title: Do tilt-in-space wheelchairs increase occupational engagement: a critical literature review.
abstract: OBJECTIVE
  A wheelchair can enhance the quality of life of an individual with limited mobility, poor trunk control and stability, by enabling activity and participation and so occupational engagement. High specification wheelchairs which can tilt-in-space enable the position of users to be altered to suit activity and context. Despite tilt-in-space wheelchairs being expensive little is known about their therapeutic value.
  
  
  METHODS
  A critical literature review of the evidence was undertaken to evaluate whether the use of tilt-in-space increases occupational engagement. A wide ranging search strategy identified 170 articles which were screened using inclusion criteria. The eligible literature (n = 6) was analysed thematically using open coding.
  
  
  RESULTS
  The majority of the participants used tilt-in-space but the data was too heterogeneous to combine. Measures of occupational engagement were not used so the therapeutic value could not be assessed.
  
  
  CONCLUSIONS
  There is a lack of high quality evidence about the therapeutic benefits of tilt-in-space wheelchairs. Given the expense associated with providing these wheelchairs, and the increase in their provision, research is needed to justify provision of high specification wheelchairs to meet the occupational needs of users within the limited resources of health and social care. Implications for Rehabilitation Tilt-in-space wheelchairs. Wheelchairs are an important and essential assistive device for promoting independence and function. Suggests there are benefits for tilt-in-space wheelchairs. Identifies the need for additional large scale research.
authors: a Wheelchair Services Department , Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Diana, Princess of Wales Hospital , North East Lincolnshire , UK and.
authors: Jenny
authors: J
authors: Harrand
authors: b Research Centre for Occupational and Mental Health, York St John University , York , UK.
authors: Katrina
authors: K
authors: Bannigan
mesh_terms: D006233:Persons with Disabilities; D004867:Equipment Design / Q000379:methods; D006801:Humans; D011187:Posture; D011788:Quality of Life; D013222:State Medicine; D006113:United Kingdom; D014910:Wheelchairs / Q000191:economics
keywords: Occupation; participation; tilt; tilted; tilting; variable position; varying position; wheelchair