Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 8, 2014
   Pages 1265 — 1276

Abstract — Effects of conventional and alternating cushion weight-shifting in persons with spinal cord injury

Gary A. Wu, PhD;1 Kath M. Bogie, DPhil1–2*

1Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, Cleveland, OH; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH; and Advanced Platform Technology Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH; 2Department of Orthopaedics, Case Western Reserve University, Cleveland, OH

Abstract — A repeated-measures study of 13 adult full-time wheelchair users with spinal cord injury (SCI) was carried out to determine whether alternating-pressure air cushion (APAC) use compared with independent pressure relief (IPR) provides reliable, effective pressure relief for individuals with SCI. Bilateral mean ischial interface pressure (IP), transcutaneous oxygen tension (TcPO2), and unilateral laser Doppler blood flow were evaluated. Blood flow component contributions were determined using short-time Fourier transform (STFT)-based spectral analysis. IPR assessment was carried out at recruitment. Study participants then used an APAC for 2 wk every 3 mo for 18 mo. IPR weight-shifting decreased mean ischial IP (p < 0.05) and increased mean TcPO2 (p < 0.05). All variables rapidly returned to preintervention levels following weight-shifting except for the cardiac component of blood flow. APAC-induced weight-shifting decreased mean ischial IP (p < 0.05). Mean TcPO2 increased and was higher than for IPR. STFT analysis indicated that quiet sitting following APAC-induced weight-shifting produced a higher neurogenic component of blood flow than following IPR (p = 0.02). Thus, IPR positively affects multiple aspects of tissue health but produces transient improvements and must be repeated regularly. APAC activation dynamically and continuously alters IP distribution with more sustained positive tissue health effects.

Key words: alternating-pressure air cushion, blood flow, independent pressure relief, interface pressure, repeated measures, spinal cord injury, tissue health, tissue oxygenation, weight-shifting, wheelchair seating.


View HTML ¦ View PDF ¦ Contents Vol. 51, No.8

This article and any supplementary material should be cited as follows:
Wu GA, Bogie KM. Effects of conventional and alternating cushion weight-shifting in persons with spinal cord injury. J Rehabil Res Dev. 2014;51(8):1265–76.
http://dx.doi.org/10.1682/JRRD.2014.01.0009
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