Category: Spinal Cord Injury; Technology (e.g. robotics, assistive technology, mHealth)
Objective : The objective of this research was to assess postural and functional skills between an unsupportive fabric back and an add-on wheelchair back designed to support the spinal curves.
Design : Intervention study with randomization being the order of intervention on each participant.
Setting : Multi-site involving 2 Free-standing Spinal Cord Injury Model System Hospitals in Chicago and Denver
Participants (or Animals, Specimens, Cadavers) :
50 Non-ambulatory participants with complete SCI from C5-T5, between the ages of 18-60, with the mean age of 34. 78% were male.
A fabric back, which allowed a posterior pelvic tilt and kyphosis, was compared to a firm back that supported the spinal curves. The order of back use was randomized for each participant. The participants used their own wheelchair and seat cushion with the only variable being the back support
Main Outcome Measure(s) :
Outcome measures included: seated body angle measurements, which include the pelvic angle (femur to pelvis) and spinal angle of kyphosis (femur to acromion), Vertical Forward Reach Test (VFRT), spirometry, pulse oximetry, one stroke push,Timed forward and Wheeling/Wheelchair Propulsion Test (WPT), and Ramp Ascent (forward wheeling), a pain rating scale, and a survey about perceptions of each back in terms of stability, function, and use.
Results : The mean difference in pelvic angle between the two backs was 9.16 with a p-value of
Conclusions : Vertical Forward Reach increased when a person sat in a wheelchair with the spinal curves supported. Participants consistently reported a feeling of increased stabilization when using the supportive back. This pilot study demonstrated that four outcome measures could be used to evaluate the effectiveness of the back on upward reach, ramp ascent, one stroke push, and forward propulsion. A larger multi-site study is recommended to increase the number of participants and further validate the use of the outcome measures when assessing functionality and postural support of a wheelchair back support.
Jessica Presperin Pedersen– Assistant Professor Research OT, Shirley Ryan AbilityLab, Chicago, Illinois
Cynthia Smith– Outpatient Therapy Manager, Craig Rehabilitation Hospital, Englewood, Colorado
Margaret Dahlin– Physical Therapist, Craig Hospital, Englewood, Colorado
Molly Henry– Physical Therapist and Researcher, Shirley Ryan AbilityLab, Chicago, Illinois
Janell Jones– Physical Therapist, Craig Hospital, Englewood, Colorado
Kelly McKenzie– Senior Physical Therapist, Shirley Ryan AbilityLab, Chicago, Illinois
Heather Roussel– Stealth Regional Manager, Quantum Rehab / Stealth Products, Houston, Texas
Lindsey Yingling– Physical Therapist and Researcher, Shirley Ryan AbilityLab, Chicago, Illinois