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The area surrounding the ischial tuberosities is therefore particularly vulnerable to these pressures. Pelvic obliquity, when the pelvis is tipped at an angle, can lead to excessive weight being transferred to the sacral area [17].This often occurs so weight is redistributed as if rolling backwards off the back of the ischial tuberosities.

The seated individual potentially exposes a small area of their anatomy to considerable forces.Early findings suggest that the new risk indicator should include measures of degree of physical disability and ability to transfer as an integral part of self assessment and therefore prevention of pressure ulcers.The study was due for completion in the autumn of 2002.Inam and Firth [5] reported a prevalence of 4.9% in a study of over 1000 community patients and more recently Stockton and Parker [6] reported an overall prevalence of up to 58%.From the clinical experience of the authors of this paper, pressure ulcers are a frequent and distressing aspect of the management of persons with complex physical disability.

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