The Influence of Backrest Inclination on Buttock Pressure
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objective To assess the effects of backrest inclination of a wheelchair on buttock pressures in spinal cord injured (SCI) patients and normal subjects. Method The participants were 22 healthy subjects and 22 SCI patients. Buttock pressures of the participants were measured by a Tekscan® pressure sensing mat and software while they were sitting in a reclining wheelchair. Buttock pressures were recorded for 90°, 100°, 110°, 120° and 130° seat-to-back angles at the ischial tuberosity (IT)and sacrococcygeal (SC) areas. Recordings were made at each angle over four seconds at a sampling rate of 10 Hz. Results The side-to-side buttock pressure differences in the IT area for the SCI patients was signifi cantly greater than for the normal subjects. There was no signifi cant diff erence between the SCI patients and the normal subjects in the buttock pressure change pattern of the IT area. Significant increases in pressure on the SC area were found as backrest inclination angle was changed to 90o, 100o and 110° in the normal subjects, but no signifi cant diff erences were found in the SCI patients. Conclusion Most of the SCI patients have freeform posture in wheelchairs, and this leads to an uneven distribution of buttock pressure. In the SCI patients, the peak pressure in the IT area reduced as the backrest angle was increased, but peak pressure at the SC area remained relatively unchanged. To reduce buttock pressure and prevent pressure ulcers and enhance ulcer healing, it can be helpful for tetraplegic patients, to have wheelchair seat-to-back angles above 120°.
Abstract
Objective To assess the effects of backrest inclination of a wheelchair on buttock pressures in spinal cord injured (SCI) patients and normal subjects. Method The participants were 22 healthy subjects and 22 SCI patients. Buttock pressures of the participants were measured by a Tekscan® pressure sensing mat and software while they were sitting in a reclining wheelchair. Buttock pressures were recorded for 90°, 100°, 110°, 120° and 130° seat-to-back angles at the ischial tuberosity (IT)and sacrococcygeal (SC) areas. Recordings were made at each angle over four seconds at a sampling rate of 10 Hz. Results The side-to-side buttock pressure differences in the IT area for the SCI patients was signifi cantly greater than for the normal subjects. There was no signifi cant diff erence between the SCI patients and the normal subjects in the buttock pressure change pattern of the IT area. Significant increases in pressure on the SC area were found as backrest inclination angle was changed to 90o, 100o and 110° in the normal subjects, but no signifi cant diff erences were found in the SCI patients. Conclusion Most of the SCI patients have freeform posture in wheelchairs, and this leads to an uneven distribution of buttock pressure. In the SCI patients, the peak pressure in the IT area reduced as the backrest angle was increased, but peak pressure at the SC area remained relatively unchanged. To reduce buttock pressure and prevent pressure ulcers and enhance ulcer healing, it can be helpful for tetraplegic patients, to have wheelchair seat-to-back angles above 120°.
참고문헌 (36)
- Kwon H, "Clinical observation of the pressure ulcer", J Korean Soc Plast Reconstr Surg, 23, pp.818~826 (1996)
- Uhm KI, "Clinical observations of pressure ulcer", J Korean Soc Plast Reconstr Surg, 7, pp.281~289 (1980)
- Dowling AS, "Pressure sores-their cause, prevention, and treatment", Md State Med J, 19, pp.131~134 (1970)
- Fuhrer MJ, "Pressure ulcers in community-resident persons with spinal cord injury: prevalence and risk factors", Arch Phys Med Rehabil, 74, pp.1172~1177 (1993)
- Kernozek TW, "Seat interface pressures of individuals with paraplegia: influence of dynamic wheelchair locomotion compared with static seated measurements", Arch Phys Med Rehabil, 79, pp.313~316 (1998)
- Richardson RR, "Prevalence and incidence of pressure ulcers in acute spinal cord injuries", Paraplegia, 19, pp.235~247 (1981)
- Rodriguez GP, "Prospective study of pressure ulcer risk in spinal cord injury patients", Paraplegia, 32, pp.150~158 (1994)
