Do tilt-in-space wheelchairs increase occupational engagement: a critical literature review

Purpose: 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. Conclusion: 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.