Weight shifts are important because they allow you to relieve the pressure points on your body while in the wheelchair or sitting on other surfaces (bed, etc). By relieving the pressure over your sitting areas, you keep the skin over your sitting bones (ischia) healthy and prevent pressure sores from occurring.
Weight shifts are done every 30 minutes and should last a full 60 seconds to relieve the pressure properly. Depending on the type of injury and condition of your skin, you may be advised to do weight shifts every 45-60 minutes. If you have a skin sore, weight shifts will need to be done more often. It is important to perform weight shifts as instructed by your therapist.
This lesson will review different types of weight shifts. Do the type of weight shift that your therapist has recommended.
Tilting Weight Shifts
Tilting weight shifts relieve pressure on both sitting bones at the same time. Tilt the chair back and have the leg rests raised up so you are in a lying position.
You will need the help of another person to do this, depending on the type of wheelchair you use and your own strength and ability to move.
If your chair is motorized, you may be able to make it tilt on your own. This type of weight shift should be done for a full 60 seconds.
Tilting weight shift in a manual wheelchair:
Step 1: Raise the wheelie bars to the "up" position and lock the brakes.
Step 2: Recline the person back gently.
Side to Side Weight Shift
Leaning side to side relieves pressure over one sitting bone at a time. Lean on each side for 60 seconds (one minute). This weight shift should take a total of 120 seconds (two minutes), since there are two sides to do.
This is a side to side weight shift. Notice the hip is lifted off the seat to relieve pressure.
Push Up Weight Shift (Depression Weight Shift)
Push up weight shifts relieve pressure on both sitting bones at one time.
You must have enough strength in your upper body to push down on the armrests or tires of the wheelchair and lift your buttocks completely off the chair seat.
This weight shift should take a total of 60 seconds (one minute). The video below demonstrates a push up weight shift.
Forward Lean Weight Shift
The forward lean weight shift allows you to relieve pressure from both sitting bones at one time. Lean forward as though you are looking at your feet, making sure to clear your buttocks off the seat of the chair. This will properly relieve the pressure. It is helpful to scoot all the way back in the chair first before leaning over. Hold this weight shift for 60 seconds.
Be careful when leaning forward so as not to tip over. To prevent tipping, keep the front caster wheels (small wheels in front) facing forward.
Standing Weight Shift
Depending on the nature of the spinal cord injury, standing may be possible. This weight shift relieves pressure on the whole sitting area at one time. The standing weight shift should only be done if you can safely support your body weight on your legs and maintain your balance. When rising from your chair to stand, make sure the chair is locked and you have a solid structure to hold onto while standing. You may have another person assist in supporting you. This weight shift should be done for 60 seconds.
Always keep your chair locked when doing any weight shift in a manual wheelchair.
Turning in bed is just as important as doing weight shifts in your chair to help protect your skin. Stay on the schedule your rehabilitation team prescribed. You may need to turn every 2, 4, or 6 hours depending on your personal state of health, age, type of injury, newness of injury and/or type of bedding you have. See the Padding and Positioning lesson in this module for more information related to turning.
Remember to spend time on each side, your back, and, if suggested by your rehabilitation team, your stomach.
The stomach is actually preferred if you can tolerate it. Check with your doctor before using the prone position.
If you have a sore in a particular area, avoid lying on that part of your body unless otherwise directed. See the "Signs of Skin Problems" lesson in this module if you need help recognizing a skin sore.