Wheelchairs are an important partner for many older people to maintain mobility and integrate into society. However, a wheelchair-bound lifestyle poses health threats that cannot be ignored. Complications such as skin ulcers, muscle atrophy, cardiopulmonary decline and joint stiffness often silently erode the quality of life of the elderly. Living in a wheelchair for a long time has become a hidden war for the health of the elderly, and scientific prevention is the key to winning this war.
一. Four “invisible killers” of long-term wheelchair sitting
1. Pressure ulcers(bedsores): the silent destroyer
Risk points: Long-term pressure on bony protrusions such as the buttocks, ischial tuberosity, coccyx, spine, and heels can cause severe obstruction of local blood supply.
Reason: Thin skin, poor elasticity, decreased nutrition, dulled perception, and moisture, and moisture(incontinence or sweating).
Consequences: From skin redness and blisters to deep tissue ulceration, necrosis, and infection, treatment is difficult and the pain is enormous.
2. Muscle atrophy and weakness: loss of strength
Risk points: Long-term lack of weight-bearing and activity of the legs and core muscles.
Reason: Frequent use will make it develop, while infrequent use will gradually degenerate.
Consequences: More difficult transfers, increased risk of falls, decreased sitting stability, reduced metabolic rate.
3. Circulatory disorders and venous thrombosis: potential dangers
Risk points: Lower limbs(especially the deep veins in the calves).
Reason: Leg muscle contraction decreases(muscle pump failure), blood flow slows down; the elderly are often accompanied by decreased vascular elasticity.
Consequences: High risk of deep vein thrombosis, which may lead to pulmonary embolism(life-threatening) if it falls off; edema and pain in the feet.
4. Joint contractures and stiffness: loss of flexibility
Risk points: Hip knee and ankle joints are in flexion position for a long time; shoulder and elbow joints have limited movement.
Reason: Unbalanced muscle tone and lack of active joint of active joint movement.
Consequences: Reduced joint mobility, pain, decreased comfort, and deformed sitting posture.
二. Comprehensive prevention strategy: building multiple lines of health defense
1. Skin guard: stay away from pressure sores
Regular stress relief is the key:
Frequency: Perform small-scale”lifting hips”(lifting the body for 1-2 seconds by using the handrails) every 15-30 minutes; every 1-2 hours, others are required to assist in completely transferring or changing the sitting position(such as leaning forward or sideways≥30°)
Operation: You can put a triangular pad or a small pillow on the back to achieve body position deviation(alternate left and right).
Use professional pressure relief cushion:
Recommended types: Alternating inflatable air cushions, high-density foam cut cushions(customized to body shape), gel/fluid cushions. Consult a rehabilitation specialist to choose the right model.
Avoid: Ordinary seat cushions(such as donut-shaped air cushions) will compress local tissues and cause ulcers.
Daily skin testing and care:
Visual inspection+touch: Check the bony prominences(especially the coccyx and hips) in the morning and evening to see if there are any areas of persistent redness.
Hygiene maintenance: After cleansing, dry skin thoroughly, paying special attention to wrinkles. Use a mild moisturizer to prevent dryness.
Clothing selection: Underwear should be made of pure cotton to aviod seams rubbing against vulnerable areas.
2. Vitality guardian: fighting against muscle atrophy
Exercise program for wheelchair users:
Shoulder circles: Slowly more forward and backward in large circles to improve upper back flexibility.
Knee lifts: Sit up straight and alternately lift your knees(imitating marching in place) to strengthen your lower limb muscles.
Elastic band training: Hold the elastic band with both hands to perform resistance traning such as pushing forward and pulling backward on the upper limbs(3 times a week).
Seated balance exercise: Under safe supervision, try to maintain seated balance for a short period of time(starting from 5 seconds).
Get out of your wheelchair regularly:
Stand/walk short distances daily using a walker or brace depending on physical condition(if possible).
Perform bedside passive joint motion exercises(caregiver assists in knee and ankle flexion). Repeat key movements 10-15 times a day.
Standing frame assistance:
After medical evaluation, a wheelchair-to-standing conversion device can be tried(1-2 times a day, 10-20 minutes each time) to promote bone mass and circulation.
3. Circulation accelerator: preventing blood clots
Active/passive lower limb movements:
Foot “accelerator” action: Alternately curling your toes(dorsiflexion) and pressing down(plantar flexion) to stimulate the calf muscles to contract.
Leg elevation: Periodically elevate your legs(above heart level) on a leg rest to relieve swelling.
Family assistance: Passive massage of both lower limbs(gently massage from bottom to top to thighs).
Wearing medical elastic stockings:
Key benefits: Gradient pressure(highest at the ankle) improves venous return.
How to use: Put it on before getting up in the morning and take it off before going to bed at night(need to be customized according to actual size).
Rehydrate+beware of symptoms:
Make sure you drink enough water every day(more than 1500ml) to avoid dehydration which may lead to thichening of the blood.
Be alert to symptoms such as calf pain, redness, swelling and fever, and screen in time to eliminate the risk of venous thrombosis.
4. The battle for flexibility: maintaining joint function
Wheelchair posture adjustment:
The footrest height is appropriate(thighs can be laid flat without hanging in the air).
The back cushion keeps the spine in a neutral position and avoids hunching over when sitting.
The elbows can be naturally bent 90° and placed on the armrests.
Whole body joint movement exercises:
Do it twice a day morning and evening, covering the neck, shoulders, elbows, wrists, fingers, hips, knees and ankle joints(actively/assisted).
Special attention should be paid to strengthening ankle rotation(to prevent foot drop) and shoulder lifting training(to avoid frozen shoulder).
Stretching exercises:
Gently stretch the muscles that are prone to contracture(such as the back of the thigh and the back of the calf) for 15-30 seconds(under the guidance of a professional).
三. Four pillars that form the foundation of comprehensive health
1. Professional team collaboration:
Establish a collaborative model of rehabilitation physicians/physical therapists/nurses+caregivers.
Systematic functional assessment(muscle strength, range of motion,mobility) every six months.
2. Personalized care plan:
The plan should be adjusted dynamically based on the elderly’s mobility, underlying diseases, and nutritional status(e.g., diabetic patients need to dtrengthen pressure ulcer prevention).
Caregivers need to receive standardized training(correct movement of patients, use of assistive devices).
3. Nutritional support program:
Protein is the core: Ensure adequate intake of dairy products, fish, meat, beans and eggs(calculated at 1.2-1.5 grams per kilogram of body weight).
Key vitamin combination: Vitamin C(accelerates wound healing), vitamin D+calcium(protects bones), zinc(enhances skin resistance).
Water management: Determine the amount of water you drink according to your doctor’s orders(especially those with poor heart and kndney function who need to limit their water intake).
4. Psychological support nework:
Active participation in moderate community/social activities(e.g.chess, gardening) is encouraged.
Design interactive games/entertainment programs that are accessible to wheelchair users to slow down cognitive decline.
Be alert to depression(such as low mood, insomnia, and anorexia lasting for two weeks) and provide timely psychological intervention.
Post time: Jul-22-2025