Which wheelchair feature is helpful for a patient with multiple sclerosis who has significant extensor tone to prevent sliding out of the chair?

• A. Tilt-in-space wheelchair with pelvic belt
• B. Reclining back only
• C. Elevating leg rests
• D. Standard rigid frame

Answer: (A)

When extensor tone is significant, keeping the pelvis and trunk securely aligned in the chair is essential to prevent the person from sliding forward or out of the chair. A tilt-in-space wheelchair changes the seating angle by tilting the entire seat backward while preserving the back angle, which helps maintain pelvic contact with the seat and reduces forward shift caused by stiff, extensor patterns. Adding a pelvic belt then secures the pelvis to the seat, preventing movement that could lead to a person sliding out. This combination provides both dynamic control of posture and a physical barrier to slipping, enhancing safety and stability.

Reclining the back alone doesn’t lock the pelvis or control forward sliding; elevating leg rests don’t address trunk or pelvic stability; and a standard rigid frame lacks the adjustability to counteract extensor tone and prevent sliding out.