Ann Rehabil Med.  2015 Dec;39(6):971-979. 10.5535/arm.2015.39.6.971.

The Effects of Body Mass Composition and Cushion Type on Seat-Interface Pressure in Spinal Cord Injured Patients

• Cho KH
• Beom J
• Yuk JH
• Ahn SC

• KMID: 2165624
• DOI: http://doi.org/10.5535/arm.2015.39.6.971

Abstract

OBJECTIVE
To investigate the effects of body mass composition and cushion type on seat-interface pressure in spinal cord injured (SCI) patients and healthy subjects.
METHODS
Twenty SCI patients and control subjects were included and their body mass composition measured. Seat-interface pressure was measured with participants in an upright sitting posture on a wheelchair with three kinds of seat cushion and without a seat cushion. We also measured the pressure with each participant in three kinds of sitting postures on each air-filled cushion. We used repeated measure ANOVA, the Mann-Whitney test, and Spearman correlation coefficient for statistical analysis.
RESULTS
The total skeletal muscle mass and body water in the lower extremities were significantly higher in the control group, whilst body fat was significantly higher in the SCI group. However, the seat-interface pressure and body mass composition were not significantly correlated in both groups. Each of the three types of seat cushion resulted in significant reduction in the seat-interface pressure. The SCI group had significantly higher seatinterface pressure than the control group regardless of cushion type or sitting posture. The three kinds of sitting posture did not result in a significant reduction of seat-interface pressure.
CONCLUSION
We confirmed that the body mass composition does not have a direct effect on seat-interface pressure. However, a reduction of skeletal muscle mass and body water can influence the occurrence of pressure ulcers. Furthermore, in order to minimize seat-interface pressure, it is necessary to apply a method fitted to each individual rather than a uniform method.

Keyword

Spinal cord injuries; Body mass index; Pressure ulcer; Pressure

MeSH Terms

Adipose Tissue
Body Mass Index
Body Water
Humans
Lower Extremity
Muscle, Skeletal
Posture
Pressure Ulcer
Spinal Cord Injuries
Spinal Cord*
Wheelchairs

Figure

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  Fig. 1 Measurement of seat interface pressure. (A) Pressure mapping technology showing a computer with pressure mapping software, flexible sensor pad and electronics unit. (B) CONFORMat pressure sensor. (C) An example of pressure distribution on the buttocks.

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  Fig. 2 Cushions analyzed in the present study. (A) Low-priced air-filled cushion. (B) 5 cm air-filled cushion (ROHO). (C) 10 cm air-filled cushion (ROHO).

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  Fig. 3 (A) Upright sitting posture, (B) 20° posterior leaning posture, (C) 20° trunk forward flexion posture.

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  Fig. 4 Correlation between seat-interface peak pressure and skeletal muscle mass in spinal cord injury (SCI) and control groups.

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  Fig. 5 Effect of seat cushion on seat-interface peak pressure in spinal cord injury (SCI) and control groups. a)indicates a significant difference between SCI and control. b)indicates a significant difference depending on application of wheelchair cushion.

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