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Measuring seating pressure, area, and asymmetry in persons with spinal cord injury

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Abstract

The goal of this study was to measure characteristics of seat loading in manual wheelchair users with complete spinal cord injury (SCI). Pressure distribution on the seating area of 25 adult males with SCI and eight non-injured adult males was measured in a relaxed and an upright posture on a standardized hard surface. Subjects with SCI were also tested in their wheelchairs. Maximum pressure, contact area, area of the highest pressure, and three asymmetry indices were compared. Subjects with SCI have higher pressure distributed over a smaller area, have a much smaller contact area, and distribute the loading more asymmetrically than non-injured subjects. Upright posture only corrects for some loading problems, while the wheelchair corrects for more loading parameters. Routine clinical seat loading evaluation may lead to improved chair and cushion selection for patients with SCI and may even alert clinicians to patients at high risk for complications due to high or unbalanced loads.

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References

  1. Aissaoui R, Kauffmann C, Dansereau J, de Guise JA (2001) Analysis of pressure distribution at the body-seat interface in able-bodied and paraplegic subjects using a deformable active contour algorithm. Med Eng Phys 23:359–367

    Article  CAS  PubMed  Google Scholar 

  2. Alm M, Gutierrez E, Hultling C, Saraste H (2003) Clinical evaluation of seating in persons with complete thoracic spinal cord injury. Spinal Cord 41:563–571

    Google Scholar 

  3. Apatsidis DP, Solomonidis SE, Michael SM (2002) Pressure distribution at the seating interface of custom-molded wheelchair seats: effect of various materials. Arch Phys Med Rehabil 83:1151–1156

    Article  PubMed  Google Scholar 

  4. Burney RE, Maio RF, Maynard F, Karunas R (1993) Incidence, characteristics, and outcome of spinal cord injury at trauma centers in North America. Arch Surg 128:596–599

    CAS  PubMed  Google Scholar 

  5. Garber SL, Krouskop TA, Carter RE (1978) A system for clinically evaluating wheelchair pressure-relief cushions. Am J Occup Ther 32:565–570

    CAS  PubMed  Google Scholar 

  6. Gerhart KA, Bergstrom E, Charlifue SW, Menter RR, Whiteneck GG (1993) Long-term spinal cord injury: functional changes over time. Arch Phys Med Rehabil 74:1030–1034

    CAS  PubMed  Google Scholar 

  7. Hobson DA, Tooms RE (1992) Seated lumbar/pelvic alignment. A comparison between spinal cord-injured and noninjured groups. Spine 17:293–298

    CAS  PubMed  Google Scholar 

  8. Koo TK, Mak AF, Lee YL (1996) Posture effect on seating interface biomechanics: comparison between two seating cushions. Arch Phys Med Rehabil 77:40–47

    CAS  PubMed  Google Scholar 

  9. Levi R, Hultling C, Nash MS, Seiger A (1995) The Stockholm spinal cord injury study. 1. Medical problems in a regional SCI population. Paraplegia 33:308–315

    CAS  PubMed  Google Scholar 

  10. Levi R, Hultling C, Seiger A (1995) The Stockholm Spinal Cord Injury Study. 2. Associations between clinical patient characteristics and post-acute medical problems. Paraplegia 33:585–594

    CAS  PubMed  Google Scholar 

  11. Luo ZP, Berglund LJ, An KN (1998) Validation of F-Scan pressure sensor system: a technical note. J Rehabil Res Dev 35:186–191

    CAS  PubMed  Google Scholar 

  12. Maynard FM Jr, Bracken MB, Creasey G, Ditunno JF Jr, Donovan WH, Ducker TB, Garber SL, Marino RJ, Stover SL, Tator CH, Waters RL, Wilberger JE, Young W (1997) International Standards for Neurological and Functional Classification of Spinal Cord Injury. American Spinal Injury Association. Spinal Cord 35:266–274

    Google Scholar 

  13. Samuelsson K, Larsson H, Thyberg M, Tropp H (1996) Back pain and spinal deformity: common among wheelchair users with spinal cord injuries. Scand J Occ Ther 3:28–32

    Google Scholar 

  14. Shields RK, Cook TM (1992) Lumbar support thickness: effect on seated buttock pressure in individuals with and without spinal cord injury. Phys Ther 72:218–226

    CAS  PubMed  Google Scholar 

  15. Takechi H, Tokuhiro A (1998) Evaluation of wheelchair cushions by means of pressure distribution mapping. Acta Med Okayama 52:245–254

    CAS  PubMed  Google Scholar 

  16. Thorfinn J, Sjoberg F, Lidman D (2002) Sitting pressure and perfusion of buttock skin in paraplegic and tetraplegic patients, and in healthy subjects: a comparative study. Scand J Plast Reconstr Surg Hand Surg 36:279–283

    Article  PubMed  Google Scholar 

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Acknowledgments

This project was funded by Permobil AB, Timrå, Sweden, Spinalis Foundation, Stockholm, Sweden and Norrbacka-Eugenia Foundation, Stockholm, Sweden.

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Authors and Affiliations

  1. Department of Surgical Sciences, Orthopedics Section, Karolinska Institutet, 171 76, Stockholm, Sweden

    Elena M. Gutierrez & Helena Saraste

  2. MotorikLab Q2:07 ALB, Karolinska Hospital, 171 76, Stockholm, Sweden

    Elena M. Gutierrez

  3. Spinalis SCI Unit, Rehab Station Stockholm, Karolinska Hospital, 169 86, Stockholm, Sweden

    Marie Alm & Claes Hultling

  4. Department of Orthopedics, Huddinge University Hospital, 141 86, Stockholm, Sweden

    Helena Saraste

Authors
  1. Elena M. Gutierrez
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  2. Marie Alm
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  3. Claes Hultling
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  4. Helena Saraste
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Correspondence to Elena M. Gutierrez.

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Gutierrez, E.M., Alm, M., Hultling, C. et al. Measuring seating pressure, area, and asymmetry in persons with spinal cord injury. Eur Spine J 13, 374–379 (2004). https://doi.org/10.1007/s00586-003-0635-7

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  • DOI: https://doi.org/10.1007/s00586-003-0635-7

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