P Tederko1, T Besowski2, K Jakubiak2, M Łyp2, K Bobecka-Wesołowska3, J Kiwerski2. 1. 1] Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland [2] Department of Physiotherapy, College of Rehabilitation, Warsaw, Poland. 2. Department of Physiotherapy, College of Rehabilitation, Warsaw, Poland. 3. Faculty of Mathematics and Information Science, Warsaw University of Technology, Warsaw, Poland.
Abstract
OBJECTIVE: To describe the effect of wheelchair footrest height on sitting pressures in persons with paraplegia. METHODS: Seventeen manual wheelchair users with paraplegia underwent a seat pressure examination while footrests were elevated from the initial position with the thighs parallel to the seat (p0), by 10% (position p10) and by 20% of the fibula length (position p20). We analyzed average pressure (AP), the contact surface of the body with the seat (CS), pressures on the ischial tuberosities-left (LIP) and right (RIP)--and average pressure on both ischial tuberosities (AIP). RESULTS: A gradual increase in footrest elevation was accompanied by significant increases in AP (p0: 57.24±14.31; p10: 60.65±14.85; p20: 62±15.3 mm Hg; Kendall coefficient of concordance W=0.962), AIP (p0: 159.35±54.95; p10: 176.35±53.3; p20: 184.26±54.09 mm Hg; W=0.896), LIP (p0: 165.24±54.05; p10: 183±52.08; p20: 193.18±56.32 mm Hg; W=0.751) and RIP (p0: 153.71±71.23; p10: 167.35±72.19; p20: 175.35±70.84 mm Hg; W=0.524) and a significant decrease in CS (p0: 1218.2±100.8; p10: 1131.8±134.6; p20: 1065±142.6 cm(2); W=0.985). There was a moderate correlation between the relative increase in LIP and RIP between p0 and p10, and between p10 and p20 (Pearson's correlation coefficient for LIP r=0.66; P=0.04, for RIP r=0.77; P=0.003), and a high correlation between relative changes in AIP (r=0.87; P<0.0001). CONCLUSION: Wheelchair footrest elevation caused a steady rise in AIP; however, left to right side pressure differences changed variably, suggesting that the risk of pressure ulcers may increase disproportionately with footrest elevation.
OBJECTIVE: To describe the effect of wheelchair footrest height on sitting pressures in persons with paraplegia. METHODS: Seventeen manual wheelchair users with paraplegia underwent a seat pressure examination while footrests were elevated from the initial position with the thighs parallel to the seat (p0), by 10% (position p10) and by 20% of the fibula length (position p20). We analyzed average pressure (AP), the contact surface of the body with the seat (CS), pressures on the ischial tuberosities-left (LIP) and right (RIP)--and average pressure on both ischial tuberosities (AIP). RESULTS: A gradual increase in footrest elevation was accompanied by significant increases in AP (p0: 57.24±14.31; p10: 60.65±14.85; p20: 62±15.3 mm Hg; Kendall coefficient of concordance W=0.962), AIP (p0: 159.35±54.95; p10: 176.35±53.3; p20: 184.26±54.09 mm Hg; W=0.896), LIP (p0: 165.24±54.05; p10: 183±52.08; p20: 193.18±56.32 mm Hg; W=0.751) and RIP (p0: 153.71±71.23; p10: 167.35±72.19; p20: 175.35±70.84 mm Hg; W=0.524) and a significant decrease in CS (p0: 1218.2±100.8; p10: 1131.8±134.6; p20: 1065±142.6 cm(2); W=0.985). There was a moderate correlation between the relative increase in LIP and RIP between p0 and p10, and between p10 and p20 (Pearson's correlation coefficient for LIP r=0.66; P=0.04, for RIP r=0.77; P=0.003), and a high correlation between relative changes in AIP (r=0.87; P<0.0001). CONCLUSION: Wheelchair footrest elevation caused a steady rise in AIP; however, left to right side pressure differences changed variably, suggesting that the risk of pressure ulcers may increase disproportionately with footrest elevation.
Authors: Sharon Gabison; Sunita Mathur; Ethne L Nussbaum; Milos R Popovic; Mary C Verrier Journal: J Spinal Cord Med Date: 2017-06-14 Impact factor: 1.985