That’s the opinion of Chris Maurer, MPT, ATP, who works in the seating & mobility clinic at Shepherd Center in Atlanta, regarding why so many wheelchair users don’t use their tilt systems as often as they should to perform weight shifts.

“Most spinal cord injury systems do educate people about skin issues,” Maurer says. “They have ugly pictures and all sorts of things to scare people into doing their weight shifts. I also think that when they go home, real life interferes. You go back to work, you’re watching TV, you’re talking to people, and you forget to [perform weight shifts] two to four times an hour.”

The most effective way to change a client’s actions for the better might not be showing more pictures of stage 4 pressure sores, but rather looking for ways to work weight shifting into the client’s day.

Some tips:

• TV commercial = Time to tilt:
  “Do a weight shift during every commercial,” Maurer suggests. “At the end of a half-hour show, weight shift.” The idea is to pair weight shifting with an activity that happens regularly, so that weight shifting becomes easier to remember.

• Privacy, please:
  Helping clients to create a way to tilt away from curious eyes could make them more willing to perform weight shifts. Maurer says she’s worked with a businesswoman “who is in an office by herself, and she’s still self conscious. I said, ‘Just shut the door so you can do it without worrying about people watching you tilt back.”

• “I’m just stretching”:
  Maggie Love, OTR, clinical education specialist with Permobil, suggests teaching clients to perform other types of weight shifts that they can use if they feel uncomfortable tilting in public, such as “leaning forward on a desk while doing computer/school work. ‘Stretching’ while leaning to each side was another weight shift that many of my clients felt was more socially acceptable in a public setting.”

• Incorporate technology:
  Love points out that weight-shift reminders via cell phone, watch or timer “are noticed immediately by the user, but not overly distracting in a public situation.” And don’t overlook the potential value of old-school technology, either. “I even had a client achieve success by using a clicker to log how many weight shifts she performed each day,” Love says. “She was shocked to discover she only performed three weight shifts that first day.”