Date: Monday, December 7, 2015
Editor’s Note: Ride Designs has graciously donated their blog post space to Sharon Sonenblum, a rehabilitation engineer and Senior Research Scientist at Georgia Tech, to share her thoughts and research findings on some very important topics: sitting mechanics, pressure ulcers, wheelchair cushions, and butts. Sharon is Senior Research Scientist at Georgia Tech, and she has been studying wheelchair use, ulcer prevention, and the response of buttocks to loading for over a decade. This is the second in a series. To read the first blog, What Butts Tell Us About Biomechanical Risk, click here.
Wheelchair cushions serve many roles for the individuals sitting on them for more than 10 hours per day. Identifying a cushion that will provide sufficient protection from pressure ulcer development while meeting the other goals such as comfort, stability, and postural support can be very challenging, and there is little scientific evidence available to support those decisions.
What do we know about skin protection cushions? Skin protection cushions are covered by insurance for pressure ulcer prevention. Currently, entry into this class of cushions requires that that the cushion experiences a minimum level (40 mm) of immersion using a standardized test. The immersion measurement was developed by Dr. Stephen Sprigle at Georgia Tech as a multi-part test to describe cushion features and characteristics. While informative, it does not offer enough sensitivity to represent a cushion’s ability to support the buttocks tissues. In fact, as of right now, no standardized test exists to evaluate the Shape Compliance of a wheelchair cushion, or the ability of a cushion to support the buttocks with minimal buttocks deformation.
So how do we match an individual (and their distinct buttocks) with an appropriate wheelchair cushion? Clinicians certainly have strategies they use, but wouldn’t it be great to have a tool that clinicians (especially new clinicians) could use? Pop a few demographics and some measurements about the clients’ Biomechanical Risk into your mobile device, and out comes a list of cushions that should support the clients’ buttocks adequately. Now the clinician can focus on other practical and functional concerns to narrow down the options.
My colleagues and I are very interested in developing just such an app. First, that will require some investigation into the factors that best predict an individual’s Biomechanical Risk. We would appreciate your feedback on these questions:
- What factors do you use to pair someone with a wheelchair cushion?
- Would you be willing to measure someone’s tissue compliance if it required a mat exam? If it took only 3 minutes?
- Would you use interface pressure mapping if you knew what to do with the resulting pressure map?
Thanks for your feedback!