Comparative analysis of effects of various toilet seat cushions on buttock pressure during toileting in persons with spinal cord injury

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2021.1953314 · Published: November 1, 2023

Spinal Cord Injury Rehabilitation Dermatology

Simple Explanation

This study investigates how different toilet seat cushions affect pressure on the buttocks of individuals with spinal cord injury (SCI) during toileting. The research aims to identify which type of cushion (foam, gel, or air) can best reduce pressure and potentially prevent pressure ulcers, a common complication for those with SCI. By measuring buttock pressure with and without cushions, the study provides recommendations for cushion use based on where individuals experience the most pressure during toilet seating.

Study Duration

Not specified

Participants

41 persons with SCI

Evidence Level

Case series study

Key Findings

1
Toilet seating without a cushion results in significantly higher maximum buttock pressure compared to wheelchair seating with an air cushion.
2
The location of maximum buttock pressure during toilet seating varies among individuals with SCI, with pressure concentrated in the greater trochanter (GT), ischial tuberosities (IT), or sacral region (SR).
3
Gel cushions are most effective for individuals in the IT group, while air cushions are recommended for the GT and SR groups to reduce buttock pressure during toilet seating.

Research Summary

This study measured buttock pressure in 41 individuals with SCI during toilet seating with and without various cushions (foam, gel, air). The results showed that different cushions affected buttock pressure distribution, with air cushions beneficial for those with pressure in the GT and SR regions, and gel cushions for those with pressure in the IT region. The study concludes that using appropriate cushions can reduce the risk of pressure ulcers during toileting for individuals with SCI, emphasizing the importance of individualized cushion selection.

Practical Implications

Cushion Selection

Healthcare providers can use these findings to recommend specific types of toilet seat cushions based on an individual's pressure distribution during toileting.

Pressure Ulcer Prevention

The study highlights the importance of pressure relief during toilet seating for individuals with SCI, suggesting targeted interventions to reduce pressure ulcer risk.

Toilet Seat Design

The results may inform the design of toilet seats and cushions to better accommodate the needs of individuals with SCI and reduce pressure points.

Study Limitations

1
The study lacks information on soft tissue volume in the buttocks, which can influence pressure distribution.
2
The study only included individuals with ASIA Impairment Scale A.
3
The sample size for the IT and SR groups was relatively small compared to the GT group.

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