Taking proper and accurate measurements of the client is an essential part of the seating and wheeled mobility equipment provision process. According to the document A Clinican Application Guide to Standardized Wheelchair Seating Measures of the Body and Seating Support Surfaces, Revised Edition (Waugh & Crane 2013), there are two levels of linear body measurements that can be taken to ensure proper fit of a wheelchair. When an individual has a bariatric presentation, one may need to take Level 2 measurements. These measurements may include maximum lower body width, ischial depth, waist depth, and individual knee width.
During the assessment, landmarks may be difficult to palpate, so one may need to utilize these additional measures to accurately recommend support surfaces. Adipose tissue may be significant enough that "effective" linear measurements may need to be taken instead of actual linear measurement. "Effective" measures should be added to any length, depth, or width measure to indicate that the measure does not reflect the actual dimension of the body segment as defined, because the methodology has been altered in some way for clinical reasons. One should also consider the effects of adipose tissue on the measurements from supine to sitting and document accordingly. Lastly, the measurements should be taken without squeezing the adipose tissue, but may need to be slightly compressed using a hard measuring stick or caliper to ensure consistency with the measurement.
The Wheelchair Assessment Measuring Guide below shows the Level 1 Linear measurements and common Level 2 measurements used with the bariatric assessment.
Download the Bariatric Wheelchair Assessment Measuring Guide
Please refer to the Helpful Links section for access to a downloadable PDF of the Clinical Application Guide to Standardized Wheelchair Seating Measures of the Body and Seating Support Surfaces, which includes a definition and description of all of the linear measurements.