Sitting position–Posture and performance in C5–C6 tetraplegia

Bolin, I; Bodin, P; Kreuter, Margareta

doi:10.1038/sj.sc.3101031

Cited by 50 publications

(36 citation statements)

References 13 publications

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“…Lower backrests allow for greater freedom of upper extremity movement. 18,19 Further, headrest is necessary if the patient does not have enough neck control and has an upper level of cervical SCI. 2 Although it was required, only one patient did not have headrest in our study.…”

Section: Discussionmentioning

confidence: 99%

Wheelchair appropriateness in patients with spinal cord injury: a Turkish experience

2014

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Study design: Descriptive. Objective: To determine the wheelchair appropriateness in patients with spinal cord injury (SCI). Setting: National Rehabilitation Center in Ankara, Turkey. Methods: Twenty-seven (25 male, 2 female) SCI patients were included. Demographic and clinical characteristics of the patients were noted. All wheelchairs were evaluated considering each part (seat length, seat depth, seat height, back height, armrest, headrest, wheels and seat belt) by a physiatrist who had attended the wheelchair-training course. The wheelchair was declared as inappropriate if at least three parts of wheelchair were not appropriate. Results: The mean age of the patients was 32.9 ± 9.3 years and mean duration of wheelchair use was 19.63 ± 23.02 months. Among the patients, 21 (77.8%) were American Spinal Injury Association Impairment Scale (AIS) A, 4 (3.7%) AIS B, 1 (3.7%) AIS C and 1 (3.7%) AIS D. Five (18.5%) wheelchairs were motorized and 22 (81.5%) were manual. Overall, 15 (55.6%) wheelchairs were inappropriate. Seat height, cushion and back height were the most common inappropriate parts. Conclusion: In light of our first and preliminary results, we can argue that 55% of the patients with SCI use inappropriate wheelchairs. In order to achieve better mobility; personally designed wheelchairs should be prescribed by the clinicians.

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Section: Discussionmentioning

confidence: 99%

Wheelchair appropriateness in patients with spinal cord injury: a Turkish experience

2014

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“…Several studies have investigated the effect of wheelchair configurations or seating systems on reach and UE functional tasks. These studies found results differed depending on the task and the configuration used in the study (2,7,15,18,(26)(27)(28).…”

Section: Introductionmentioning

confidence: 99%

Development of Valid and Reliable Measures of Postural Stability

Sprigle

Maurer²,

Holowka³

2007

The Journal of Spinal Cord Medicine

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Background/Objective: The development of simple postural stability tests that relate to performance of activities of daily living (ADL) and can be quickly performed in a clinical setting may assist clinicians in determining appropriate wheelchair configurations and postural supports in an efficient manner. The study's purpose was to validate 3 clinical measures of reach-functional reach (FR), reach area (RA), and bilateral reach (BR)-against the performance of ADL tasks.Methods: Two groups of 20 subjects differing by time since spinal cord injury were tested. Three measures of reach-FR, RA, and BR-were recorded with and without permitting compensatory strategies. Subjects also attempted a series of ADL tasks. Group 2 subjects participated in test-retest reliability of the reach measures and to measure reach while using compensatory strategies. Correlation, ANOVA, and linear regression were used for analysis.Results: Regression analysis showed that injury level was a significant predictor of success in performing ADL tasks (%ADL). Significant but not strong correlations were found between %ADL and all uncompensated reach measures. Within Group 2 subjects, compensated FR (r ¼ 0.663) and RA (r ¼ 0.647) were more related to the %ADL score than the uncompensated FR (r ¼ 0.348) and RA (r ¼ 0.305) measurements. BR had the strongest relationship with %ADL scores (P ¼ 0.031) and was the only significant uncompensated reach measurement within the regression analyses.Discussion and Conclusion: While working with clients on seated stability and functional movement, clinicians should be encouraged to incorporate BR tasks because it has the strongest relationship to ADL performance. Researchers interested in studying postural control and stability during functional tasks should consider using uncompensated reach measures.

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“…Other authors have used skin-mounted markers on ASIS, trochanter major, and vertical and horizontal lines. 30 Myhr and von Wendt 31 analyzed video films and photographs of children with cerebral palsy in different sitting positions. In order to calculate angles on photographs, anatomical landmarks were used and a line drawn vertically through the landmark of trochantor major was used to define the fulcrum.…”

Section: Introductionmentioning

confidence: 99%

Clinical evaluation of seating in persons with complete thoracic spinal cord injury

et al. 2003

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Study Design: Consecutive male patients studied with photographic measurement of a combination of clinical methods. Objectives: To describe seating in individuals with complete thoracic spinal cord injury (SCI) by using a combination of clinical methods. Setting: Spinalis SCI unit, Stockholm, Sweden. Methods: Wheelchair specifications were documented. Measurements of posture from photographs in 30 male subjects with complete thoracic SCI, sitting in a relaxed and an upright position on a standardized surface and in a wheelchair were calculated. A comparison was made between positions and seating surfaces. An examiner's classification of lower trunk position in wheelchair was compared to subjects' evaluations. SCI subjects reported sitting support, satisfaction, and wishes for improvement. Results: Most SCI subjects used similar wheelchair specifications. None of the backrests were custom designed. Relatively small differences were found between the relaxed and upright position in the wheelchair regarding measurements of posture and according to the examiner's classification of the lower trunk position. Only 13/30 SCI subjects were sitting with the lower trunk centered relative to the backrest in the upright position. The examiner's classification and the subjects' evaluation of asymmetric sitting were not always in agreement. Only 12/30 SCI subjects were satisfied with their way of sitting. Conclusion: Current wheelchair specifications and adjustments seem to inhibit a postural correction towards upright sitting and fail to provide sufficient lateral support. Findings indicate an inability for SCI subjects to vary their sitting position in a wheelchair to a large extent. Both an examiner's classification and subjects' evaluation of asymmetric sitting are necessary to obtain a sufficient knowledge base for subsequent adjustment. By using methods regarding different aspects of seating, a more comprehensive view of seating was achieved. The combination of clinical methods seems to be useful in order to describe seating in individuals with complete thoracic SCI.

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Sitting position–Posture and performance in C5–C6 tetraplegia

Cited by 50 publications

References 13 publications

Wheelchair appropriateness in patients with spinal cord injury: a Turkish experience

Wheelchair appropriateness in patients with spinal cord injury: a Turkish experience

Development of Valid and Reliable Measures of Postural Stability

Clinical evaluation of seating in persons with complete thoracic spinal cord injury

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