AA + hEDS research review · companion sheet

Wheelchair & seating evaluation checklist

Name

Evaluation date

Clinic / supplier

Bring this to a seating clinic appointment with a physiatrist, OT or PT, and a credentialed supplier. Check items as they're covered and write in your own numbers. Superscripts refer to the sources at the end.

01 Record before the appointment

Minutes I can sit before pain builds:
Minutes I can stand before pain builds: ⁴
Relieves pain: standing / reclining / lying down / walking (circle)
Where pain is worst when seated (low back, buttocks, tailbone, legs, pelvis)
Joints that sublux or dislocate:
Shoulder, elbow, wrist, or hand pain with pushing or gripping

Orthostatic symptoms (dizziness, racing heart, fainting) and any POTS diagnosis
Leg or foot swelling by end of day
Pelvic-floor findings (tenderness on exam, pain with sitting or intercourse)
Falls or near-falls in the last 3 months:
Current mobility aids and how often used
Relevant imaging (lumbar MRI findings, Tarlov cysts, etc.)

Where will the chair be used? Check all that apply.

Home (doorway widths, thresholds, bathroom)
Car — make/model:
Campus or work
Outdoors (gravel, grass, slopes, curbs)
Public transit or air travel
Who can help with lifting or loading:

02 Ask the team to assess

Mat exam lying down and sitting: pelvic tilt, obliquity, rotation, and whether each is flexible or fixed^2,3
Spinal alignment, sitting balance, and range of motion at hips, knees, ankles, and spine^2,3
Hamstring tightness and the knee angle that lets my pelvis sit neutral³
Upper-limb strength and pain with propulsion, including shoulder stability²
Skin and pressure risk, with pressure mapping on candidate cushions³
Whether I can do my own weight shifts, and for how long^1,3

03 Base types to trial

Type	Trialed?	Pain with use (0–10)	Notes
Ultralight manual (under 30 lb)²
Power-assist manual²
Power wheelchair²
Scooter (if relevant)²

RESNA recommends product trials before final selection, ideally in the environments you'll use.³

04 Seat functions to trial

Power tilt-in-space reaching at least 30° (smaller tilts did not reduce sit-bone pressure in cited studies) — max tested: ¹
Power recline, used together with tilt — range tested: ¹
Power elevating leg rests, always paired with recline¹
Standing function — standing tolerance tested first²
Seat elevator for transfers and reaching^2,3
Programmed sequence for returning upright: recline → leg rests → tilt¹
Tilt reminder schedule agreed (one cited study: every 30 min for at least 1–2 min)¹

05 Pelvic positioning and seating components

Seat depth set about 2 inches short of the back of the knee²
Seat width: hips/thighs plus 1–2 inches total²
Seat slope (“dump”) set and recorded: ²
Cushion type chosen with pressure mapping; contours or build-ups for any obliquity or subluxing hip^2,3
Solid or contoured back with posterior pelvic support^2,3
Pelvic belt or anterior pelvic support for stability^2,3
Footrest height 1–2 in above floor and angle set so hamstrings don't pull the pelvis back^2,3
Armrests at about 30° shoulder flexion and 60° elbow flexion²
If manual: axle position, ergonomic handrims, and rigid frame reviewed^2,3

06 Measurements recorded

Measurement	Value	Measurement	Value
Seat width		Seat-to-floor height
Seat depth		Back height
Seat slope / dump		Footrest length
Seat-to-back angle		Armrest height

07 Team, paperwork, and timeline

Licensed clinician (OT/PT) involved in the evaluation: ¹
Supplier holds RESNA ATP or SMS credential: ¹
Face-to-face mobility exam documented by prescriber (power mobility) — date: ²
Order sent to supplier within 45 days of exam — date: ²
Delivery within 120 days — expected date: ²
Letter of medical necessity covering sitting intolerance, upper-limb limits, and orthostatic symptoms⁵
Insurance prior authorization status:

08 At delivery and follow-up

Fitting confirms pelvis sits neutral and level; pressure map repeated on final setup³
Training on seat functions, the return-to-upright order, and tilt schedule^1,3
Follow-up scheduled (RESNA case examples used one month) — date: ³
Refit triggers noted: weight change, progression, new condition, new environments³
Plan to keep active out of the chair to limit deconditioning⁶

Questions for the team:

Educational material, not medical advice. Equipment choices, angles, and settings must be determined by your seating team based on an individual evaluation. From the research review at ginalyncox.github.io/adhesive-arachnoiditis-and-heds.

RESNA. Position on the Application of Tilt, Recline, and Elevating Leg Rests for Wheelchairs: Literature Update 2023 (approved Feb 26, 2025). 0201.nccdn.net/…/resna-position-on-the-application-of-tilt-recline-2025.pdf
Doan T, Delaney K, Manguinao M. Wheelchair and Power Mobility for Adults. AAPM&R KnowledgeNow (updated Jan 9, 2025). now.aapmr.org/wheelchair-and-power-mobility
Arledge S, et al. RESNA Wheelchair Service Provision Guide (2011). resna.org/…/RESNAWheelchairServiceProvisionGuide.pdf
Tennant F, Porcelli MJ, Guess KS. Adhesive Arachnoiditis: A Clinical Update (2020). arachnoiditishope.com/…/AA-Clinical-Update-2020.pdf
hEDS Info. Assistive Devices (patient-education site, not peer reviewed). hedsinfo.com/heds/assistive-devices
The Ehlers-Danlos Society. Braces, Splints & Mobility Aids. ehlers-danlos.com/braces-splints-mobility-aids