Effect of Wheelchair Tilt-In-Space and Recline Angles on Skin Perfusion Over the Ischial Tuberosity in People With Spinal Cord Injury

Arch Phys Med Rehabil, 2010 · DOI: 10.1016/j.apmr.2010.07.227 · Published: November 1, 2010

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study looks at how different angles of tilt and recline in wheelchairs affect blood flow to the skin over the ischial tuberosities (the bony part of your bottom) in people with spinal cord injuries. Researchers measured skin perfusion (blood flow) using laser Doppler flowmetry while participants sat in various tilted and reclined positions. The goal was to find out which angles are most effective for improving blood flow and potentially preventing pressure ulcers.

Study Duration

Not specified

Participants

11 wheelchair users with SCI

Evidence Level

Repeated measures, intervention and outcomes measure design

Key Findings

1
When combined with 100° recline, a 35° tilt-in-space significantly increased skin perfusion compared to sitting upright.
2
When combined with 120° recline, tilt-in-space at 15°, 25°, and 35° all significantly increased skin perfusion.
3
Smaller angles of tilt-in-space and recline may not be sufficient for effective pressure reduction to enhance skin perfusion.

Research Summary

This study investigated the impact of various wheelchair tilt-in-space and recline angles on skin perfusion over the ischial tuberosity in individuals with spinal cord injury (SCI). The results suggest that a tilt-in-space angle of at least 35° combined with a 100° recline, or a tilt-in-space angle of at least 25° combined with a 120° recline, is needed to significantly enhance skin perfusion. The findings highlight the importance of using sufficient angles of tilt and recline to promote blood flow and potentially prevent pressure ulcers in wheelchair users with SCI.

Practical Implications

Clinical Practice

Clinicians should recommend tilt-in-space angles of at least 35° with 100° recline or at least 25° with 120° recline to enhance skin perfusion.

Wheelchair Configuration

Wheelchairs should be configured to allow users to achieve the recommended tilt and recline angles for effective pressure relief.

User Education

Wheelchair users need to be educated about the importance of using adequate tilt and recline angles to prevent pressure ulcers.

Study Limitations

1
The study used skin perfusion as the primary outcome measure, but other factors also contribute to pressure ulcer development.
2
The study used a standard foam cushion, and results may not be generalizable to other cushion types.
3
The sample size was relatively small (n=11), which may limit the generalizability of the findings.

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