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alterations for wheel chair patients

sarahemily | Posted in Fitting on

I would really appreciate some advice on alterations for a blouse for a wheel chair patient.  I made a top that fits well except it pouches out in the center front, seems hollow above the bust and is too long.  I can make it shorter easily but am wondering about shortening the center front length to remove the pouching.  Would I make a V shaped fold in the pattern with the point of the v at the side seams?  I think that the sides and the back need to stay the regular length. 

I made the mock up of cotton and the fabric that I will be using for the blouse is rayon that looks like it is sandwashed.  It may drape better than the cotton but I don’t want it to pouch out.  The top has princess lines and I don’t think that is the type pattern I want as her bust seems lower than the pattern.  Perhaps princess lines make her bust appear to be low  or close to her waist.  Maybe I should find a pattern with no bust darts?  I used Burda 8503 size 22.  None of the ready made blouses that she wears have bust darts.  This garment will be for my friends’ son’s wedding and I had hoped to give it more shape and style than her usual cotton blouses. 

Any suggestions would be appreciated.  Does anyone know any references for information on clothing construction for wheel chair bound people? 


  1. jscraphappy | | #1

    Instead of a blouse & skirt which can bundle up why not a smooth/princessstyle/ teeshirt dress (tasteful fabric) that will sit nice without being bunched /comfortable & give a nice line.nothing worse than wrinkles & bumps for someone to sit on.no belt/waiistband either to cut of the middle.hope this may help.

  2. Michelle | | #2

    I seem to remember a thread in this forum several months ago that discussed sewing  for the physically challenged.  Perhaps if you do a search in the archives you might come across it.  (ie click on 'Advanced search')


    Edited 8/1/2003 7:59:12 AM ET by shelly

  3. SEWWRITER | | #3

    Virginia, I worked with wheel-chair clients.  The pouching above the bustline is likely due to the fact that her shoulders are rolled forward, thus collapsing the upper chest.  It's the front neckline that needs adjusting. (Even standing people need this adjustment when they've developed a rounded upper back.)

    Have her put on the blouse you made and pin out the excess.  Imagine a point on either side of the neck, half way between the shoulder line and center front. Start pinning there on both right and left sides.  Angle the excess toward the armhole, to a point about 1/3 of the way down from the shoulder line.  In your case, if the princess seam you spoke of ends at the shoulder, the pinned-out area will cross the princess line.  That's OK.

    What to do the pattern: if the princess seams end at the shoulder, tape the pattern together on the seamline.  Then, slash it from neckline to the seamline (not the cut line) of the armhole.  Overlap the slash as needed and tape closed.  Place any collar, facing, or other neckline treatment on top of the adjusted pattern and record the same changes. 

    As for the lower bust, well, it probably is at her waist.  Making that adjustment isn't rocket science, but it would require some illustrations.  Any decent book on fitting will show this.

    If you plan to try another pattern and your current one has princess seams that end at the armhole, consider one that ends at the shoulder instead.  It's a lot more accessible on a seated client and is much easier to adjust.

    Finally, about the length: What you need to do for her is create a contoured hemline.  Make the neckline and bustline adjustments first, then have her put on another mock-up.  Turn up a hem that will hang flat and plan to finish it with a facing.

    There is an out of print book entitled Design Without Limits.  It doesn't do the best job of explaining the pattern adjustments per se, but it will help you understand where the wrinkles/pouching/discomfort come from.  A web search might turn up a copy.  At one time, it was published by Simplicity, but I believe there was another previous publisher.

    -Stephanie Corina Goddard-                                                                              Member, Professional Association of Custom Clothiers (PACC)

    Edited 8/1/2003 8:36:55 AM ET by SEWWRITER

  4. Tish | | #4

    Virginia, clothing my mother in her last years was difficult due to a combination of her lack of muscle control, leading to slumped posture, and severe osteoporosis with its "dowager's hump."  We also had trouble getting her in and out of her clothes because she couldn't help us help her.  I hope your blouse client doesn't have all these problems.  Anyway, Threads had an article on fitting for curved back and "Dowager's hump" in issue #83.  If you have back issues, that might help you.

    1. sarahemily | | #5

      Thank you for the suggestions! 

      We had our second fitting yesterday and I felt so much better about the fit!  I took the excess fullness out of the neckline and the pouchiness in front is gone.  I also used the princess line seam from the shoulder and it worked great.  I think that it feels and looks very different to her as she wears such loose, unstructered clothing.  It is quite slimming on her.

      I'm uncertain what was meant by using a contour hem.  Stephanie, could you please explain that to me?  Do you mean slightly curved down from the sides to the center front?

      The Burda pattern that I have altered has long sleeves with a dart to take the fullness out and shape for the elbow.  I will be making 3/4 lenghth sleeves.  Should I put in a short dart or leave it with no dart?  I don't think it makes any difference when dressing her.

      I'm ready to begin! Thanks again!

      1. SEWWRITER | | #6

        Hello again Virginia.  On a seated figure, the center front is going to be shorter than the sides or back.


        1. sarahemily | | #7

          Good Morning! 

