Wheelchair backs that support the spinal curves: Assessing postural and functional changes

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2020.1760530 · Published: March 1, 2022

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study compares the effects of two types of wheelchair backs on posture and function in people with spinal cord injuries. One back is designed to support the natural curves of the spine, while the other is a standard upholstered back. The research found that the solid back, which supports spinal curves, led to better posture, improved functional reach, and increased satisfaction among participants compared to the standard upholstered back. The solid back promotes a more neutral pelvic position and spinal alignment, which can enhance stability and functional mobility for wheelchair users with spinal cord injuries.

Study Duration

Not specified

Participants

50 adults with motor complete SCI C6-T4, between the ages of 18–60 years who use a manual wheelchair

Evidence Level

Cross-over intervention

Key Findings

1
The solid back significantly reduced posterior pelvic tilt compared to the upholstery back, indicating improved upright posture.
2
Participants using the solid back showed trends toward higher scores in functional outcome measures, including vertical forward reach and one-stroke push distance.
3
Participants reported increased satisfaction with the solid back in terms of comfort and stability compared to the upholstery back.

Research Summary

This study investigated whether a solid back, designed to support natural spinal curves, improves postural alignment, forward reach, respiratory function, and wheelchair mobility compared to an upholstery back. Results suggest the solid back promotes a more neutral pelvis, improves functional mobility, and increases comfort and overall satisfaction compared to a standard upholstery back. Data trended toward higher vertical forward reach, further one stroke push, and faster timed push and ramp ascent. Statistical significance was not reached due to the relatively low number of participants and high variability in this pilot study, but clinical significance was observed in vertical forward reach and one stroke push tests.

Practical Implications

Improved Wheelchair Prescription

Clinicians can use the findings to make informed decisions about wheelchair back support selection, potentially improving posture and function for manual wheelchair users with SCI.

Enhanced Functional Outcomes

The solid back's demonstrated trends toward improved functional reach and propulsion suggest it may enhance independence and mobility for individuals with SCI.

Increased User Satisfaction

Higher user satisfaction with comfort and stability associated with the solid back implies better adherence and overall quality of life for wheelchair users.

Study Limitations

1
The sample size did not provide adequate statistical power to determine statistical significance.
2
The variability of performance, level, and chronicity of injury may have impacted the results.
3
The study did not evaluate the effect of lateral stability in participants.

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