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Measuring the effect of incremental angles of wheelchair tilt on interface pressure among individuals with spinal cord injury.
MedLine Citation:
PMID:  21242997     Owner:  NLM     Status:  Publisher    
Study design:This study was a repeated measures study.Objectives:The objective was to systematically measure the relative reduction in interface pressure (IP) at the ischial tuberosities (IT) and sacrum through 10° increments of tilt in a manual wheelchair among individuals with motor complete spinal cord injury (SCI).Setting:This study was carried out in Manitoba, Canada.Methods:A total of 18 adults with ASIA A or B level of injury were recruited through an out-patient SCI clinic. Using a standardized protocol, participants were tilted in 10° increments between 0° and 50°, and IP readings were obtained at the IT and sacrum using pressure mapping technology. Relative pressure reduction from baseline was calculated and compared between tilt angles.Results:Tilt angle had a highly significant effect on pressure reduction at the IT (P=0.000) and the cosine relationship between these variables was expressed as quadratic. Reduction in sacral pressure did not occur until 30° tilt, with increased loading at smaller tilt angles. Pressure reduction at the IT and sacrum was not significantly different for tetraplegic and paraplegic participants.Conclusion:Small tilt angles are more suitable for postural control than pressure management. A minimum tilt of 30° is required to initiate unloading the sacrum and to achieve a clinically important reduction in pressure at the IT. Larger tilt angles resulted in more substantial pressure reduction than previously reported. Tilt-in-space appears to have similar benefits for individuals with paraplegia and tetraplegia.Spinal Cord advance online publication, 18 January 2011; doi:10.1038/sc.2010.194.
E M Giesbrecht; K D Ethans; D Staley
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-18
Journal Detail:
Title:  Spinal cord : the official journal of the International Medical Society of Paraplegia     Volume:  -     ISSN:  1476-5624     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Occupational Therapy, University of Manitoba, Winnipeg, Manitoba, Canada.
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