Tilt-in-space wheelchair is indicated for which condition?

• A. Upper cervical SCI requiring active pressure relief
• B. Trunk extensor spasms
• C. Bariatrics
• D. Metatarsalgia

Answer: (B)

Tilt-in-space seating is designed to change the orientation of the pelvis and trunk without altering the knee and hip angles, which is especially helpful when trunk muscles are prone to extensor spasms. By gradually tilting the seat posteriorly, the pelvis achieves a more comfortable posterior tilt and the trunk can rest with less demand from the paraspinal extensors to stay upright. This reduces involuntary extension and provides a stable, supported seated posture, making it easier to tolerate sitting for longer and to perform pressure-relief shifts safely. It also distributes pressure more evenly and reduces shear forces, which helps with comfort and skin protection.

Other scenarios like upper cervical spinal cord injury needing active pressure relief, bariatric seating needs, or metatarsal pain have different primary considerations (nerve or muscle control, weight capacity and width, or foot/forefoot comfort, respectively) and are not the main indication for tilt-in-space seating.