Pressure ulcer in a man with tetraplegia and a poorly fitting wheelchair: a case report with clinical and policy implications

Batavia, Mitchell; Batavia, AI

doi:10.1038/sj.sc.3100763

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…Most reclining wheelchairs are light-weight, inexpensive, foldable, and commercially available. Moreover, reclining wheelchairs provide better trunk support [2] to stroke patients who suffer from hemiplegia and poor sitting balance and/or tolerance and also help reduce the sitting pressure [3] of elderly stroke patients, who are susceptible to pressure sores [4]. …”

Section: Introductionmentioning

confidence: 99%

Sliding and pressure evaluation on conventional and V-shaped seats of reclining wheelchairs for stroke patients with flaccid hemiplegia: a crossover trial

Huang

Yeh

Chen

et al. 2011

J NeuroEngineering Rehabil

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BackgroundReclining wheelchairs are commonly used to transport elderly stroke patients in Taiwan. However, there is concern that the patient's body in the wheelchair often slides forward when they return to a seated position, increasing the sitting pressure. Therefore, a novel reclining wheelchair with an ergonomic "V-Seat" was designed to prevent forward sliding and pressure sores. The use of these reclining chairs by stroke patients has not yet been studied. Thus, we investigated the effects of V-shaped and conventional seats in reclining wheelchairs on the extent of forward sliding and on the sitting pressure of stroke patients with flaccid hemiplegia and of able-bodied elders.MethodsWe recruited 13 able-bodied elders and 11 stroke patients with flaccid hemiplegia and performed 5 reclining cycles in both types of wheelchair. The amount of sliding along the backrest (BS) plane and the seat (SS) plane, the mean sitting pressure (MP), and the sacral peak pressure (SPP) of the subjects were recorded. We used the Wilcoxon signed-rank test to compare the BS, SS, MP, and SPP in wheelchairs with conventional and V-shaped seats, and we used the Wilcoxon rank sum test to compare the differences in BS and SS between stroke patients and able-bodied elders in both types of reclining wheelchair.ResultsThe BS, SS, and SPP of stroke patients were significantly lower in the wheelchairs with V-shaped seats than in conventional wheelchairs in most comparisons; however, the BS of able-bodied elders was higher in V-shaped seats than in conventional seats. The SS and SPP of stroke patients were significantly higher than those of able-bodied elders in both types of reclining wheelchair, and the BS of stroke patients was significantly higher than that of able-bodied elders only in conventional reclining wheelchairs.ConclusionsThe use of V-shaped seats in reclining wheelchairs can help reduce the forward sliding and sacral peak pressure of stroke patients with flaccid hemiplegia. The back displacement of able-bodied subjects when using both conventional and V-shape seats in reclining positions differs from the back displacement of stroke patients with flaccid hemiplegia when using such seats. These results are of paramount value and should be considered when prescribing the use of reclining wheelchairs to subjects with flaccid hemiplegia.

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Section: Introductionmentioning

confidence: 99%

Sliding and pressure evaluation on conventional and V-shaped seats of reclining wheelchairs for stroke patients with flaccid hemiplegia: a crossover trial

Huang

Yeh

Chen

et al. 2011

J NeuroEngineering Rehabil

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Changing chairs: anticipating problems in prescribing wheelchairs

Batavia

Friedman³

2001

Disability and Rehabilitation

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Development and Testing of an Innovative User-Adjustable Support Surface for Wheelchair Seating Discomfort

Crane

Hobson

Stadelmeier

2010

Assistive Technology

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Beginning in 2000, a study of discomfort experienced by wheelchair users and development of technology solutions were undertaken. This research culminated with the present study of a new technology targeting sitting discomfort. Support for development of the "Butt Scooter" prototype and its testing was provided through an NIH research grant. Investigators tested a prototype device, called the "Butt Scooter," and conducted a focus group to obtain expert clinical opinions about the potential usefulness of the prototype. Subject testing of the prototype device followed a single subject design (ABABA). Subjects self-administered the Tool for Assessing Wheelchair disComfort (TAWC) to evaluate their discomfort levels. Results from three subjects are reported. All three expert therapists participating in the focus group responded favorably to the prototype. In summary, results from subject testing were somewhat mixed with regard to discomfort management, however all subjects commented positively on the features of the device.

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Pressure ulcer in a man with tetraplegia and a poorly fitting wheelchair: a case report with clinical and policy implications

Cited by 3 publications

References 4 publications

Sliding and pressure evaluation on conventional and V-shaped seats of reclining wheelchairs for stroke patients with flaccid hemiplegia: a crossover trial

Sliding and pressure evaluation on conventional and V-shaped seats of reclining wheelchairs for stroke patients with flaccid hemiplegia: a crossover trial

Changing chairs: anticipating problems in prescribing wheelchairs

Development and Testing of an Innovative User-Adjustable Support Surface for Wheelchair Seating Discomfort

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