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- Alm, M., et al.
(författare)
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Clinical evaluation of seating in persons with complete thoracic spinal cord injury
- 2003
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 41:10, s. 563-571
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Tidskriftsartikel (refereegranskat)abstract
- Study Design: Consecutive male patients studied with photographic measurement of a combination of clinical methods. Objectives: To describe seating in individuals with complete thoracic spinal cord injury (SCI) by using a combination of clinical methods. Setting: Spinalis SCI unit, Stockholm, Sweden. Methods: Wheelchair specifications were documented. Measurements of posture from photographs in 30 male subjects with complete thoracic SCI, sitting in a relaxed and an upright position on a standardized surface and in a wheelchair were calculated. A comparison was made between positions and seating surfaces. An examiner's classification of lower trunk position in wheelchair was compared to subjects' evaluations. SCI subjects reported sitting support, satisfaction, and wishes for improvement. Results: Most SCI subjects used similar wheelchair specifications. None of the backrests were custom designed. Relatively small differences were found between the relaxed and upright position in the wheelchair regarding measurements of posture and according to the examiner's classification of the lower trunk position. Only 13/30 SCI subjects were sitting with the lower trunk centered relative to the backrest in the upright position. The examiner's classification and the subjects' evaluation of asymmetric sitting were not always in agreement. Only 12/30 SCI subjects were satisfied with their way of sitting. Conclusion: Current wheelchair specifications and adjustments seem to inhibit a postural correction towards upright sitting and fail to provide sufficient lateral support. Findings indicate an inability for SCI subjects to vary their sitting position in a wheelchair to a large extent. Both an examiner's classification and subjects' evaluation of asymmetric sitting are necessary to obtain a sufficient knowledge base for subsequent adjustment. By using methods regarding different aspects of seating, a more comprehensive view of seating was achieved. The combination of clinical methods seems to be useful in order to describe seating in individuals with complete thoracic SCI.
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- Gutierrez-Farewik, Elena M., et al.
(författare)
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Measuring seating pressure, area, and asymmetry in persons with spinal cord injury
- 2004
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Ingår i: European spine journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 13:4, s. 374-379
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Tidskriftsartikel (refereegranskat)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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