Multi-joint Muscle Action on the Pelvis: Impact on Seating and Positioning


Vol 2, 2020, CEU Article Review



During seating and mobility evaluations it is best practice to begin analyzing flexibility, movement, and posture of the pelvis when planning seating and positioning interventions. Therefore a thorough understanding of multi-joint muscles is essential, in relation to the pelvis as a foundation for seating. The lumbar spine and lower extremities are connected by multi-joint muscle groups with the pelvis caught in the middle, often resulting in a complex chain of movements. Understanding these multi-joint movement patterns of the pelvis is key to successful, functional seating and positioning outcomes. We will show how they work, and describe how seating accommodations and 24-hour posture care management can mitigate and improve problems caused by multi-joint muscle dysfunction around the pelvis.

Learning Outcomes:
1. The participant will be able to identify three multi-joint muscle groups affecting pelvic posture and their unique actions.
2. The participant will be able to describe the differences between seating strategies for accommodating tight hamstrings vs hip flexors.
3. The participant will be able to explain the rationale for using postural support outside the wheelchair, in lying, as a corrective strategy for multi-joint muscle group limitations.

T. Sammie Wakefield is an occupational therapist who has worked in seating and mobility for over 37 years. She has degrees from Berea College and Texas Woman’s University and is a founding mother of New Hampshire ATECH – an assistive technology program that served clients in New Hampshire for over thirty years. Now retired from paid work, she continues her 13 years of volunteer work with Eleanore’s Project both as a board member, and by sharing her knowledge and skills with American OT students and therapists in Peru. She is the inventor of Hammie, a simplified anatomical model and teaching tool for understanding the multi-joint muscles of the pelvis.

Tamara Kittelson-Aldred is an occupational therapist, RESNA Assistive Technology Professional/Seating and Mobility Specialist, and holds advanced postural care certificates through the U.K. Open College Network West Midland. She directs the Montana Postural Care Project and Eleanore’s Project, promoting posture care and management with responsible wheelchair provision in low resource settings. Tamara has written and presented on these topics in the United States, Canada, Peru and Colombia. She has served individuals with complex neurodisabilities in Montana since 1983, currently through Moving Mountains Therapy Center, and is a Friend of NRRTS. She credits her daughter Eleanore, born with cerebral palsy and profound deafness, as her best teacher.