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The Importance of Comfort to Wheelchair Users: A Preliminary StudyBarbara Crane, MA, PT, ATP Slide 1
Barbara Crane, MA, PT, ATP This preliminary study was conducted as the first phase of a multi-phase study of wheelchair seat comfort issues and the potential of a new dynamic seat technology in improvement of wheelchair seat comfort. This study is being conducted as a part of the RERC on Wheelchairs and related technology at the University of Pittsburgh. Slide 2
Individuals who use wheelchairs because of severe mobility impairment and have sensation are at high risk of comfort related problems Comfort and discomfort have not been extensively investigated in the wheelchair seating industry There are two basic problems that are the impetus for this phase: People who use wheelchairs, cannot move, but have intact sensation are perceived as having many problems related to comfort. Clinically we know that this can be a very difficult problem to resolve. The second issue is that this topic has had very little research directed towards it. Greg Shaw investigated discomfort in a population of nursing home residents and several others have done some preliminary study, but overall it has not been the focus of a great deal of seating research up to this point. Slide 3
Discomfort may occur in any wheelchair using population Most common in sensate populations with inability to move -- i.e. multiple sclerosis, amyotrophic lateral sclerosis, muscular dystrophy, post polio, frail elders with arthritis and debility, Guillian Barre syndrome Notes: Populations of wheelchair users with relatively intact sensation and severe motor impairment seem to be particularly affected. These include: MS, ALS, MD, PPS, GBS, frail elders, arthritic, debility, some instances of CVA Individuals with cerebral palsy may also be affected, but they seem to be spared this complication in many cases -- possibly because of spared motor function and the ability to use spasticity and abnormal movement patterns to their benefit. Clinically, this does not seem to be a population of individuals with a great deal of discomfort. (it could be that they are not asked about discomfort and do not report it) This study will focus on a subset of these populations -- MS, MD, ALS, and polio. These populations were selected because of their propensity toward discomfort and related functioning problems. Slide 4
Multiple sclerosis
MS, ALS and MD combined account for 150,000 wheelchair users in the US The primary cause of wheelchair use in all age groups is CVA, followed by arthritis -- tend to be frail elder population IN contrast, the population of individuals who use wheelchairs because of quadriplegia or paraplegia (the focus of the majority of seating research) is around 90,000 (NIDDR report) This does not even include institutionalized populations -- which Shaw determined also had a high prevalence of comfort problems Slide 5
Determine the prevalence of discomfort as a problem in this population Investigate the importance of comfort to this population Determine strategies or equipment that might mitigate discomfort Note: Slide 6
Questionnaire based descriptive study Nine individuals: MS, MD, ALS All full time wheelchair users All had intact sensation and difficulty weight shifting All had experienced some problems with discomfort Note: Slide 7
Four parts Part I - general/demographic info Part II - functional information Part III - current level of comfort Part IV - suggestions for improving comfort Notes: Slide 8
Demographic information: Age range 18 - 66, mean age 41 Slide 9
Average time spent in wheelchair -- 15 hours per day (range 8 - 24 hours) All 9 reported routinely ignoring discomfort in order to function 5 reported experiencing discomfort on a daily basis Most common site - low back (7), next most common - buttocks(6) Slide 10
Most important aspect of wheelchair: Importance of adjustability: Notes: The first was related to the most important aspect of the wheelchair itself. The other related to the importance of having various features of the wheelchair be adjustable. This information was targeted specifically to gather suggestions as to what needed to be included in our test chair. Slide 11
All participants indicated that comfort is very important to them All indicated that discomfort is a significant problem associated with wheelchair use 3 reported getting out of their chairs in order to manage discomfort 5 indicated problems with skin breakdown Notes: All participants indicated that comfort was very important and that discomfort was a significant problem in their lives. Three of the nine individuals reported that they had to get out of their chairs in order to relieve discomfort. Five of these individuals had experienced at least one episode of skin breakdown -- in spite of the fact that this is considered a low risk group. (another individual was excluded from the study because of a current skin breakdown episode) Slide 12
National Institute on Disability Rehabilitation and Research -- Rehabilitation engineering and research center on wheelchairs and related technology Grant #H133E990001 Technical assistance in questionnaire development provided by Shirley Fitzgerald, PhD, University of Pittsburgh Slide 13
Barbara Crane, MA, PT, ATP RERC on Wheelchairs and Related Technology Slide 14
Updated: March 22, 2002 |
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