Seating and occupational performance

When assessing for an appropriate chair for our clients, we often concentrate on the physical needs including the seat width, height, depth measurements, pressure requirements and postural stability.   All this is vital, however what is just as important is what they want to do in that chair whilst sitting.  It is rare that anyone just sits in a chair doing nothing, it could be watching the television, sleeping, having a cup of tea or just chatting to a friend.

Therefore, a critical part of the assessment is discussing with your client the occupations (activities) they need to be able to carry out whilst sat in the chair. Occupations are very important to our clients and help to promote wellbeing.  The World Federation of Occupational Therapist, state ‘In occupational therapy, occupations refer to the everyday activities that people do as individuals, in families and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do’.[i]

It is therefore critical to complete an individual assessment of physical, cognitive and sensory needs, whilst enabling a client to carry out the activities they wish to engage in.

When visiting your clients, it is useful to keep the PET[ii] approach at the forefront of the assessment:

  • Person
  • Environment
  • Task (occupation)

Person – this covers the motor, sensory, cognitive and anthropometrics (measurements) needs of a client, their impairment and prognosis.  Also, it is important to look at any weight limits and pressure risks.

Environment – This specifically looks at the environment in which the chair is going to be used, discuss with your client where the chair is going to be placed or where it may be moved to in the future.  Does it need to be moved on a regular basis, if so by whom?  Is the flooring suitable for the type of chair if it needs to be moved?  Finally, does the chair, fit in with the client’s home decoration, there is significant evidence that providing equipment that creates a clinical atmosphere is often not used and placed in another room, leaving the client to continue to struggle to get in or out of their chair.

Task – What does the client want to do in the chair? And what barriers will the potential chair play in restricting the activity.  When assessing the task, it is essential that you observe the task and see what movements are needed to achieve the task without undue effort. For example, if a client likes to complete a crossword, do they need a table, do they need to be able to lean forwards? How do they extend their arms, is the movement bilateral? The aim of the assessment is to provide a chair that enables the chosen activity and not to hinder it.

By using the above approach, you will meet the needs of your client. Remember a chair is not just for sitting on and there has to be a balance between posture and pressure needs and purposeful activity.

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[ii] Law, M., Cooper, B,. Strong, S., Stewart, D., Rigby, P. & Letts, L. 1996. The Person-Environment-Occupation Model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy. 63(1):9-23