          When I read your answer to my husband, he said, "That's what I thought, especially on the skirt."  I feel like a dolt, but did you mean skirt and the top?  I have always made her skirts the same length all the way around.  She likes them long as she has heavy legs.  One thing that I wish I could change is that the skirt falls between her legs-her knees are at least 10-12 inches apart.  She can't bring them together.  She doesn't wear a slip.  Any suggestions for that sinking?  I have to use jacket zippers on the skirts and the weight of the zipper also pulls the skirt down.  I will ask her husband to turn the zipper to the side for these outfits, but the skirt will still fall between her legs. 

          Thank you.  Virginia

          1. SisterT | | #8

            I am speaking from pragmatism and not from experience, so take this with a grain of salt.  Would it be possible to make an underskirt, like a lining, that is more narrow and fits more securely over her legs, and that would allow the fuller outer skirt to drape over it for a nicer fit and modesty?


          2. sarahemily | | #9

            That is a possibility, I think.  I could sew lining in with the zipper seam allowance and just do it in the front-perhaps I would need to have elastic just in the back for the waist and very slightly gathered (sewn together but gathered separately) across the front- or it might be more slenderizing to have the outer fabric with a couple of pleats on each side of the center front.  I wonder if that would make the outside pull in (the lining being smaller than the outside fabric)or fall in a strange way.

            I don't want to tell her that I don't like the dip-she has enough on her plate.  It could just be that there would be a lining for the wedding ensembles.  I don't think that I could do a mock up skirt.  I have made 8 or 10 skirts for her and never made a mock-up before.

            Thanks for the suggestion.

          3. stitchmd | | #10

            How about a "split skirt" which is just another name for long, loose culottes. You ought to consider making the back of the skirt longer to accommodate the sitting position. Fabric can bunch up on the front of the skirt too.

            Do the lady's thighs rest against the sides of the wheelchair frame? If she has her own wheelchair, as opposed to one provided by a nursing home, she can get attachments to hold her legs in a better position. If not there are quick, temporary ways to hold her legs closer together. The problem is actually at the hips, which are rotated to the outside. This can be improved by putting something between the thigh and the flat side of the wheelchair seat frame. You could use a rolled towel for instance, or for the occasion you could make a quick roll or long, narrow rectangular pillow covered in an elegant fabric. If she is large and already wedged into a too-narrow seat her legs can be held closer just below the knee with a soft, cushioned band with a velcro closure. Check with her doctor or other health care person for circulatory issues before you put even this much pressure on her legs. Have her try it out for an hour with checks every 15 minutes for red marks indicating too much pressure.

            I suggest she have a physical or occupational therapist knowlegeable in seating evaluate for improving her posture and support in the chair. Something as simple as replacing the stretched out back support can improve trunk position.

          4. sarahemily | | #11

            Thank you for the suggestions.  She is at home with her own wheelchair, which now adjusts like the back of a car seat.  Why didn't someone think of that several years ago?  Her husband has total home care of her. On some disablitity chart, she is 8 1/2 of 10. She really can't help at all. It is easier for him to dress her with a skirt that has an elastic waist-he puts it around her, hooks the waist and can use the long separating zipper after he sits her down.  She probably takes a  size large- 18 ready made, probably. 

             I really haven't noticed how tight her thighs are against the chair.  I don't think that it bothers her that her knees are apart.  It is a bit tricky and I may just think about the soft cloth and velcro and discuss it with the other two ladies who are special friends.   I don't want to make more work for her husband.

            I don't know if her husband has had someone check her seating position.   I think that her husband has become very knowledgeable about her disease.  She has told us that a few of the doctors have been impressed with his research. She has had a number of different wheel chairs. 

            I appreciate your ideas. 

          5. stitchmd | | #12

            This topic just came up on another forum and these sites were recommended




            (this site has alot of other great links, scroll down the page)

          6. SisterT | | #13


            I have been thinking about the skirt and the fact that she sits with her knees apart.  My initial impule was to fix the gap.....Instead of correcting the visual--she sits with her knees apart--is it possible to make her skirts with enough fullness in the front and of a fabric weight that softens the lines so that it does not look too bad?  Maybe her comfort is more important?

            We have been through this with some of our older Sisters who are wheelchair bound.  At some point we have had to accept the fact that people would rather be able to be around them, and those people would not care if the Sisters were dressed in newspapers and sitting on a cardboard box!  :)

            Sr. Tracey

          7. sarahemily | | #14

            You are so right!  Our friendship is the most important thing!

            There are three friends that visit with our former co-worker at her home every 4-6 weeks for a long afternoon of food, laughter, tears and much caring for each other.  We have been doing this for 12 years now.  We have shared so much.  One of our friends has become a cancer survivor during that time.  We all are blessed to have strong marriages.  Sometimes our friend says that she thinks we just come to see her as a sense of duty-not that we want to.  We assure her that she has an important part in our lives also.  We cherish our times together. The last few times (spring is always hardest for her) have been difficult in that we are doing some grieving for some recent loss of some of her activities. We know that she and her husband are also adjusting to this new level of activity. 

            We know that this wedding is not going to be easy for her.  The bride is from the midwest (we live in WA) and our friend always thought the wedding would be far away and she would watch the VCR tape and that was just fine with her.  Well, the bride and groom moved the whole wedding out here and she thinks they did it just because of her.  She hasn't met the bride's parents, etc. so it is going to be many new situations.  So, we think if she looks like a million dollars, it well all be a bit easier for her.  We tell her that she has more courage than anyone we know.  Fortunately, she is happy for her son and his bride.

            Thank you for your thoughts and advice.  Each of you have been such a help for me!  

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