- Prevent Pressure Sores -

For wheelchair users... call it doing a "pressure relief" or doing a "weightshift" it doesn't matter what it's called, it must be done!  This is how you can stay in your chair "all day" and not develop pressure sores (decubitus ulcers).  Here are my thoughts on doing weightshifts and a weightshift ratio analysis... this is a MUST READ, especially for people new to life using a wheelchair.

Remember when you were able-bodied (AB) and you sat in class for 45-50 minutes, and your butt started to hurt after a while, so you shifted forward or backward in your chair?

At Shepherd Center, one of the leading rehab facilities in the Country, I was instructed that when I'm in my wheelchair -- in order to avoid pressure sores -- I need to do a weightshift (fully tilting or reclining, as opposed to remaining upright) for AT LEAST one minute, EVERY half hour.

If I am doing the exact minute -- the absolute minimum to help prevent pressure sores -- that means I'm upright for 29 minutes, doing a weightshift for 1 minute, a ratio of 29:1.  They tell me that's acceptable -- and I've learned that it isn't difficult to do -- except when watching an action movie that cannot be paused (and I weightshift anyway).  But what about doing longer weightshifts?  Obviously, your body might appreciate a little longer break, maybe another 60 seconds, double the required length.  Look what happens to the ratio of upright to weightshift:

30 minutes: 29 min. upright, 1 min. weightshift: ratio 29:1 (MINIMUM!)
30 minutes: 28 min. upright, 2 min. weightshift: ratio 14:1 (or 28:2)
30 minutes: 27 min. upright, 3 min. weightshift: ratio
  9:1 (or 27:3)
30 minutes: 25 min. upright, 5 min. weightshift: ratio
  5:1 (or 25:5)

I'm often in my chair for 15 straight hours, although I've been told I should limit that to 12 hours.  Fortunately, thanks to doing weightshifts regularly, my body tolerates 15 hours a day pretty well.  Guess what length of weightshift I try to do?

Generally, when I'm on my computer (which is usually about 8 hours a day) I try to alternate a two-minute weightshift with a 3-minute weightshift, for total of about 5 minutes every hour.  Sometimes I'll start writing an e-mail when tilted back or play a game of Solitaire to do an extended weightshift (especially if I'm tardy on starting my weightshift).  If I'm watching TV, I'll generally weightshift during the commercials (every 15 minutes isn't necessary, but usually there's a good three minutes of commercials every half hour).  When I'm out, I don't care where I am, I'm going to do weightshifts.  I stick my size 14 shoes up in the air everywhere -- at a nice restaurant, during a presentation I'm giving (first I explain what I need to do and why:) and anywhere I happen to be.

The alternative is to get a pressure sore which can put a wheelchair user on bed rest for weeks and also endanger one's life (Christopher Reeve passed away from complications stemming from an infected pressure sore) and I'm not willing to take those chances.

- Bill Miller :-)

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