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Pressure distribution at the seating interface of custom-molded wheelchair seats: Effect of various materials

      Abstract

      Apatsidis DP, Solomonidis SE, Michael SM. Pressure distribution at the seating interface of custom-molded wheelchair seats: effect of various materials. Arch Phys Med Rehabil 2002;83:1151-6. Objective: To identify which of 4 materials has the most favorable pressure distribution when used in custom-molded seats (CMSs) to assist clinicians in providing appropriate seating for wheelchair-bound individuals who are prone to develop pressure ulcers. Design: Repeated-interface pressure measurements for all materials, followed by statistical analysis. Setting: The general community and referral centers. Participants: Seven subjects, 5 with cerebral palsy, 1 with Schilder's disease, and 1 with postmeningitis effects. All subjects were seated in a CMS and had spinal deformities. Interventions: Viscoelastic polyurethane foams (Pudgee, Sunmate) and gels (Floam™, Jay) were used as inserts in the CMSs. Evazote foam was used as a control material. Main Outcome Measures: Pressure readings were taken at the seat interface with pneumatic pressure sensors and the Talley Pressure Monitor. Peak pressure readings, mean pressure ratio, and peak pressure ratio for the different materials were compared. Results: Foams, Sunmate in particular, produced lower peak-interface pressures and also showed better pressure distribution than did gels. Conclusion: Foams are the preferred insert material with CMSs when increased tissue breakdown risk is present. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

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      References

        • Ham R
        • Aldersea P
        • Porter D.
        Wheelchair users and postural seating. A clinical approach.
        Churchill Livingstone, New York1998
        • Nelham RL
        The manufacture of moulded supportive seating for the handicapped.
        Biomed Eng. 1975; 10: 379-381
        • Nelham RL
        Seating for the chairbound disabled person—a survey of seating equipment in the United Kingdom.
        J Biomed Eng. 1981; 3: 267-274
        • Kang TE
        • Mak AF
        Development of a simple approach to modify the supporting properties of seating foam for pressure relief.
        J Rehabil Res Dev. 1998; 35: 52-60
        • Reswick JB
        • Rogers J.
        Experiences at Rancho Los Amigos Hospital with devices and techniques to prevent pressure sores.
        in: Bedsore biomechanics. MacMillan, London1976: 301-310
        • Zacharkow D.
        Wheelchair posture and pressure sores.
        CC Thomas, Springfield (IL)1984
        • Bennett L
        • Kavner D
        • Lee BY
        • Trainor FS
        • Lewis JM
        Skin stress and blood flow in sitting paraplegic patients.
        Arch Phys Med Rehabil. 1984; 65: 186-190
        • Garber SL
        • Krouskop TA
        Body build and its relationship to pressure distribution in the seated wheelchair patient.
        Arch Phys Med Rehabil. 1982; 63: 17-20
        • Sprigle S
        • Faisant TE
        • Chung KC
        Clinical evaluation of custom-contoured cushions for the spinal cord injured.
        Arch Phys Med Rehabil. 1990; 71: 655-658
        • Sprigle S
        • Chung KC
        • Brubaker CE
        Reduction of sitting pressures with custom contoured cushions.
        J Rehabil Res Dev. 1990; 27: 135-140
        • Brienza DM
        • Lin CT
        • Karg PE
        A method for custom-contoured cushion design using interface pressure measurements.
        IEEE Trans Rehabil Eng. 1999; 7: 99-108
        • Michael SM
        • Walker PS
        Clinical trial of body-contoured wheelchair cushioning.
        Clin Rehabil. 1990; 4: 229-234
        • Ferguson-Pell M
        • Cardi M.
        Pressure mapping systems. Pressure mapping systems can add a powerful tool to a therapist's seating and positioning evaluations.
        TeamRehab Rep. 1992; : 28-32
        • Ring ND
        • Nelham RL
        • Pearson FA
        Moulded supportive seating for the disabled.
        Prosthet Orthot Int. 1978; 2: 30-34
        • Medical Devices Agency
        The effects of posture, body mass index and wheelchair adjustment on interface pressure. Medical Devices Agency Report.
        Dept of Health, London: UKJuly 1997 (Report No. MDA 97/20)
        • Medical Devices Agency
        Wheelchair cushions static and dynamic, a comparative evaluation, special issue. Cushion Evaluation Report. Medical Devices Agency.
        Dept of Health, London: UKJune 1997 (Report No. PS4)