Leaning to one side after a stroke, that is, the upper body tilting towards one side while seated, is a change to be described and assessed, not a position to be corrected by force. What matters is understanding whether it is already present when the person settles into the seat, whether it appears during an activity and which supports remain available. The description lays the groundwork for the discussion with professionals; an added cushion does not, on its own, explain the cause. [1, 4]
This guide concerns difficulties that are already known in the course of recovery after a stroke. If a new loss of balance, weakness, facial asymmetry or difficulty speaking appears suddenly, call the emergency services immediately. Do not wait for a consultation about the chair or for an observation sheet to be completed. [2]
In brief
A person who leans while seated after a stroke may need an assessment that takes into account motor abilities, spatial perception, supports and the activity being carried out. A family member can contribute by describing a typical episode: what the person was doing, how their body was positioned in the seat and what help was needed. The choice of chair then starts from these needs, with dimensions and adjustments consistent with the guidance received, without aiming for forced symmetry.
Saying “leans to the right” or “leans to the left” is not enough
The side towards which the upper body leans is useful information, but it does not describe the whole situation. It also matters at what point the position changes: while the person is talking, when reaching for an object, after the transfer to the chair or during a rest.
After a stroke, motor and cognitive difficulties may coexist, with effects on daily activities. The recommendations of the French National Authority for Health (Haute Autorité de Santé) stress the importance of assessment and rehabilitation adapted to the characteristics of the person. [1] It is therefore not correct to automatically put every lean down to weakness on one side alone.
The page dedicated to Sollevita for people who have had a stroke presents the broader picture of seating, standing up and transfers. This article, by contrast, focuses on one question: how can the lean be described during an activity so that the seating assessment becomes more precise?
Separate three observations: pelvis, trunk and activity
You do not need clinical terms to describe what happens. It is more useful to distinguish three visible aspects, without moving the body to check them.
The first is the starting position: is the person already leaning when settling into the seat, or do they start in a different posture? The second concerns the supports: do the pelvis, back and arms keep the expected contact? The third is the activity: does the position change while the person turns to someone, looks for the handset or tries to reach an object?
These observations must not turn into a diagnosis. Two similar descriptions may call for different assessments; even a photograph shows only a single moment. When the professionals have already given guidance, use their language to report what you have noticed and ask which details are genuinely useful.
For example, “during the conversation he leans towards the family member sitting on his left” and “he stays leaning even when he is not looking for anything” are different accounts. They do not prove a cause, but they avoid reducing both situations to the sentence “the chair doesn’t keep him upright”.
Choose a single everyday activity to describe
A short description can be more informative than a list covering the whole day. Choose an episode that has already happened and that is part of the daily routine: a conversation, watching television or a rest.
Report the context without recreating it. Do not ask the person to lean out, let go of a support or hold a position for longer in order to get a picture. Do not deliberately move objects from one side to the other as a test of attention.
In your account, separate what you saw from what you assume. “He was looking for the remote control and his upper body leaned over” describes a sequence. “He leaned because he can’t feel that side”, on the other hand, puts forward an explanation that must be assessed by whoever is overseeing the rehabilitation programme.
Also take into account what the person says: do they feel supported? Would they like a different support? Do they report pain or fatigue? Communication difficulties do not make their point of view irrelevant. Use the methods already agreed to listen to them, without imposing complex answers or turning the conversation into a test.
An episode sheet, not a test to carry out
This outline gathers information to discuss with your points of contact. It does not measure balance, does not assign a score and does not require the lean to be reproduced.
| Aspect | What to describe |
|---|---|
| Activity and time | What the person was doing and at what point in the day. |
| Starting position | Whether the lean was already present or appeared during the activity. |
| Part of the body observed | Upper body, head or a visible shift of the pelvis, without clinical interpretations. |
| Supports available | Backrest, armrest, leg support and any supports already prescribed. |
| Objects and people | Where the remote control, the screen or the person they were talking to were located. |
| Sensations and help | What the person reported, which activity was interrupted and which of the usual forms of help was needed. |
| Question to clarify | The point you would like to discuss with the professional or with the technical contact. |
An illustrative example: “During the afternoon conversation his upper body leaned to the left. The remote control was on the side table on the same side. We don’t know whether he was looking for the remote control or for a support; we stopped the activity and followed the guidance we had already received.” This is a description with an open question, not a clinical case or an explanation of the symptom.
