Remote monitoring of sitting behaviors for community-dwelling manual wheelchair users with spinal cord injury

Abstract

Study design: A case series study. Objectives: To describe the sitting behaviors in community-dwelling manual wheelchair users (MWUs) with spinal cord injury (SCI) by using a custom data logger and to compare the sitting time parameters between the groups with paraplegia and tetraplegia. Setting: Data were collected from the MWUs living in the community area of Kaohsiung, Taiwan. Methods: A custom data logger with six force sensor resistors was designed and installed on a personal daily-use wheelchair. Twenty MWU participants were instructed to disregard the activation of data logger and pursue their regular activities of daily living. Cumulative sitting time, averaged uninterrupted sitting time, lift-off frequency, and the symmetry ratio of sitting weight distribution for 24 h per day over a 1-week period were recorded. Results: Manual wheelchair users spent an average of 9.2 h (median 9.7, range 3.2-12.2 h) per day in their own wheelchair. They sat for an average of 97 min (median 62, range 24-284 min) without displaying any lift-off behavior. The average lift-off frequency was 9.4 times (median 9.2, range 2-20 times) per day. During sitting, the median value of symmetrical right-left and front-rear weight distribution ratio was 0.9 (range 0.5-1.4), and 0.5 (range 0.01-1.6), respectively. There was no significant difference in sitting time parameters between MWUs with paraplegia and those with tetraplegia. Conclusion: Community-dwelling MWUs spent long periods of time in their wheelchairs and did not engage frequently in pressure relief activities. Regardless of their neurological levels, education on the pressure relief activity is still a core component for all MWUs.

Everyday sitting behavior of full-time wheelchair users

“…Measurements of wheelchair occupancy and transfers were consistent with prior work investigating wheelchair use for individuals who use a manual wheelchair [31][32][33]. The low frequency of complete off-loading, or PRs, has been indicated in previous studies [33,35].…”

“…As expected, larger movements are typically done with a lower frequency than smaller movements. At this time, studies of the sitting behavior of wheelchair users have been limited to measurement of occupancy [29][30][31][32][33] or complete off-loadings [33][34][35] and a single pilot study that considered smaller movements but was never expanded to a full study [36].…”

Lifestyle risk factors for pressure ulcers in community-based patients with spinal cord injuries in Japan

“…11 However, in our study, the patients in the No PU group practiced pressure relief activities at almost the recommended frequency. We consider this result useful for planning PU prevention programs in the future.…”

“…As previous studies have recommended, we also consider it necessary to educate patients with SCI about the importance of skin monitoring to prevent PUs. 6,11 In the interviews, both groups reported performing a similar number of pressure relief maneuvers. However, several patients in both groups could not answer the question, which suggests that it is difficult to remember the number of pressure relief maneuvers performed because they are unconsciously practiced.…”

“…Previous reports suggest that community-living SCI patients seldom perform pressure relief. 11 Thus, the objectives of this study were:…”