Critical review of the research literature of seating interventions: a focus on adults with mobility impairments.

An expanding area in rehabilitation practice is the prescription of seating interventions for clients with mobility impairments. The goal of this intervention is to enhance comfort and functional performance. The purpose of this paper is to review the body of knowledge from the research literature concerning the effectiveness or impact of seating interventions for adults who have mobility impairments. In this review both the scope and the gaps in the literature are defined to identify areas for future research. Specifically, this review was undertaken to identify what outcomes have been examined and what methods have been used in carrying out the research studies. A content analysis based on the conceptual framework of the modified International Classification of Impairment, Disability, and Handicap (ICIDH) and review guidelines for evaluating the quality of research studies has been helpful in informing future research design in this area. The results of the 16 studies that comprised this review indicate that the majority of research conducted thus far has numerous methodological limitations, which in turn limits the extent to which this body of research can be drawn upon to provide evidence for effectiveness in seating interventions. There was an emphasis on constructs at the impairment level and inadequate attention to functional and psychosocial issues. Recommendations regarding future research required to support this specific type of intervention are presented. This research review is an important first step in facilitating discussion among researchers, clinicians, research funders, and seating device users regarding future priorities for research and development in this practice area.