- Hackler RH, "A 25-year prospective mortality study in the spinal cord injured patient: comparison with long-term living paraplegic", J Urol, 117, pp.486~488 (1977)
- Staas WE Jr, "Pressure sores-a multifaceted approach to prevention and treatment", West J Med, 154, pp.539~544 (1991)
- "Pressure sores-a ticking time-bomb", Intensive Crit Care Nurs, 11, pp.44~48 (1995)
- Edberg EL, "Prevention and treatment of pressure sores", Phys Th er, 53, pp.246~252 (1973)
- Kosiak M, "Etiology of decubitus ulcers", Arch Phys Med Rehabil, 42, pp.19~29 (1961)
- Byrne DW, "Major risk factors for pressure ulcers in the spinal cord disabled: a literature review", Spinal Cord, 34, pp.255~263 (1996)
- Linder-Ganz E, "Mechanical compressioninduced pressure sores in rat hindlimb: muscle stiff ness, histology, and computational models", J Appl Physiol, 96, pp.2034~2049 (2004)
- Allen V, "Accuracy of interface pressure measurement systems", J Biomed Eng, 15, pp.344~348 (1993)
- Castro MJ, "Influence of complete spinal cord injury on skeletal muscle within 6 mo of injury", J Appl Physiol, 86, pp.350~358 (1999)
- Modelsky CM, "Assessment of skeletal muscle mass in men with spinal cord injury using dual-energy X-ray absorptiometry and magnetic resonance imaging", J Appl Physiol, 96, pp.561~565 (2004)
- Gutierrez EM, "Measuring seating pressure, area, and asymmetry in persons with spinal cord injury", Eur Spine J, 13, pp.374~379 (2004)
- Aissaoui R, "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, pp.359~367 (2001)
- Drummond D, "Relationship of spine deformity and pelvic obliquity on sitting pressure distributions and decubitus ulceration", J Pediatr Orthop, 5, pp.396~402 (1985)
- Henderson JL, "Efficacy of three measures to relieve pressure in seated persons with spinal cord injury", Arch Phys Med Rehabil, 75, pp.535~539 (1994)
- Koo TK, "Posture effect on seating interface biomechanics: comparison between two seating cushions", Arch Phys Med Rehabil, 77, pp.40~47 (1996)
- Rosenthal MJ, "A wheelchair cushion designed to redistribute sites of sitting pressure", Arch Phys Med Rehabil, 77, pp.278~282 (1996)
- Lancourt JE, "Paralytic spinal deformity following traumatic spinal-cord injury in children and adolesents", J Bone Joint Surg Am, 63, pp.47~53 (1981)
- Hobson DA, "Seated lumbar", pelvic alignment. A comparison between spinal cord-injured and noninjured groups, 1992, pp.17, 293~298
- Andersson GB, "The infl uence of backrest inclination and lumbar support on lumbar lordosis", Spine, 4, pp.52~58 (1979)
- Gardocki RJ, "Measurements of lumbopelvic lordosis using the pelvic radius technique as it correlates with sagittal spinal balance and sacral translation", Spine Journal, 2, pp.421~429 (2002)
- Yarkony GM, "Contractures complicating spinal cord injury: incidence and comparison between spinal cord centre and general hospital acute care", Paraplegia, 23, pp.265~271 (1985)
- Gajdosik RL, "Influence of hamstring length on the standing position and fl exion range of motion of the pelvic angle, lumbar angle, and thoracic angle", J Orthop Sports Phys Ther, 20, pp.213~219 (1994)
- Sumiya T, "A survey of wheelchair use by paraplegic individuals in Japan. Part 2: Prevalence of pressure sores", Spinal Cord, 35, pp.595~598 (1997)
- Schue RM, "Pressure ulcer prevalence and incidence and a modifi cation of the Braden Scale for a rehabilitation unit", J Wound Ostomy Continence Nurs, 25, pp.36~43 (1998)
- Hanson DS, "Evaluation of pressure ulcer prevalence rates for hospice patients post-implementation of pressure ulcer protocols", Am J Hosp Palliat Care, 11, pp.14~19 (1994)
- Shields RK, "Effect of seat angle and lumbar support on seated buttock pressure", Phys Ther, 68, pp.1682~1686 (1988)
- Henderson JL, "Efficacy of three measures to relieve pressure in seated persons with spinal cord injury", Arch Phys Med Rehabil, 75, pp.535~539 (1994)
- Tam EW, "Pelvic movement and interface pressure distribution during manual wheelchair propulsion", Arch Phys Med Rehabil, 84, pp.1466~1472 (2003)
- Bush CA, "Study of pressures on skin under ischial tuberosities and thighs during sitting", Arch Phys Rehabil, 50, pp.207~213 (1969)
