Your Second Skin.
Let a Doctor Prescribe It.

The core objective of clinical wheelchair seating is the management of interface pressure and the stabilization of the pelvis. The pelvis serves as the biomechanical foundation for the entire seated posture. In a standard sling wheelchair, the hammock effect forces the femurs into internal rotation and the pelvis into a severe posterior pelvic tilt. This shifts the patient's center of gravity directly onto the sacrum and coccyx—areas with minimal subcutaneous tissue—creating extreme interface pressure and shear forces that rapidly occlude capillary blood flow, resulting in ischemic tissue necrosis (pressure ulcers). Our clinical seating assessment utilizes firm, contoured bases and highly specialized materials (like viscoelastic foam or ROHO air-cell cushions) to maintain a neutral or font-weight: 500; anterior pelvic tilt. This deliberately shifts the weight-bearing load onto the ischial tuberosities and posterior thighs, safely distributing the force over a vast surface area and neutralizing shear.

At Tera Care, prescribing a wheelchair begins outside of the chair. Dr. Rabara performs a comprehensive Mechanical Assessment Tool (MAT) evaluation. The patient is first assessed in a supine position (lying down) on a clinical mat to eliminate the influence of gravity. This allows the clinician to differentiate between fixed orthopedic deformities (which the wheelchair must accommodate) and flexible postural asymmetries (which the wheelchair seating system must actively correct). We measure hamstring length, hip flexion limits, and spinal mobility. Only by establishing these baseline biomechanical parameters can we accurately specify the required seat-to-back angle, footrest hanger angle, and lateral thoracic supports required to achieve optimal seating.

The most critical risk factor evaluated during a seating clinic is the patient's insensate skin (lack of physical sensation). Patients with complete spinal cord injuries or severe diabetic neuropathy cannot feel the ischemic pain that normally prompts a healthy individual to shift their weight. Without this biofeedback mechanism, catastrophic stage III or IV pressure ulcers can develop in a matter of hours. During the assessment, Dr. Rabara evaluates the patient's pressure relief capabilities (e.g., can they perform a wheelchair push-up, or do they require a power-tilt-in-space mechanism?). The seating prescription is then engineered entirely around mitigating these specific dermatological and vascular risks.

For patients presenting with severe neuromuscular conditions (such as ALS or high-level cervical spinal cord injuries) who lack the upper extremity strength to propel a manual chair or use a standard joystick, Dr. Rabara's assessment expands into Complex Rehab Technology (CRT). We evaluate the patient's remaining voluntary motor control to prescribe alternative drive systems. This may involve sip-and-puff mechanisms, head-array switches, or chin controls. Additionally, the assessment will dictate the necessity of power positioning features—such as power tilt-in-space, power recline, or elevating leg rests—which are medically vital for patients who cannot independently manage their own weight shifts to prevent pressure injuries.