How to Stop Someone Leaning To One Side in a Chair

As we age, our bodies go through changes that can result in mobility and postural issues. One common problem that many elderly people experience is leaning to one side while sitting in a chair. This can be due to a range of factors, from incorrect pelvic positioning, skeletal disorders, or poor muscle tone.

Leaning to one side in a chair can be uncomfortable and lead to other problems, such as pressure sores and increased risk of falls. Fortunately, there are specialist chairs and accessories available that can help to address this problem and provide people with the support and comfort needed.

In this article we look at medical reasons for leaning to one side in a chair and how you can prevent this from happening.

Jump straight to…

• • • What Causes Leaning To One Side
    • The Effects of Leaning To One Side
    • How to Fix Leaning To One Side
    • Conclusion
    • Frequently Asked Questions

What Causes Leaning To One Side?

What does it mean if you lean to one side in a chair? The factors that cause this issue fit into three main categories: the person, the chair, and the environment.

There is a direct relationship between the seat sizing, patient posture and pressure care.

The Person

Neurological problems

Parkinson’s Disease is caused by a reduction of the chemical dopamine in the brain, which helps regulate movement. As the dopamine level in the brain reduces, balance problems occur and patients find it harder to control their posture while sitting. Another symptom of Parkinson’s is muscle rigidity, or “stiffness”. If muscles become rigid on one side of the body it can cause patients to lean to one side.

Alzheimer’s patients tend to suffer with balance in the late stages of the disease as brain cells deteriorate. There is a specific kind of Alzheimer’s called posterior cortical atrophy, which affects balance in the brain, therefore causing leaning.

Is leaning a symptom of dementia?

PISA syndrome (or pleurothotonus) is a sustained sideways lean that can be associated with Lewy Body dementia, due to prolonged side effects of medication.

Poor muscle tone

As we get older, our muscle mass decreases as a proportion of our overall body mass and we have less core strength. This makes it harder for someone to maintain an upright posture while seated.

Skeletal disorders

Skeletal disorders like scoliosis occur where the spin twists and curves to one side.  It is characterised by a lean to one side and one shoulder blade being higher than the other. People who have scoliosis often experience lower back pain, stiffness and fatigue. We cover a lot of other skeletal disorders and other postural skeletal disorders covered in Chapter 6 of our seating e-book.

Osteoporosis can be a common cause of leaning to one side when sitting. With a reduction in bone mass, fractures in the spine can occur, causing a hunched posture or lean to one side to avoid pressure on painful areas of the back.

Scoliotic spine

Chronic Pain

Chronic back pain and sometimes nerve pain can occur as a result of the skeletal conditions outlined above. This can cause stiffness on one side, and sufferers often lean to one side to relieve the pain, particularly where nerves in the spine are affected.

Other chronic pain conditions like fibromyalgia can cause muscle pain and fatigue, making it harder to maintain an upright position.

Sciatica can also cause shooting pains that radiate from the lower back to the leg, causing someone to shift to one side to alleviate the pain.

The Chair

Size and the importance of seat measurements

Seat measurement in the context of specialist seating is the number one factor when considering a person’s posture and comfort because having the right seat dimensions can significantly impact the user’s comfort, support, and posture. A seat that is too small or too large can cause discomfort, pressure points, and poor alignment, which can exacerbate existing conditions or lead to new postural problems over time.

For example, if a chair is too small for the user, it can cause them to hunch over and place additional strain on their neck and shoulders, which can result in pain and discomfort. On the other hand, if the chair is too large, the user may struggle to maintain proper posture and could experience pressure points or circulation issues.

Additionally, seat measurement is especially important for those with conditions such as scoliosis or kyphosis, as these conditions can affect the shape of the spine and require custom seating solutions. A properly measured and fitted chair can provide the necessary support and alignment to alleviate discomfort and promote better posture.

How to Check Whether a Chair Fits Correctly

This checklist is useful for measuring chair dimensions correctly, which you can download with our free seat sizing guide.

Seat Height

• The feet should rest flat on the floor or footplate
• The knees and hips should be positioned at approximately 90 degrees.
• If the feet dangle or knees sit higher than hips, this can make posture unstable.

Seat Depth

When sitting fully back in the chair, there should be about two finger-widths of space between the front edge of the seat and the back of the knee.

