The Effects of Body Mass Composition and Cushion Type on Seat-Interface Pressure in Spinal Cord Injured Patients

Annals of Rehabilitation Medicine, 2015 · DOI: http://dx.doi.org/10.5535/arm.2015.39.6.971 · Published: December 1, 2015

Spinal Cord Injury Rehabilitation Dermatology

Simple Explanation

This study investigates how body composition (muscle, fat, water) and different wheelchair cushions affect pressure between the body and the seat in people with spinal cord injuries (SCI) compared to healthy individuals. The study found that while body composition differences exist between SCI and control groups, these differences don't directly correlate with seat pressure. However, lower muscle mass and body water in SCI patients may increase the risk of pressure ulcers. The research suggests that choosing a cushion and seating method tailored to each individual is more effective in reducing pressure than using a one-size-fits-all approach.

Study Duration

Not specified

Participants

20 SCI patients and 20 healthy adults

Evidence Level

Not specified

Key Findings

1
Body mass composition does not have a direct effect on seat-interface pressure in SCI patients or healthy controls.
2
The SCI group had significantly higher seat-interface pressure than the control group regardless of cushion type or sitting posture.
3
Three types of seat cushions (low-cost air cushion, 5-cm anti-decubitus air cushion, and 10-cm anti-decubitus air cushion) resulted in significant reduction in seat-interface pressure compared to no cushion.

Research Summary

The study aimed to determine the impact of body composition and cushion type on seat-interface pressure in SCI patients and healthy individuals. Body composition was measured, and seat-interface pressure was assessed using different cushions and sitting postures. Results showed that SCI patients had significantly lower muscle mass and body water in the lower extremities, and higher body fat, compared to the control group. However, there was no significant correlation between body mass composition and seat-interface pressure in either group. The use of seat cushions significantly reduced seat-interface pressure compared to no cushion, but different sitting postures did not result in significant pressure reduction. SCI patients consistently exhibited higher seat-interface pressure than the control group, regardless of cushion type or posture.

Practical Implications

Personalized Cushion Selection

Clinicians should consider individual patient characteristics like weight, BMI, and muscle mass when selecting wheelchair cushions to optimize pressure relief.

Muscle Strengthening

Rehabilitation programs for SCI patients should include exercises or electrical stimulation to increase skeletal muscle mass in the buttock area, potentially reducing the risk of pressure ulcers.

Low-Cost Cushion Use

Proper use of low-cost air cushions can effectively reduce seat-interface pressure, offering a cost-effective solution for pressure ulcer prevention.

Study Limitations

1
Age differences between the SCI and control groups may have influenced the results.
2
The study included a limited range of sitting postures, with only a 20-degree change in posterior leaning and trunk forward flexion.
3
The classification of the duration from onset or complete or incomplete paralysis in the statistical analysis of the SCI groups because due to a lack of individuals with SCI in our study sample.

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