Ann Rehabil Med.  2018 Apr;42(2):270-276. 10.5535/arm.2018.42.2.270.

Pressure Relieving Effect of Adding a Pelvic Well Pad to a Wheelchair Cushion in Individuals With Spinal Cord Injury

• Shin H
• Kim J
• Kim JJ
• Kim HR
• Lee HJ
• Lee BS
• Han ZA

• KMID: 2432197
• DOI: http://doi.org/10.5535/arm.2018.42.2.270

Abstract

OBJECTIVE
To identify the pressure relieving effect of adding a pelvic well pad, a firm pad that is cut in the ischial area, to a wheelchair cushion on the ischium.
METHODS
Medical records of 77 individuals with SCI, who underwent interface pressure mapping of the buttock-thigh area, were retrospectively reviewed. The pelvic well pad is a 2.5-cm thick firm pad and has a cut in the ischial area. Expecting additional pressure relief, it can be inserted under a wheelchair cushion. Subjects underwent interface pressure mapping in the subject's wheelchair utilizing the subject's pre-existing pressure relieving cushion and subsequently on a combination of a pelvic well pad and the cushion. The average pressure, peak pressure, and contact area of the buttock-thigh were evaluated.
RESULTS
Adding a pelvic well pad, under the pressure relieving cushion, resulted in a decrease in the average and peak pressures and increase in the contact area of the buttock-thigh area when compared with applying only pressure relieving cushions (p < 0.05). The mean of the average pressure decreased from 46.10±10.26 to 44.09±9.92 mmHg and peak pressure decreased from 155.03±48.02 to 131.42±45.86 mmHg when adding a pelvic well pad. The mean of the contact area increased from 1,136.44±262.46 to 1,216.99±255.29 cm².
CONCLUSION
When a pelvic well pad was applied, in addition to a pre-existing pressure relieving cushion, the average and peak pressures of the buttock-thigh area decreased and the contact area increased. These results suggest that adding a pelvic well pad to wheelchair cushion may be effective in preventing a pressure ulcer of the buttock area.

Keyword

Spinal cord injuries; Pressure ulcer; Wheelchairs

MeSH Terms

Buttocks
Ischium
Medical Records
Pressure Ulcer
Retrospective Studies
Spinal Cord Injuries*
Spinal Cord*
Wheelchairs*

Figure

• 

  Fig. 1 (A) A three-dimensional image of the pelvic well pad (blue). It is 2.5 cm thick and has a cut in the ischial area. A ready-made air cushion (translucent grey) is placed over it. (B) A schematic view from below of the pelvic well pad. The pelvic well pad is expressed as a translucent blue figure. The pelvic well pads were cut so that the relief area would be 3 cm in front of the anterior tip of the ischial tuberosity and 2.5 cm from the lateral borders of the ischial tuberosity.

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  Fig. 2 The XSENSOR X3 system. Interface pressure distribution between the seat cushion and the buttock-thigh area is displayed in color on a monitor.

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  Fig. 3 Pictures on the screen of XSENSOR X3 system presenting a graphical image of a subject's interface pressure of the buttockthigh area. Left side of each picture reflects the pressure of the buttock area, and right side reflects thigh area. (A) Image with application of only pressure relieving cushion. (B) Image with and additional pelvic well pad applied beneath the cushion.

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