A seat that is too deep will encourage slouching, while one that is too shallow reduces thigh support.

Seat Width

Seat width should give enough room to sit comfortably without feeling restricted.

Too much width can encourage leaning against the side of the chair as the armrests are too far away.

Armrest Height

Arms should rest naturally on the armrests with relaxed shoulders.

Armrests that are too low may cause the user to lean towards them for support, whereas armrests that are too high can cause a hunched posture and shoulder pain.

Why this matters

Even a small discrepancy in seat dimensions can misalign posture throughout the day. Correct measurements help maintain good postural alignment, improve comfort and reduce the chance of developing a lean.

Lateral Support

Lateral support is an important consideration when selecting patient chairs for healthcare facilities. If a patient does not have enough strength and support on each side of their upper body to ‘hold’ them in the chair they will tend to fall to one side.

Patients with conditions such as muscle weakness, spasticity, cerebral palsy, stroke, and postural collapse require optimal lateral support to prevent leaning to one side and to maintain good posture.

When selecting lateral support cushions, it is important to consider the material and design. Cushions should be made from high-quality materials and be adjustable to accommodate individualised positioning. This ensures that each patient receives optimal support and comfort, reducing the risk of discomfort and pain.

Selecting patient chairs with lateral support accessories is essential to maintain good posture and prevent health complications in patients with conditions that inhibit lateral support.

Pelvic positioning

Pelvic positioning is an important factor in maintaining proper posture while sitting. When the pelvis is not in the correct position, it can cause the body to lean to one side. This can be due to a range of factors, including weak muscles, injury, or deformity. Specialist seating can help address pelvic positioning issues by providing lateral supports and a wide range of adjustability options.

Specialist seating can help address pelvic positioning issues by providing lateral supports and a wide range of adjustability options. Our Lento patient treatment and therapy chairs are designed specifically to help with this and other regularly occurring issues.

The position of the pelvis in relation to the rest of the body is a key driver in postural science and we have dedicated chapter 5 to this topic in our seating e-book.

Other Factors

The Environment

You may puzzle slightly at how the external environment can affect a patient’s lean but consider the following. The direction that the windows are facing in a room and where the patient is situated may be causing them to lean to avoid the glare of strong sunlight. Have you ever been blinded by a mirror reflecting light into your eyes? It can be easy to overlook mundane factors like these, but careful consideration of the patient’s physical environment can bring surprising results.

Vision and Hearing Difficulties

Someone with partial hearing or vision loss may lean towards someone speaking to hear them, or lean towards an object like a TV to see it more clearly. For leaning that develops gradually over time with no clear postural issues, it may be worth getting a hearing or vision assessment alongside a seating review.

The Effects of Leaning To One Side

Having looked at the causes of the issue, this leads us on to look at the effects that prolonged leaning to one side in a chair can have.

Pressure sores

Increased pressure on the skin for long periods of time can cause pressure sores, particularly on bony areas like elbows or buttocks. They are more likely to develop if someone is leaning and resting heavily on one part of the body. With pressure sores, the skin and underlying tissue deteriorates, and they can progress and become very serious if not treated properly. Treating pressure sores coasts the NHS more than £3.8 million everyday so this is seen as a major issue in hospitals. At Vivid Care, we have done extensive research into what our products can do to help the issue and have dedicated a section to this in our seating e-book, see chapter 7.

Pressure can build on parts of the body that are in contact with the chair surface quickly.

Spinal deformities

As well as spinal deformities causing leaning, the reverse is true, so it is important to make sure postural issues are corrected when choosing the right type of seating so that a vicious cycle is not created.

Postural issues

Bad posture can cause muscle spasms and cramps, and even lead to complications like trapped nerves and intestinal problems.

How to Fix Leaning to One Side

So what can we do to stop someone leaning to one side in a chair?

Correct seat size

Choosing the correct seat dimensions is critical to ensure the chair fits the patient, and this will go a long way in minimising any leaning or postural issues. It is important to remember that seat size and posture are inextricably linked. Vivid.Care seating specialists are trained to measure the correct seat dimensions for any client. There are fully adjustable chairs available such as the Lento Mobile patient treatment rise and recliner chair that feature multiple adjustments ensuring a perfect fit for 80% of the adult population.

