Load Redistribution in Variable Position Wheelchairs in People With Spinal Cord Injury

J Spinal Cord Med, 2010 · DOI: · Published: February 1, 2010

Spinal Cord Injury Assistive Technology Dermatology

Simple Explanation

This study examines how different wheelchair positions (tilting, reclining, and standing) affect the distribution of pressure on the body, especially for people with spinal cord injuries who are at high risk for pressure ulcers. The researchers measured the forces on the seat and backrest in these different positions to see how much each position reduced pressure on the buttocks. The study found that standing and reclining resulted in greater pressure reduction compared to tilting. Standing also reduced pressure on the backrest.

Study Duration

Not specified

Participants

6 able-bodied subjects and 10 subjects with spinal cord injury

Evidence Level

Not specified

Key Findings

1
Normalized seat loads had strong linear relationships with the angles of change in tilt, recline, and standing for both able-bodied and SCI groups.
2
Maximum decreases in seat load occurred at full standing and full recline in the SCI subjects and in full standing in the AB subjects.
3
Standing also reduced loading on the backrest.

Research Summary

This study provides quantitative information on the magnitudes of loading on the seat and back during phases of tilt, recline, and standing. The objective of this study was to show that the amount of force reduction at the seat would differ across these 3 methods within their respective clinical ranges. The results of this study indicate that tilt, recline, and standing systems should be considered as a means of weight shifting for wheelchair users.

Practical Implications

Clinical Practice

Clinicians should consider tilt, recline, and standing systems as options for weight shifting in wheelchair users to prevent pressure ulcers.

Rehabilitation

Rehabilitation programs should incorporate training on the benefits and drawbacks of each variable positioning method (tilt, recline, standing) for pressure relief.

Wheelchair Prescription

When prescribing wheelchairs, consider the individual's needs and abilities to determine the most effective variable position system for pressure management and functional activities.

Study Limitations

1
The study measured forces on the seat and backrest during variable positioning maneuvers, obviating the ability to use the results to track pressure changes at specific body locations
2
Because only normal force was measured, the impact of friction and shear was not quantified.
3
Commercial recline and standing devices differ in system articulation. Therefore, some difference in how weight is shifted may occur over their respective ranges.

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