Effect of durations of wheelchair tilt-in-space and recline on skin perfusion over the ischial tuberosity in people with spinal cord injury

Arch Phys Med Rehabil, 2013 · DOI: 10.1016/j.apmr.2012.11.019 · Published: April 1, 2013

Spinal Cord Injury Assistive Technology Dermatology

Simple Explanation

This study investigates how different durations of tilting and reclining in a wheelchair affect blood flow to the skin over the ischial tuberosity (the bony part of the buttocks) in people with spinal cord injury (SCI). The goal is to find out if longer or shorter periods of tilt and recline are more effective in improving blood flow, which can help prevent pressure ulcers. The researchers compared three different durations: 3 minutes, 1 minute, and zero minutes (continuous sitting) of tilt and recline, and measured skin perfusion using laser Doppler flowmetry.

Study Duration

Not specified

Participants

9 power wheelchair users with SCI

Evidence Level

Not specified

Key Findings

1
A 3-minute duration of tilt-in-space and recline was more effective at enhancing skin perfusion during recovery compared to a 1-minute duration.
2
Skin perfusion during the second sitting period was significantly higher after the 3-minute tilt-in-space and recline compared to the 1-minute and zero-minute durations.
3
There was no significant difference in skin perfusion between the 1-minute and zero-minute durations.

Research Summary

This study evaluated the impact of different durations of wheelchair tilt-in-space and recline on skin perfusion over the ischial tuberosity in individuals with spinal cord injury (SCI). The findings suggest that a 3-minute duration of tilt and recline is more effective than a 1-minute duration in enhancing skin perfusion and that a 1-minute duration is not significantly different from continuous sitting. The results indicate that longer durations of tilt-in-space and recline may be necessary to adequately improve blood flow and reduce the risk of pressure ulcers in wheelchair users with SCI.

Practical Implications

Clinical Practice

Clinicians should consider recommending longer durations (e.g., 3 minutes) of wheelchair tilt-in-space and recline for individuals with SCI to improve skin perfusion and potentially reduce the risk of pressure ulcers.

Wheelchair Adjustment

Wheelchair users should be educated on the importance of using large angles of tilt-in-space and recline (at least 35° tilt-in-space and 120° recline) in combination with appropriate durations to maximize benefits.

Future Research

Further studies are needed to validate these findings and correlate the usage patterns of tilt-in-space and recline with the actual incidence of pressure ulcers in real-life settings.

Study Limitations

1
The study only assessed skin perfusion over a short time period.
2
The sample size was small (9 participants), which may limit the generalizability of the findings.
3
The study may not be applicable to all people with SCI due to variations in the level and severity of injury.

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