Date Presented 04/03/2025
The purpose of this study is to examine the influence of environmental mobility conditions (e.g., static sitting, flat surface propulsion, and ascending in an elevator) on sitting pressure using different commercially available wheelchair cushions.
Primary Author and Speaker: Martin S. Rice
PURPOSE: Occupational therapists have a role in prescribing strategies to mitigate decubitus ulcer formation for wheelchair users. This study examined the influence of environmental mobility conditions (e.g., static sitting, flat surface propulsion, and ascending in an elevator) upon sitting pressure using different commercially available wheelchair cushions.
DESIGN: This study used a counter-balanced repeated measures design to investigate sitting pressure across wheelchair cushions (no-cushion, foam [Spectrum Foam SPP], and pneumatic [High Profile Roho] cushions) and wheelchair mobility activities (static sitting, linear propulsion, and riding up and down in an elevator). Using a sample of convenience, 16 healthy ambulatory adult participants were recruited.
METHOD: A standard K0001 wheelchair was adjusted for proper sitting posture and after obtaining informed consent, participants were randomly assigned to a presentation-of-order group involving the cushion conditions. Average and peak sitting pressure was measured using an XSensor Pressure Imaging system.
RESULTS: A 3x4 (Cushion Condition X Mobility Activity) ANOVA revealed significant differences across the mobility activities and cushion conditions. Post-hoc comparisons revealed a significant difference between the no-cushion and the 2 cushion conditions, but not between the 2 cushions. Repeated contrasts revealed a significant difference between static sitting and the other mobility activities including propulsion and elevator conditions.
CONCLUSION: This study determined that sitting pressure was significantly reduced with wheelchair cushions and that this difference existed regardless of mobility activity. Static sitting pressure was significantly less compared to propulsion and during elevator ascension. Because pressure increased with activity, it is imperative for OTs to prescribe proper cushions to help prevent decubitus ulcers, particularly for active wheelchair users.
References
Lung, C. W., Yang, T. D., Liau, B. Y., Cheung, W. C., Jain, S., & Jan, Y. K. (2020). Dynamic changes in seating pressure gradient in wheelchair users with spinal cord injury. Assistive Technology, 32(5), 277–286.
Sonenblum, S. E., McDonald, A., Maurer, C. L., Bass, A., Watson, M., & Zellner, H. (2024). Reducing pressure with the goal of improving outcomes: a retrospective chart review of cushion evaluations and recommendations at one seating clinic. Disability and Rehabilitation: Assistive Technology, 19(4), 1552–1560.