If the behaviour is new or getting worse, reporting it comes before gathering information. The sheet is not a reason to wait for further episodes.
Link the supports to the activity observed
A seat must offer supports within reach and adequate space. A generous width does not automatically solve a difficulty in supporting the trunk; excessive depth can make contact with the backrest more difficult. This is why the size of the chair and the postural need should be considered together. [3]
Sollevita is available with seat widths of 52 or 63 cm and three seat depths. [3] Bring these figures to the assessment together with the supports already in use and the activity you have described. The discussion is about whether the supports can be reached, not about a promise to keep the trunk upright by choosing a particular size.
Distinguish what can be shown on the empty chair from what requires professional observation of the person. The distance to an armrest can be documented; the reason why someone loses support during a conversation cannot be deduced from the measurement alone.
The Swiss Paraplegic Centre describes an interdisciplinary approach to complex seating problems, including asymmetries and pain. [4] The reference concerns specialist assessment; it does not show that a particular width or a headrest can correct a neurological after-effect.
Gradual adjustments: offering possibilities, not forcing the body upright
Sollevita’s movements are designed to support changes of position slowly, smoothly and gradually. The adjustments can be used in the intermediate positions provided for, according to the needs of the person and the product instructions. [3]
This gradual approach is worth observing together with the supports: how does comfort change when the backrest is adjusted? Is the remote control still within reach? Does the caregiver understand which part is moving? There is no need to recline fully to assess a resting position.
Tilt-in-space tilts the seat and backrest together while keeping the angle between them. It is not a sideways tilt and it is not an automatic correction of the upper body. The Push Head powered headrest adjusts the support for the head and neck, but it does not replace specialist support when this is needed. [3]
The Sollevita Product page describes these technical possibilities. Here they are mentioned to help you understand which information to compare with individual guidance, not to prescribe a sequence of button presses after a stroke.
Cushions, arm and objects: avoid improvised solutions
A support recommended by the professionals must be included in the assessment of the new seat. It should not be removed because the backrest already seems comfortable, nor replaced with a cushion chosen only to get a more symmetrical photograph.
Do not improvise manual corrections of the upper body or the arm. Ask whoever is overseeing the rehabilitation which way of assisting to follow so that the person regains contact with the supports; if the assistance already recommended is difficult to apply in the current chair, describe exactly that obstacle. INRS (the French National Research and Safety Institute) links assisting a person’s mobility to their existing abilities and to individual guidance, not to extra force applied by the caregiver. [5]
For the remote control and everyday objects, there is no position to impose automatically on the right or on the left. Report where they are and how they are used; then ask whether the arrangement should be changed. Motor needs and needs related to attention may require specific guidance. [1]
If the problem only concerns reaching and using the handset, the guide on checking the controls with weak or painful hands deals with that task separately. Trunk lean should not be reduced to a problem with the remote control.
From description to a shared assessment
The professional in charge clarifies the postural need, any supports and the appropriate activities. The Sollevita Team provides information on the dimensions, components and adjustments of the chair. The family contributes its knowledge of the person’s day and relevant observations.
The discussion works when each party answers its own question: what the person needs, what the product offers and how the two can meet. There is no need to turn the family into a testing team or to choose a chair before a specialist need has been clarified.
Once the configuration has been defined, keep a note of the guidance that is useful for everyday use and share it with everyone who takes turns providing care. Support by video call from the Sollevita Team can help you understand the product; changes in health or in body control remain to be discussed with the professionals.
Reference sources
[2] French National Health Insurance (Assurance Maladie) — Stroke: what to do? (in French)
[3] Sollevita / La Castellana — Product documentation
Features taken from the documentation provided to the editorial team; the link points to the product page, not to a clinical verification.
[4] Swiss Paraplegic Centre — Centre for wheelchair seating (in French)
[5] INRS — The ALM approach: supporting the mobility of the person being assisted (in French)
The health sources support the principles referred to; they do not recommend or certify Sollevita. Tables and examples were prepared by the editorial team; they are not clinical tests or documented cases.
The person comes before the chair
Share with the Sollevita Team the activities you would like to make more comfortable and the guidance you have already received on supports. We can clarify dimensions and adjustments to discuss with the professionals, so that the choice respects the person’s body, habits and level of care, without forcing either their posture or the purchase decision.
