Hygro-thermo-mechanical performance of wheelchair cushion technologies in the prevention of pressure ulcers and moisture-associated skin damages

Bogard, Fabien; Polidori, Guillaume; Murer, Sébastien; Maalouf, Chadi; Blancheteau, Yannick; Quinart, Hervé; Beaumont, Fabien

doi:10.1080/10400435.2021.1949406

Cited by 1 publication

(6 citation statements)

References 37 publications

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“…Measures of relative humidity to examine the moisture at the cushion‐user interface were reported in four of the eight studies (Bogard et al, 2023; Hsu et al, 2018; Liu et al, 2017; Yang et al, 2018). Two studies measured the relative humidity at the cushion‐user interface between the wheelchair cushion and clothed participants (Bogard et al, 2023; Liu et al, 2017). Two of the studies measured the relative humidity at the skin with sensors taped to the skin (Hsu et al, 2018; Yang et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

“…Two of the studies measured the relative humidity at the skin with sensors taped to the skin (Hsu et al, 2018; Yang et al, 2018). Data for relative humidity measures were reported as relative humidity change from baseline (Hsu et al, 2018), mean (Bogard et al, 2023; Hsu et al, 2018; Liu et al, 2017; Yang et al, 2018), median (Liu et al, 2017), and maximum (Liu et al, 2017) relative humidity and time taken to reach 50% of total change (Hsu et al, 2018). Measures of thermal perception were reported in two of the eight studies (Dattoli et al, 2020; García‐Molina et al, 2021) using customised Likert scales to gain subjective responses from the participants.…”

Section: Resultsmentioning

confidence: 99%

“…A forest plot for temperature responses between ‘air’ and ‘foam’ cushions is presented in Figure 2a. A meta‐analysis of two studies (68 participants, 39 female) found no significant difference in temperature between these cushions (standardised mean difference; SMD = −0.27, 95% CI: −0.75, 0.22; p = 0.28) (Bogard et al, 2023; Hsu et al, 2018). In this analysis, there was evidence of high heterogeneity ( I 2 = 78%, p = 0.03) in the data which could be attributed to differences in the sitting protocol duration between the two studies, which were 45 minutes (Bogard et al, 2023) and 2 hours (Hsu et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

“…A meta‐analysis of two studies (68 participants, 39 female) found no significant difference in temperature between these cushions (standardised mean difference; SMD = −0.27, 95% CI: −0.75, 0.22; p = 0.28) (Bogard et al, 2023; Hsu et al, 2018). In this analysis, there was evidence of high heterogeneity ( I 2 = 78%, p = 0.03) in the data which could be attributed to differences in the sitting protocol duration between the two studies, which were 45 minutes (Bogard et al, 2023) and 2 hours (Hsu et al, 2018). Further to this, the differences in temperature measurement methods could contribute to this high heterogeneity, with Hsu et al (2018) measuring skin temperature using sensors and Bogard et al (2023) measuring the cushion temperature using a thermal camera.…”

Section: Resultsmentioning

confidence: 99%

“…Other measures of temperature included cushion temperature, and the cushion-user interface temperature between the wheelchair cushion and clothed participants (i.e., a sensor embedded into a cushion). One study measured the cushion temperature while the user was sitting on it in (Liu et al, 2011) and another study measured the cushion temperature immediately after the user stood up (Bogard et al, 2023). Data for temperature measures were reported as absolute values (mean, median, and maximum temperature) or as a change from baseline.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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The effect of wheelchair cushion properties on the microclimate at the cushion‐user interface: A systematic review and meta‐analysis

Couzens,

Peterson,

Innes

et al. 2024

Aus Occup Therapy J

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IntroductionPressure injuries are a preventable yet highly prevalent health concern. Wheelchair cushion prescription can have significant implications for wheelchair users' risk of pressure injury development, which can impact functional abilities and quality of life. The efficacy of a wheelchair cushion to redistribute pressure has been well‐researched, but the efficacy to manage the microclimate is less clear, particularly in warm‐hot environments. The aim of this study was to systematically review studies examining the effect of wheelchair cushions on temperature, moisture and thermal perception to determine which cushions are superior to improve these responses.MethodA systematic review with meta‐analyses of randomised cross‐over and randomised control trials of wheelchair cushion interventions on measures of temperature, moisture, and thermal perception was conducted.ResultsEight studies were identified that met the eligibility criteria and six meta‐analyses were conducted. Pooled analyses identified a significantly lower temperature on foam‐gel cushions compared to air cushions (MD = 0.80, 95% CI: 0.31, 1.29; p = 0.002) and a significantly lower temperature on foam‐gel cushions compared to foam cushions (SMD = 0.76, 95%CI; 0.45, 1.06; p < 0.00001). Pooled analyses also demonstrated significantly lower relative humidity (i.e., moisture) on foam cushions compared to foam‐gel cushions (p = 0.02). Differences in thermal perception were inconclusive due to limited data found.ConclusionIt is clear that not one cushion is ideal in managing all aspects of microclimate, as foam‐gel cushions were the superior cushion to manage temperature and foam cushions were the superior cushion to manage moisture. This article provides occupational therapists and other health professionals with evidence‐based information to assist with wheelchair cushion prescription that minimises the temperature and moisture accumulation, and associated risk of pressure injury for wheelchair users.

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