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Pubmed for Handhelds

PUBMED FOR HANDHELDS

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  • Title: Measuring the effect of incremental angles of wheelchair tilt on interface pressure among individuals with spinal cord injury.
    Author: Giesbrecht EM, Ethans KD, Staley D.
    Journal: Spinal Cord; 2011 Jul; 49(7):827-31. PubMed ID: 21242997.
    Abstract:
    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.
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