Pressure redistributing in-seat movement activities by persons with spinal cord injury over multiple epochs

PLoS ONE, 2019 · DOI: https://doi.org/10.1371/journal.pone.0210978 · Published: February 13, 2019

Spinal Cord Injury Rehabilitation Dermatology

Simple Explanation

This study monitored weight shift activity of full-time wheelchair users with spinal cord injury. The aim was to determine consistency or routine within and across different time periods. The study also evaluated the accuracy of self-reported pressure relief frequency.

Study Duration

Multiple epochs, each lasting more than 1 week

Participants

17 full-time wheelchair users with spinal cord injury

Evidence Level

Not specified

Key Findings

1
No consistent pattern of activity changes emerged across all in-seat activity metrics.
2
Subjects tended to overestimate their frequency of performing pressure reliefs.
3
In-seat movement does not reflect a routine, either in pressure reliefs, weight shifts or other functional in-seat movements.

Research Summary

The objective of this study was to monitor the weight shift activity of full-time wheelchair users with acute spinal cord injury over multiple epochs of time in order to determine consistency or routine within and across epochs. Subjects tended to over-estimate their frequency of performing pressure reliefs. Self-reported pressure relief behaviors are not reliable, and therefore, cannot be used to evaluate preventative behaviors either clinically or within research. The results indicated that in-seat movement does not reflect a routine, either in pressure reliefs, weight shifts or other functional in-seat movements.

Practical Implications

Clinical Implications

Improved clinical techniques are needed to develop routine behaviors to prevent pressure ulcers.

Research Implications

Self-reported pressure relief behaviors are not reliable and should not be used to evaluate preventative behaviors.

Intervention Design

Pressure redistributing activities need to include more than volitional pressure reliefs, considering other pressure redistributing events like weight shifts.

Study Limitations

1
Small cohort of full-time wheelchair users with spinal cord injury
2
Imbalance of the times between measurement epochs
3
Drawing conclusions about changes in behavior over time is not possible with this dataset.

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