Backrest Shape Affects Head–Neck Alignment and Seated Pressure

Ukita, Atsuki; Nishimura, Shigeo; Kishigami, Hirotoshi; Hatta, Tatsuo

doi:10.1260/2040-2295.6.2.179

Cited by 5 publications

(8 citation statements)

References 33 publications

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“…On P-WC, upright head-neck alignment and backward inclination of the trunk were observed. This supports the results of a previous study that the new P-WC eliminated a forward head posture and expanded cervical movement [29,30]. From a kinematic perspective, the mass of the head, neck, and trunk accounts for 64.4% of total body weight [50], and this mass is positioned forward relative to the spine when seated upright.…”

Section: Measured Variablessupporting

confidence: 89%

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Does the backrest shape of the wheelchair influence the asymmetric posture of patients with hemiparesis? A single institution pilot study

Ukita¹,

Abe²,

Nikaido³

et al. 2017

Biomed Res Clin Prac

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We have previously reported the effect of wheelchair with a unique backrest shape with pelvic and thoracic support (P-WC) on healthy individuals. However, the actual effect of P-WC on real users is still unclear. Therefore, the purpose of this study was to investigate the effect of different backrest shapes on asymmetric seated posture and pressure points in patients with hemiplegia. We compared a typical wheelchair with a flat backrest (T-WC) to P-WC. Ten subjects with hemiparesis were analyzed. Outcome measures were body alignment angles and pressure distributions of the supporting surfaces. The total seat pressure decreased (p<0.01) and total back pressure increased (p<0.05), in P-WC compared with T-WC. The head-neck was more upright (p<0.05) in P-WC than in T-WC. Moreover, the center of pressure was located in the middle of both the seat and backrest (p<0.05), and the high unilateral pressure around the ischial tuberosity was dispersed (p<0.05) in P-WC. In conclusion, the backrest shape of the P-WC contributes to reducing postural asymmetry. These results highlight the importance of the shape of the wheelchair backrest for patients with hemiparesis.

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Section: Measured Variablessupporting

confidence: 89%

“…The backrest of P-WC effectively promotes upright alignment of the head and neck in healthy individuals and the elderly [29,30]. However, the P-WC's potential to correct asymmetrical posture in patients with hemiparesis has not yet been investigated.…”

Section: Introductionmentioning

confidence: 99%

Does the backrest shape of the wheelchair influence the asymmetric posture of patients with hemiparesis? A single institution pilot study

Ukita¹,

Abe²,

Nikaido³

et al. 2017

Biomed Res Clin Prac

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“…Regarding preactive sitting posture, on the BS plane, the contact area between the wheelchair and patient, including the PL part, was increased and the COP was located nearer to the center of the supporting surface in P-WC than in C-WC. These results support the outcomes of our previous studies involving both stroke patients and healthy adults in static experiments [25,26]. The P-WC BS post is inclined backward in three stages, with a 100˚-wide angle design in the PL region as compared with a 96˚-wide angle design in C-WC.…”

Section: Plos Onesupporting

confidence: 89%

“…Focusing on the shape of C-WC, a previous study suggested that the contact area between the wheelchair and back (i.e., trunk including pelvis) was poor both in stroke patients and healthy adults [25,26]. The pelvis is the foundation of sitting posture and affects trunk positioning and lumbar and cervical spine alignment [27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Influence of back support shape in wheelchairs offering pelvic support on asymmetrical sitting posture and pressure points during reaching tasks in stroke patients

Ukita

Abe

Kishigami³

et al. 2020

PLoS ONE

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Many poststroke hemiplegic patients have an asymmetrical wheelchair-sitting posture. This study aimed to investigate the impact of different back support shapes on asymmetrical sitting posture and pressure points among poststroke hemiplegic patients during an activities of daily living-related reaching task. This study included 23 poststroke hemiplegic patients who performed tasks that involved the movement of objects using the unaffected upper limb to the affected side while sitting in a conventional wheelchair (C-WC) with a flat back support or a wheelchair providing pelvic and thoracic support (P-WC). Body alignment angles from video images and pressure distribution on supporting surfaces were measured using a twodimensional motion analysis software (Dartfish) and a pressure mapping system (FSA). Regarding movement performance, although postural asymmetry increased in both wheelchair types, the degree of postural variation was smaller with P-WC use than C-WC use (p < 0.05), with partly reduced postural asymmetry. With P-WC, one-sided ischial asymmetrical pressure was significantly less after the movement (p < 0.05). In conclusion, P-WC's back support shape contributed to a decrease in postural asymmetry for pelvic girdle support both at rest and during movement. This highlights the importance of a wheelchair back support shape and may help to increase the quality of activities of daily living movement in poststroke hemiplegic patients in wheelchairs.

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“…The back support of the standard type wheelchair comprises two parallel rods and a flat cover, which does not support individuals with kyphosis. As the trunk is pushed forward, these individuals exhibited a Forward Head Posture [2][3][4]. FHP not only fatigues the erector spinae muscle but also increases the integrated muscle activity of the suprahyoid muscle during swallowing [5,6].…”

Section: Introductionmentioning

confidence: 99%

The effect of a wheelchair with pelvic support belt on respiratory function

Okuno¹,

Nakai²,

Kishigami³

et al. 2018

Dis Disord

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Decreased respiratory function is associated with a slouched posture in a wheelchair for elderly persons with severe kyphosis. We compared the use of a wheelchair with a pelvic support belt and standard wheelchair use in persons with severe kyphosis. The subjects were 22 healthy individuals. We assessed head, neck, and trunk posture; forced vital capacity (FVC), percent predicted forced expiratory volume in 1 second (FEV 1 ), tidal volume (VT), respiratory frequency, VO 2 , and VCO 2. We found that the use of a wheelchair equipped with a pelvic support belt improved head and neck alignment and reduced forward motion in the trunk. No significant differences between the two types of wheelchairs were found in terms of VO 2 and VCO 2 . However, use of a wheelchair with a pelvic support belt was associated with increases in FVC and FEV 1 . Additionally, use of a wheelchair with a pelvic support belt was associated with greater VT and was larger than that of WC. And the respiratory frequency in those using a wheelchair with a pelvic support belt was smaller than that of WC. The postural changes that resulted from the use of a wheelchair with a pelvic support belt were found to improve respiratory functioning by increasing the tidal volume through enlargement of the thorax and decreases in respiratory frequency.

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Backrest Shape Affects Head–Neck Alignment and Seated Pressure

Cited by 5 publications

References 33 publications

Does the backrest shape of the wheelchair influence the asymmetric posture of patients with hemiparesis? A single institution pilot study

Does the backrest shape of the wheelchair influence the asymmetric posture of patients with hemiparesis? A single institution pilot study

Influence of back support shape in wheelchairs offering pelvic support on asymmetrical sitting posture and pressure points during reaching tasks in stroke patients

The effect of a wheelchair with pelvic support belt on respiratory function

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