitude of the perceived vibrations was also observed. Conclusions Studies show that wheelchair users are exposed to whole body vibration that can negatively affect their health. Cushions made of polyurethane seems to be a promising solution to reduce whole body vibration in the frequency range that is burdensome and harmful to human health.

Functional mobility, employment and safety benefits of seat elevating devices

ABSTRACT Seat-elevating devices (SEDs) allow vertical movement of the seat of a power wheelchair (PWC), so users can perform activities of daily living including transferring and reaching. RESNA’s position papers on SEDs and the wheelchair provision process highlight the benefits of SEDs and the need for outcome measurement. The Functional Mobility Assessment (FMA) is a satisfaction measure to carry out specific tasks including transferring and reaching. The purpose of this retrospective study was to evaluate the relationship between the use of SEDs on the FMA and uniform dataset (UDS) with a sample of 1,733 PWC users. Independent-samples t-tests and Mann–Whitney U tests were used to compare total FMA and individual FMA item scores between those with and without an SED. A univariate linear regression model was used to control for confounding variables and determine if SEDs were a predictor of variance in FMA. Those with SEDs had significantly higher total FMA percentage score (mean = 76.7 ± 20.9) than those without SEDs (mean = 59.6 ± 24.7; t = 11.9, p < 0.001). Those with SEDs had significantly higher reach (U = 99849.0, p < 0.001) and transfer (U = 140587.0, p < 0.001) scores. The functional, vocational, and safety benefits of SEDs should be considered when determining coverage for SEDs. Status of Research Process Study completed. Involvement of Assistive Technology Users Participants were power wheelchair users.

History, Current Practice, and the Future of Wound Care for Occupational and Physical Therapists.

History, Current Practice, and the Future of Wound Care for Occupational and Physical Therapists.

FSR-Based Smart System for Detection of Wheelchair Sitting Postures Using Machine Learning Algorithms and Techniques

This paper presents an intelligent system containing FSR-based posture detection using machine learning algorithms. This paper is aimed at detecting the sitting posture of a wheelchair user. Individuals using wheelchairs are at increased risk of pressure ulcers when they hold an incorrect position for too long because the blood supply desists at some points of their skin due to increased pressure. The main objective of this research is to find a better configuration combined with the best machine learning algorithm for the detection of posture to prevent pressure ulcers. In the proposed monitoring system, two configurations consisting of a 3 × 3 matrix configuration (9 sensors) and a crossconfiguration (5 sensors) of FSR sensors are embedded on a wheelchair seat to get pressure data generated and collected in a real-time processing unit and then compared. The posture recognition is performed for five sitting positions: ideal, backward-leaning, forward-leaning, right-leaning, and left-leaning based on five machine learning algorithms: K -nearest neighbors ( K -NN), logistic regression (LR), decision tree (DT), support vector machines (SVM), and LightGBM. The research study provides a system to detect a real-time pressure sitting posture on a processing unit (laptop) wirelessly using the ESP32 module. Consequently, a posture classification accuracy of up to 95.41% is accomplished using a 3 × 3 matrix configuration. The proposed system helps prevent pressure ulcers and is valuable in risk assessment related to pressure ulcers. This system describes the relationship between accuracy, different sensor configurations, and performance of the multiple machine learning algorithms.

Patient and Clinician Reported Outcomes and Experiences Following Advanced Tele-Rehabilitation Assessments Conducted in Rural Alberta

<h3>Research Objectives</h3> To determine the feasibility of a clinic-to-clinic tele-rehabilitation model in rural Alberta. <h3>Design</h3> This pilot study employed a Plan-Do-Study-Act (PDSA) methodology. We focused on 4 clinical areas: Hip & Knee post-arthroplasty follow-up, Vestibular & Balance issues, Severe Shoulder Pain & Instability, and Wheelchair Seating. We co-developed assessment processes with non-physician experts that connected to a general physiotherapist using new technologies. After a series of in-house trials, these assessments were then deployed to 5 rural communities in Alberta. Technologies included Kinetisense Markerless Motion Capture and a telepresence robot. Patients were provided with a minimum of two clinical visits, with follow-up approximately 4 weeks after initial assessment. Experience and outcome measures centered on ICF principles were collected from both patients and clinicians. <h3>Setting</h3> The study took place in public and private rehabilitation settings and a primary care facility. <h3>Participants</h3> Participants were selected from a convenience sample by local practitioners. Initial and follow-up assessments for 16 patients in this pilot study were completed. <h3>Interventions</h3> A novel suite of technologies and processes were developed through close consultation with expert clinicians to enable complex rehabilitation assessments to be conducted remotely. <h3>Main Outcome Measures</h3> A mix of outcome and experience measures determined the effectiveness of this model. The COPM, and a study-specific Patient Reported Experience Measure, measured patient outcomes. Two study-specific Clinician Reported Experience Measures provided clinician data. <h3>Results</h3> Across our 4 modules, 14 out of 16 participants either agreed (3) or strongly agreed (11) that they enjoyed their Tele-Rehab session overall. No participants disagreed, and 2 were neutral. Based on COPM scores, overall patients saw improvements in both performance and satisfaction for their identified goals.The remote clinicians were all confident in the treatment plans prescribed by the hub clinician (n=13, 4 Agree, 9 Strongly Agree). Both hub and remote clinicians had confidence in each other, and all agreed (5) or strongly agreed (18) that the assessments were a success. <h3>Conclusions</h3> Preliminary results indicate that this is an effective way of delivering care, but additional study is required. <h3>Author(s) Disclosures</h3> N/A.

