Abstract
Objective
To assess the efficacy of an off-loading wheelchair seat cushion in removing pressure
from high-risk ischial tuberosities and the coccyx/sacrum in wheelchair sitting.
Design
Repeated-measures design.
Setting
Private research laboratory.
Participants
Manual wheelchair users with chronic spinal cord injuries (N=10).
Interventions
Three configurations of an off-loading wheelchair seat cushion compared with a flotation
style (10-cm air inflation) wheelchair seat cushion.
Main Outcome Measures
Outcome measures included peak pressure index (PPI), ischial tuberosity peak pressures,
and the dispersion index or ratio of pressures under the ischial and sacral regions
to the total of all pressures recorded.
Results
PPI and ischial tuberosities peak pressure ranged from a low of 39±18 and 68±46mmHg
in the fully off-loaded cushion to a high of 97±30 and 106±34mmHg, respectively, for
the flotation style cushion (2-way analysis of variance main effect across 4 conditions,
P<.001). Dispersion index ranged from a low of 8%±3% in the fully off-loaded cushion
to a high of 16%±3% in the flotation style cushion. Pairwise comparisons yielded significance
in all cushion-pair analyses (P<.05 after multiple corrections).
Conclusions
The force-removal approach of this orthotic off-loading cushion design effectively
reduces a known extrinsic risk factor for pressure ulcers—interface pressure—in the
high-risk ischial tuberosity and sacral/coccygeal regions of the buttocks.
Keywords
List of abbreviations:
PPI (peak pressure index)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 28, 2016
Footnotes
Supported by Ride Designs, Denver, CO, who provided Java cushion materials for testing and provided funding for subject reimbursement and support for EC Services staff during testing.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
