Sitting pressure during wheelchair propulsion and handcycling: effects of backrest angle, movement intensity and cushion type.
Purpose: The main aim of this study was to compare sitting pressure (peak pressure index (PPI) and peak pressure gradient (PPG)) between a daily wheelchair and fixed-frame handcycle, thereby assessing the effect of handcycle backrest angle, movement intensity and cushion type. Materials and methods:...
| Publicado en: | Disability & Rehabilitation: Assistive Technology Vol. 20; no. 4; pp. 1094 - 1104 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
May2025
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=185198492&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 185198492 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17483107 1X04 jtl: Disability & Rehabilitation: Assistive Technology issn: 17483107 maglogo: Y pubinfo: dt: May2025 vid: 20 iid: 4 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 185198492 181187941 185198492 185198492 10.1080/17483107.2024.2434912 185198492 ppf: 1094 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Sitting pressure during wheelchair propulsion and handcycling: effects of backrest angle, movement intensity and cushion type. aug: au: Snoek, Thom Haarler, Annelaura van Orsouw, Ludwine Janssen, Thomas W. J. de Groot, Sonja Kouwijzer, Ingrid affil: Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands sug: subj: Spinal Cord Injuries Rehabilitation Pressure Ulcer Wheelchairs Ergonomics Sitting Body Positions Movement Physiology Equipment Design Hand Physiology Task Performance and Analysis Biomechanics Evaluation Pillows and Cushions Pressure (Physiology) Human Male Female Young Adult Physical Performance Kinematics Descriptive Statistics Data Analysis Software Repeated Measures Analysis of Variance Post Hoc Analysis Wilcoxon Rank Sum Test Skin Physiology Questionnaires Adaptive Seating Male Female ab: Purpose: The main aim of this study was to compare sitting pressure (peak pressure index (PPI) and peak pressure gradient (PPG)) between a daily wheelchair and fixed-frame handcycle, thereby assessing the effect of handcycle backrest angle, movement intensity and cushion type. Materials and methods: Twenty able-bodied participants performed static and dynamic (two intensities) tests in a wheelchair and handcycle. A honeycomb wheelchair cushion and standard foam handcycle cushion were used. Handcycle backrest angles were 45° and 60°. The PPI and PPG at the sacro-coccygeal (SC) and ischial tuberosity (IT) regions were determined with a pressure mat. Results: PPI at the IT-region was higher in the 60° handcycle condition than in the wheelchair (p = 0.04), while PPG at the IT-region did not differ significantly between the wheelchair and handcycle conditions (p > 0.05). PPI and PPG were higher at the 45° handcycle SC-region compared to the wheelchair IT-region (p < 0.03). PPI and PPG at the IT-region were higher with the 60° than with the 45° backrest angle (p < 0.01), while at the SC-region PPI was higher with the 45° backrest angle (p = 0.047). No clear influence of movement intensity was found. PPI and PPG at the IT-region and PPI of the SC-region in the handcycle were significantly lower with the wheelchair cushion than with the handcycle cushion (p < 0.01). Conclusion: Overall, sitting pressure was higher in the handcycle compared to the daily wheelchair. For handcyclists using an upright position, it is recommended to use a cushion designed to redistribute pressure, thereby reducing internal tissue pressure and shear. IMPLICATIONS FOR REHABILITATION: Individuals with a spinal cord injury are at high risk of developing pressure ulcers at the ischial tuberosities (ITs) and the sacro-coccygeal (SC) region due to elevated sitting pressure. The sitting pressure at the IT-region is higher during handcycling in an upright position compared to wheelchair propulsion, while the sitting pressure at the SC-region is higher during handcycling in a less upright position. The use of a honeycomb wheelchair cushion reduces the sitting pressure in the handcycle compared to a standard foam handcycle cushion. For handcyclists, it is recommended to use a cushion designed to redistribute pressure, thereby reducing internal tissue pressure and shear. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|