Logo for the Journal of Rehab R and D

Volume 46 Number 5, 2009
   Pages 577 — 586

Abstract – Analysis of healthy sitting behavior: Interface pressure distribution and subcutaneous tissue oxygenation

Jasper Reenalda, MSc;1* Paul Van Geffen, MSc;2 Marc Nederhand, PhD, MD;1 Michiel Jannink, PhD;1-2 Maarten IJzerman, PhD;3 Hans Rietman, PhD, MD1-2

1Roessingh Research and Development, Rehabilitation Centre het Roessingh, Enschede, the Netherlands; 2Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, and 3Department of Health Technology and
Services Research, University of Twente, Enschede, the Netherlands

Abstract — Pressure ulcers are a large problem in individuals who use a wheelchair for their mobility and have limited trunk stability and motor function. Because no relation between interface pressure and pressure ulcer development has been established and no clinical threshold for pressure ulcer development can be given, looking at the sitting behavior of nondisabled individuals is important. Nondisabled individuals do not develop pressure ulcers because they continuously shift posture. We analyzed the sitting behavior of 25 nondisabled male subjects by using a combination of interface pressure measurement and subcutaneous tissue oxygenation measurement by means of the Oxygen to See. These subjects shifted posture on average 7.8 +/- 5.2 times an hour. These posture shifts were merely a combination of posture shifts in the frontal and sagittal plane. Subcutaneous oxygen saturation increased on average 2.2% with each posture adjustment, indicating a positive effect of posture shifts on tissue viability. The results of this study can be used as a reference for seating interventions aimed at preventing pressure ulcers. Changing the sitting load at least every 8 minutes is recommended for wheelchair users.

Key words: dynamic sitting, interface pressure measurement, posture shift, pressure ulcer, recommendation, seating intervention, sitting behavior, tissue oxygenation, tissue viability, wheelchair seating.

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