There’s a wide variety of reasons why many older adults will use a wheelchair at some point in their later years, aside from paralysis. For the purpose of this article, the term “wheelchair” refers to manual and powered chairs because both come with health repercussions due to extensive use.
The following information reveals the detailed sedentary complications that come with prolonged wheelchair use among the elderly. Especially when they are physically inactive. In all honesty, the information provided should scare wheelchair users. More importantly, the listed complications can be reduced or completely prevented with the appropriate precautions or lifestyle changes. Let’s begin:
Sedentary Complications That Come With Prolonged Wheelchair Use:
Pressure Sores on Buttocks From Sitting
One of the most serious, and potentially deadly, complications that come with prolonged sitting in a wheelchair are pressure sores or pressure ulcers. Clinicians often times recommend using pressure-relieving techniques at least every 15 minutes during the period spent in a wheelchair and for this very reason.
When prolonged pressure is applied to skin, healthy or fragile, the tissue is subject to breaking down. The hot spots on the body for sores are along bony prominences including the pelvic bones along the buttocks and the heels.
Other places include all over the back of the thighs with upright sitting. Some breakdown may be superficial (or stage I) and can be reversed with proper care. Other times, pressure sores wear through to the bone (stage 4) and are termed non-healing pressure ulcers.
What makes these ulcers lethal is the deep tissue exposure that makes the victim more susceptible to serious infections that work through the bloodstream. Such infections can be septic which results in lengthy hospital stays and/or death. I suggest you read the article we did on the 5 best wheelchair cushions to prevent to prevent tailbone pain and pressure sores in the elderly.
Shoulder Pain or Rotator Cuff Injury
This is more than just about rotator cuff injuries from self-propelling a manual wheelchair. Some wheelchair users don’t acknowledge what is happening to their shoulders while their arms are just lying on the arm rests. A comfortable height for armrests should allow the shoulders to sit relatively neutral and the elbows at 90 degrees or slightly greater.
When the arm rests are positioned to high or if the user slouches, the shoulders are pushed higher above the collar bone, which over time wreaks havoc on the muscle tissue.
If left in this position too long, the wheelchair user starts to irreversibly lose shoulder range (lifting or retrieving items overhead, reaching and pulling up on a grab bar, etc.). This can be problematic for performing activities of daily living like dressing, hygiene care, transferring out of bed or doing daily tasks around the home.
Poor Hygiene and Infection
For this complication, we’re focusing on wheelchair users who have to additionally manage incontinence difficulties. Combining wheelchair use with catheter lines, colostomy/ileostomy bags, disposable diapers, paper chucks, and other incontinence items greater increases the chances for skin breakdown and infections if left unmanaged.
Soiled and wet materials left between the skin and the seat for long periods can cause pressure sores, skin infections and irritations, and urinary tract and kidney infections.
Upper/Lower Back and Joint Pain
It’s no mystery that prolonged sitting in any other circumstance performs a number on the spine. Therefore, sitting in a standard, upright wheelchair should be no different.
Numerous older adults are already battling breakdown and herniation in the spine and hips including herniated discs, osteoporosis, degenerative disc disease, scoliosis, kyphosis, and sciatica.
Sitting in one position for even one hour without movement can contribute to additional back and hip pain, joint displacement, and muscle tissue breakdown.
Generalized Edema From Prolonged Wheelchair Sitting
Edema, or lymphedema, is an accumulation of fluid that often pools in the upper and lower limbs because the body is failing to maintain it in the lymphatic system. The most common causes of lymphedema include invasive surgery, cancer and cancer treatment, and organ failure.
However, fluid can also collect in the legs and feet during prolonged sitting. This usually happens to adults who sit in an upright wheelchair with standard, non-elevating footrests because the fluid has nowhere else to go but down.
A trace amount of swelling is usually harmless and disappears with minor movement in the legs. Uncontrolled fluid build-up can damage blood veins and thin out skin making the lower limbs more susceptible to pressure sores
Muscle Atrophy ( Age Related Muscle Loss )
Lastly, sedentary wheelchair use reduces blood circulation and muscle contractions. This results in wasting away of muscle tissue because blood isn’t saturating the tissue efficiently and muscle fibers aren’t crossing each other smoothly to produce contractions to get body parts and joints to move.
This overall tissue wasting is called muscle atrophy, and it can morph into permanent damage to muscles if proactive steps aren’t taken.
Examples of movement problems include increasing difficulty transferring from a sitting to standing position, going from a sitting position to lying completely flat in bed, reaching overhead, straightening the arms at the elbows, and pointing the toes and ankles downward. At this point it will be difficult to perform any activity without the assistance of a family member or in home caregiver.
Sedentary complications from sitting in a wheelchair can happen to anyone, from those who are paralyzed from head to toe to those who use a wheelchair for only community outings.
If you are relatively new to your wheelchair or have little knowledge about complications from prolonged use, please consult with your family physician to see what you are most at-risk for and how to best prevent these unhealthy sedentary lifestyle behaviors.
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