Biomechanical evaluation of a novel wheelchair backrest for elderly people

Li, Chun Ting; Chen, Chih Hsien; Chen, Yen-Nien; Chang, Chih Han; Tsai, Kuen-Horng

doi:10.1186/s12938-015-0008-6

Cited by 13 publications

(14 citation statements)

References 27 publications

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“…Many factors can increase the risk of pressure ulcers [ 3 – 5 , 25 – 27 ]. Wheelchair seating systems are a critical concern in this regard because of their impact on human-wheelchair interface pressure [ 4 , 13 , 24 , 28 ]. When sitting in a standard wheelchair, the user’s buttocks area will bear most of their body weight, and the concentration of stress at the ITs and surrounding soft tissues may aggravate the risk of pressure ulcers [ 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…The contact area (CA), average pressure (AP), and peak pressure (PP) on the back area (BCA, BAP, and BPP), the ischial area (ICA, IAP, and IPP), and the femur area (FCA, FAP, and FPP) were recorded and calculated. Numerous studies have used these parameters to determine the risk of pressure ulcers [ 13 , 20 , 24 ]. The CA refers to the size of the interface pressure contact area between the human body and wheelchair.…”

Section: Methodsmentioning

confidence: 99%

“…These devices can be used independently on different types of wheelchairs. Some studies have shown that lumbar supports can reduce stress on the intervertebral discs by creating lumbar lordosis at the waist and shifting part of the stress from the buttocks area to the lumbar support that the back area is leaning on [ 13 – 16 , 19 ]. Furthermore, cushions correct the problem of stress concentration at the ITs by redistributing stress on the buttocks and thighs [ 4 , 12 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the effect of different sitting assistive devices in reclining wheelchair on interface pressure

Huang

Kung

et al. 2017

BioMed Eng OnLine

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BackgroundReclining wheelchair users often add one or more sitting assistive devices to their wheelchairs, but the effect of these additional sitting assistive devices on the risk of pressure ulcers has rarely been investigated. This study examined the four modes of reclining wheelchair without and with different sitting assistive devices, namely the back reclined mode, the lumbar support with back reclined mode, the femur upward with back reclined mode, and the lumbar support with femur upward with back reclined mode, in terms of their effects on human-wheelchair interface pressure.MethodsThis study recruited 16 healthy participants to undergo the aforementioned four modes in random order and have their human-wheelchair interface pressure measured. The initial setting of experimental reclining wheelchair backrest was pushed backward to reach a 150° recline. The data on interface pressure were collected for 5 s while the participant maintained a stable sitting position. The contact area, average pressure, and peak pressure on the back area, ischial area, and femur area were recorded and calculated.ResultsAmong all tested modes, the lumbar support with femur upward with back reclined mode provided the most significant reduction in stress load on the ischial area (P ≤ 0.010) and shifted part of the load to the femur area (P ≤ 0.009).ConclusionsThis study quantified the effects of and differences between various reclining wheelchair–sitting assistive device combination modes. These findings are useful for the decision-making processes of rehabilitation physicians, wheelchair users, and manufacturers.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the effect of different sitting assistive devices in reclining wheelchair on interface pressure

Huang

Kung

et al. 2017

BioMed Eng OnLine

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“…The seat cushion was adjusted to allow a gap between the cushion and popliteal fossa. When the participants were seated in the experimental wheelchair, they were asked to rest their upper body against the backrest, relax their arms and place them at their sides, try to keep their thighs parallel to the ground, place their feet firmly on top of the footrest at shoulder width, and look directly ahead [10, 28]. Next, they performed each of the 7 DSSs in random order.…”

Section: Methodsmentioning

confidence: 99%

Comparing the effects of different dynamic sitting strategies in wheelchair seating on lumbar-pelvic angle