Supportive Cushions

Supportive cushions are an essential component of specialist seating for patients who require additional support while sitting. One such chair that is ideal for these environments is the Lento Mobile, a wheeled option that has been designed to provide maximum comfort and support.

The Lento Mobile chair can be fitted with a range of supportive cushions, which attach to the chair via infection control friendly magnetic fastenings. These cushions include the standard waterfall backrest, as well as attachable cocoon, wedge, and horseshoe cushions. Each of these cushions has been specifically designed to provide support to different parts of the body and can be tailored to the individual needs of the patient.

Lateral Waterfall Backrest

A waterfall backrest is the standard cushion option on the Lento Mobile rise and recline chair. It provides full support to the spine and helps users maintain a more upright sitting position.

For people who lean to one side due to poor posture, muscle weakness or spinal conditions, the waterfall design helps supports postural deformities with individually adjustable cushions. The middle lateral cushion provides additional support around the trunk, keeping the user central in the chair and reducing the tendency to lean to the side.

By improving postural support and comfort, the waterfall backrest can help minimise leaning.

Cocoon Cushion

The Cocoon Cushion provides support around the upper body, stabilising the shoulders, neck and trunk. Its cocooned shape helps users maintain an upright position and reduces the tendency to lean to one side.

By improving upper-body posture, the Cocoon Cushion increases comfort, reduce fatigue for longer sitting periods.

Cocoon backrest

Horseshoe Cushions

The Horseshoe Head Cushion supports around the head and neck for those who struggle to maintain an upright head position. By distributing pressure more evenly and helping to maintain a neutral spinal position, it can improve comfort and reduce strain while seated.

Lateral Support & Wedge Cushions

Lateral support cushions keep the torso centralised and upright, making them useful for people with poor trunk control or a tendency to lean to one side. By providing sideways support, they help improve alignment and sitting stability.

For the best results, lateral support and wedge cushions should be used alongside a correctly fitted chair and prescribed as part of a seating assessment.

Our Lento accessories pack includes lateral support cushions to create a comfortable spinal alignment.

Tilt-in-space

Choosing the correct motorised action in the chair gives your patient the ability to ‘tilt-in-space’, i.e. pivot backwards in the chair whilst maintaining the same seat angle. This sitting position distributes pressure more evenly across contact points and helps centralise their position in the chair.

Tilt-in-space functionality

Physical and mental wellbeing

The general wellbeing of the patient is an important factor in maintaining a confident and upright body posture.

Maintaining good physical strength and muscle mass is important for good posture, which can be achieved through gentle chair-based exercises, a nutritious diet and plenty of sunlight and fresh air.

Conclusion

To conclude, leaning to one side is an issue we come across in many applications and can become a serious problem over time if not corrected. There are many medical reasons for leaning to one side, but the choice and specification of chair is a key ingredient in resolving the issue.

Supportive cushions are a crucial component of any specialist seating solution, especially for those with specific medical conditions or mobility needs. The Lento Mobile chair, along with our range of attachable cushions, provides a comfortable and supportive seating option that can cater to a wide range of patient needs.

All of our attachable cushions are designed to be easily attached to the Lento Mobile rise and recline patient treatment chair via magnetic fastening, providing a secure and comfortable seating experience for patients. Whether you’re looking for a supportive cushion to alleviate discomfort or a wheeled chair for enhanced mobility, the Lento Mobile and our range of attachable supportive cushions can provide the ideal seating solution for your needs.

How Vivid Care Can Help:

If you are looking for a solution to stop leaning to one side in a chair, Vivid Care is here to help. We offer a range of specialist seating solutions that meet the unique needs of patients in healthcare facilities throughout the UK.

With lateral support accessories designed to meet the unique needs of individuals with different conditions. Our specialist seating is designed to provide comfort and support, reducing the risk of pressure sores and musculoskeletal disorders.

To ensure optimal lateral support, it is essential to select the right chair size and accessories. Our trained assessors and occupational therapists can help determine the appropriate chair size and lateral support accessories for each patient, taking into account their unique needs and preferences.

Would you like to arrange a seating assessment, or do you want more information on the Vivid.Care seating range? Please get in touch with our team.