Design and Fabrication of Wheelchair into Foldable Bed

Abstract: In this paper lead screw mechanism is used to convert a wheelchair into bed and vice versa. When lead screw mechanism is operated, the foot rest which is downward goes till the level of seat of wheelchair and simultaneously the back support goes down to the same level making, its stretcher and vice versa, when it is converted into wheelchair from stretcher. Below the seat, a defecation system has been provided which is detachable and is operated by sliding mechanism. It is designed and fabricated in such a way that it can be used in hospitals as well as for personal use at home. Below the seat, a defecation system has been provided which is detachable and is operated by sliding mechanism. Also, obstacle avoiding sensor i.e., ultrasonic sensor is used to know if any obstacle will come in front of wheelchair, siren bell will ring. Keywords: Fabrication, Hospital, Mobility Aid, Lead Screw, Design, Wiper Motor, Wheelchair, Battery

Design and development of a wheelchair seating pressure relief reminder system for pressure ulcer prevention among paraplegics

Individuals with paraplegia spend their time on the wheelchair for life. Adapting to prolonged wheelchair seating for almost all activities of daily living is challenging. The loss of abilities to sense any pain or excessive seating pressure cause them to remain seated on the wheelchair without any pressure relief activities. This situation leads to secondary complications including pressure ulcer which further degrades the individual’s health. To overcome this, a wheelchair seating pressure relief training system (WSETs) was developed. Optimal placement of the force sensitive resistors (FSR) as seating pressure sensors on the cushion were determined, and their responses were investigated with 5 paraplegics. Two different FSR orientations, A and B, were compared. Each paraplegic sat in resting position and then performed pressure relief activities (PRA) which included whole body push-up, left and right lean and forward lean, before returning to resting position. Orientation B, with more forward positioned FSRs, showed higher sensitivity, implying better capture of high-risk area of pressure ulcer development. The FSR sensor readings were significantly different among pressure relief activities in all subjects (p < 0.05) indicating the validity of FSR measures for the intended application. In conclusion, the WSETs system was proven suitable as a training tool for new paraplegics to habituate themselves in performing PRA.

Study of castor oil‐based auxetic polyurethane foams for cushioning applications

AbstractThis work involves the study of mechanical and antibacterial properties of auxetic polyurethane (APU) foams synthesized using castor oil (CO) to ascertain their suitability as seat cushions in wheelchairs. Firstly, CO‐based PU foams (PU‐CO) were synthesized by substituting 25% synthetic polyol with CO in a polyol blend. Conventional PU foams and PU‐CO foams were then converted to auxetic foams using triaxial compression and heating. The chemical composition, microstructure and thermal, mechanical and antibacterial properties of the foams were analyzed. It was found that addition of CO improved the antibacterial and mechanical properties of the foams. CO‐based APU (CO‐APU) foams showed highest compression strength and storage modulus. An increase in thermal stability of PU‐CO was also observed as compared to PU foams. These CO‐APU foams could be a better alternative to conventional PU foams for wheelchair seat cushions and in hospital bed applications. © 2021 Society of Industrial Chemistry.

Surveying Therapists on Seating Approaches for Patients with Muscular Dystrophy in Japan.

Patients with muscular dystrophy (MD) need fitted wheelchairs. This study aimed to ascertain physiotherapists and occupational therapists’ opinions about the current wheelchair seating process for patients with MD in Japan. We identified 266 academic papers published between August 2014 and July 2019 with the keywords “muscular dystrophy” and either “physiotherapy” or “occupational therapy.” We then sent survey requests to 140 physiotherapists and occupational therapists (who were among the authors of the aforementioned papers), of whom 41 agreed to partake in this study. We found that the time required for each seating was 30–60 min for three types of MD, and the most commonly reported time to trial fitting was 1–3 months. In addition, health insurance reimbursements for seating were considered part of disease-specific rehabilitation in most cases, and most therapists were more or less satisfied with the current seating procedure. Physiotherapists had the highest degree of reflection of their views (wishes) regarding seating, followed by MDs and their families. In Japan, seating has been regarded as a medical practice since 2017. In the future, we would like to investigate the seating concept for individual therapists in detail.