Investigation of Peak Pressure Index Parameters for People with Spinal Cord Injury Using Wheelchair Tilt-in-Space and Recline: Methodology and Preliminary Report

Lee

Biomedical Human Kinetics

et al. 2021

Study aim: The aim of this study was to determine the optimal angle for maximizing pressure distribution in two types of wheelchairs (tilting and reclining) while using a ROHO cushion, which offers relatively effective pressure distribution. Material and methods: This study enrolled 28 male and female college students who understood the purpose of the study and agreed to participate. This study aimed to determine the optimal angle for tilting and reclining wheelchairs when using a ROHO cushion at angles of 10°, 20°, and 30° with tilted wheelchairs and 90°, 110°, and 130° with reclining wheelchairs. Results: The analysis showed that an improved pressure distribution when a tilting wheelchair was used versus a reclining one. A reclining position of ≥110° and a tilt angle of ≥20° led to significant pressure-reducing effects. Conclusion: The results of this study will help wheelchair users or their guardians to select the optimal wheelchair angle when changing their posture to prevent bedsores. Although no slippage was observed in our study, it is important to remember the proper back position to prevent unnecessary slippage.

Section: Discussioncontrasting

confidence: 51%

Pressure distribution in tilting and reclining wheelchairs with an air cushion: A pilot study

Lee

Biomedical Human Kinetics

et al. 2021

BioMed Research International

“…While maximal tilt and recline angles of other studies were limited to 35°T and 30°R [ 17 , 22 ], Aissaoui et al . [ 21 ] remains the only investigation other than the current in which mean sitting pressure was analysed up to 45°T and 30°R.…”

Section: Discussionmentioning

confidence: 99%

Wheelchair Tilt-in-Space and Recline Functions: Influence on Sitting Interface Pressure and Ischial Blood Flow in an Elderly Population

Zemp

Rhiner

Plüss

et al. 2019

Pressure ulcers (PUs) result from localised injury to the skin and underlying tissue and usually occur over a bony prominence as a result of pressure, often in combination with shear forces. Both pressure magnitude and duration are thought to be key risk factors in the occurrence of PUs, thus exposing wheelchair-bound subjects to high risk of PU development. As a result, wheelchairs that incorporate tilt-in-space and recline functions are routinely prescribed to redistribute pressure away from their ischial tuberosities. The goal of this study was to analyse the role of full-body tilt and recline angles in governing sitting interface pressure and blood circulation parameters in elderly subjects and thereby investigate the efficacy of tilt-in-space wheelchairs for aiding pressure relief activity. Sitting interface pressure and ischial blood flow parameters were examined in 20 healthy elderly subjects while seated in a tilt-in-space and recline wheelchair. Five different angles of seat tilt (5°, 15°, 25°, 35°, and 45°) were assessed in combination with three different angles of backrest recline (5°, 15°, and 30°). The results of the study show that when compared to the upright reference posture, every position (except 15°T/5°R) resulted in a significant decrease in sitting interface pressure. Ischial blood flow also showed significant increases at four different positions (45°T/15°R, 15°T/30°R, 35°T/30°R, and 45°T/30°R) but only at larger tilt-in-space and recline angles. The results therefore suggest that small tilt-in-space and recline angles are indeed able to reduce sitting interface pressures, whereas changes in ischial blood flow only occur at larger angles. In the literature, cell deformation is thought to be dominant over tissue ischemia in the development of tissue necrosis and PUs. Therefore, together with our findings it can be concluded that frequently undertaking small adjustments in tilt-in-space and recline angle might be important for preventing cell deformation and any associated cell necrosis. Larger angles of tilt-in-space and recline seem to support blood flow returning to the tissues, which is likely to play a positive role in healing damaged tissue.

“…This grid size was chosen due to its geometric inclusion of heel contact area without significant effects of adjacent, zero-force sensel frames. The 3 × 4 grid creates a 19.35 cm 2 sensel window, meeting the recommended 9 -10 cm 2 minimal measurement area for contact force determination on skin [21] [22]. The masking frame was used to only select data corresponding to heel to be exported from the MeasureX software.…”

Section: Methodsmentioning

confidence: 99%

Pressure Ulcer Prevention: Effectiveness of Heel Off-Loading Methodologies

Griffin¹,

Dean²,

Cayce³

et al. 2015

OJN

Skin integrity breakdown and pressure ulcer formation on the heel are predictable and preventable healthcare occurrences. By minimizing surface contact pressures that can cause heel capillary occlusion, heel off-loading devices help mitigate the risk of decubitus ulceration. The purpose of this study is to investigate the efficacy of six off-loading methods commonly used in clinical settings to decrease heel contact pressure. Pressure mapping is used to evaluate contact pressure at the heel for underweight, normal weight, and overweight simulations. Based upon averages across four trials, it is shown that all devices reduce heel contact pressure when compared to no off-loading. The PRUventor™ boot exhibits significantly lower average pressure values than other off-loading strategies tested, suggesting that the PRUventor™ is the most effective off-loading device. From the analysis of the experimental data and comparison to similar data for respective off-loading alternatives, it is concluded that the PRUventor™ boot is an effective heel off-loading device for use in clinical settings.