Dynamic Changes in Seating Pressure Gradients in Wheelchair Users with Spinal Cord Injury

Assist Technol., 2020 · DOI: 10.1080/10400435.2018.1546781 · Published: September 2, 2020

Spinal Cord Injury Assistive Technology Biomedical

Simple Explanation

This study examines how different wheelchair tilt and recline angles affect pressure on the buttocks of people with spinal cord injuries, focusing on peak pressure gradients (PPGs). The research looks at both the strength (magnitude) and direction of these pressure gradients, which can impact blood flow and tissue stress, potentially leading to pressure ulcers. The findings suggest that recline is more effective at reducing the overall pressure, while tilt is better at changing the direction of pressure, potentially offering different benefits for preventing pressure ulcers.

Study Duration

Not specified

Participants

13 power wheelchair users with SCI

Evidence Level

Not specified

Key Findings

1
Wheelchair recline is more effective at reducing the magnitude of peak pressure gradients (PPGs) under the ischial tuberosity.
2
Wheelchair tilt is more effective at manipulating the direction of peak pressure gradients (PPGs) under the ischial tuberosity.
3
Significant changes in PPG magnitudes did not always correspond to significant changes in PPG directions, suggesting that both should be assessed.

Research Summary

This study investigated the effects of wheelchair tilt and recline combinations on seating pressure gradients (PPGs) in individuals with spinal cord injury (SCI). The research focused on both the magnitude and direction of PPGs under the ischial tuberosity to understand their potential roles in pressure ulcer prevention. The findings suggest that wheelchair recline is more effective in reducing PPG magnitudes, while tilt is more effective in manipulating PPG directions, offering potentially distinct benefits for pressure ulcer prevention strategies.

Practical Implications

Personalized Wheelchair Adjustments

Clinicians can use the findings to tailor wheelchair tilt and recline settings to minimize pressure and shear stress, potentially reducing the risk of pressure ulcers in individuals with SCI.

Targeted Pressure Relief Strategies

The study suggests that recline may be prioritized for reducing pressure magnitude, while tilt can be used to alter pressure direction, offering targeted strategies for pressure relief.

Future Research Directions

Further research is needed to investigate the relationship between PPG directional characteristics and tissue viability, which could lead to more precise diagnostic and preventative measures.

Study Limitations

1
Analysis of PPG parameters was limited to the left ischial tuberosity due to the placement of a laser Doppler probe on the right side.
2
The study involved a relatively small sample size of 13 wheelchair users with SCI.
3
Participants used a standardized precontoured cushion, which may not reflect the effects of their everyday cushions.

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