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

Abstract

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.

The Reliability and Validity of the Digital Goniometer and Smart Phone to Determine Trunk Active Range of Motion in Stroke Patients

“…However, in lateral flexion, the hemiplegic side showed a larger value than the non-hemiplegic side. The asymmetrical sitting posture of patients with stroke should be considered when determining ROM measurements [39]. In addition, the stiffness and spasticity of the trunk muscles on the hemiplegic side could limit lateral flexion to the non-hemiplegic side [40].…”

Effectiveness of knee pad as an additional device for wheelchairs in improving upper-limb dexterity during seated tasks: a pilot study

“…Fujita et al 8 ) reported that increasing the thickness of the rear part of the seat cushion provided posterior pelvic support and could suppress posterior pelvic tilt. Ukita et al 9 ) stated that adjusting the shape of the back support could improve asymmetry in individuals with hemiparesis. Nagata 10 ) examined the effect of anterior knee support on sitting posture stability in severely disabled children.…”

Analysis of Postural Control in Sitting by Pressure Mapping in Patients with Multiple Sclerosis, Spinal Cord Injury and Friedreich’s Ataxia: A Case Series Study

“…However, in the laboratory environment there are tools capable of quantifying the posture control. These are usually devices of high economic cost and with difficult accessibility in the daily clinic, although they are very reliable and sensitive (i.e., posturography and inertial measurement units) [ 12 , 13 ]. Taking into account this reality, the evaluation of neurological patients with a high degree of dependence is even more problematic, since, even if there are force platforms, electronic gateways, or inertial devices that can quantify the quality of their postural control, these people cannot stand on their own, which is usually the minimum requirement for these devices to perform measurements [ 14 , 15 ].…”