Peng

Tseng

et al. 2016

BMC Musculoskelet Disord

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BackgroundProlonged static sitting in a wheelchair is associated with an increased risk of lower back pain. The wheelchair seating system is a key factor of this risk because it affects spinal loading in the sitting position. In this study, 7 dynamic sitting strategies (DSSs) are examined: lumbar prominent dynamic sitting (LPDS), back reclined dynamic sitting (BRDS), femur upward dynamic sitting (FUDS), lumbar prominent with back reclined dynamic sitting (LBDS), lumbar prominent with femur upward dynamic sitting (LFDS), back reclined with femur upward dynamic sitting (BFDS), and lumbar prominent with back reclined with femur upward dynamic sitting (LBFDS). The objective of this study was to analyze the biomechanical effects of these sitting strategies on lumbar-pelvic angles.MethodsTwenty able-bodied participants were recruited for the study. All participants performed LPDS, BRDS, FUDS, LBDS, LFDS, BFDS, and LBFDS in a random order. All lumbar-pelvic angle parameters, including the static lumbar angle, static pelvic angle, lumbar range of motion, and pelvic range of motion were measured and compared.ResultsResults show that LBDS and LBFDS enabled the most beneficial lumbar movements, although the difference between the 2 strategies was nonsignificant. BRDS and BFDS enabled the most beneficial pelvic movements, although the difference between the 2 strategies was nonsignificant. Among all the upright DSSs, LPDS and LFDS enabled the most beneficial lumbar and pelvic movements, although no significant difference was observed between these 2 strategies.ConclusionsWe identified the effects and differences among 7 DSSs on lumbar-pelvic angles. Wheelchair users can choose the most suitable DSS that meets their needs. These findings may serve as a reference for practicing physicians or wheelchair users to choose an appropriate dynamic wheelchair seating system.Trial registration ISRCTN12389808, 18th November 2016, retrospectively registered.

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“…One study suggested that different positioning of the wheelchair seat and back affected the lumbarpelvic angle and dynamic movement [21]. Additionally, variable thoracic or lumbar or pelvic (PL) support can generate different changes in muscle activation or pressure distribution or postural alignment, respectively [22][23][24]. This indicates that the shape or setting of wheelchairs also changes the posture or movement of users.…”

Section: Introductionmentioning

confidence: 99%

Influence of back support shape in wheelchairs offering pelvic support on asymmetrical sitting posture and pressure points during reaching tasks in stroke patients

Ukita

Abe

Kishigami³

et al. 2020

PLoS ONE

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Many poststroke hemiplegic patients have an asymmetrical wheelchair-sitting posture. This study aimed to investigate the impact of different back support shapes on asymmetrical sitting posture and pressure points among poststroke hemiplegic patients during an activities of daily living-related reaching task. This study included 23 poststroke hemiplegic patients who performed tasks that involved the movement of objects using the unaffected upper limb to the affected side while sitting in a conventional wheelchair (C-WC) with a flat back support or a wheelchair providing pelvic and thoracic support (P-WC). Body alignment angles from video images and pressure distribution on supporting surfaces were measured using a twodimensional motion analysis software (Dartfish) and a pressure mapping system (FSA). Regarding movement performance, although postural asymmetry increased in both wheelchair types, the degree of postural variation was smaller with P-WC use than C-WC use (p < 0.05), with partly reduced postural asymmetry. With P-WC, one-sided ischial asymmetrical pressure was significantly less after the movement (p < 0.05). In conclusion, P-WC's back support shape contributed to a decrease in postural asymmetry for pelvic girdle support both at rest and during movement. This highlights the importance of a wheelchair back support shape and may help to increase the quality of activities of daily living movement in poststroke hemiplegic patients in wheelchairs.

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Biomechanical evaluation of a novel wheelchair backrest for elderly people

Cited by 13 publications

References 27 publications

Evaluation of the effect of different sitting assistive devices in reclining wheelchair on interface pressure

Evaluation of the effect of different sitting assistive devices in reclining wheelchair on interface pressure

Comparing the effects of different dynamic sitting strategies in wheelchair seating on lumbar-pelvic angle

Influence of back support shape in wheelchairs offering pelvic support on asymmetrical sitting posture and pressure points during reaching tasks in stroke patients

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