Article

OBJECTIVE: To compare the efficacy of wheelchair tilt-in-space and recline on
enhancing muscle and skin perfusion over the ischial tuberosities in people with
spinal cord injury (SCI). DESIGN: Repeated-measures and before-after trial
design. SETTING: University research laboratory. PARTICIPANTS: Power wheelchair
users with SCI (N=20). INTERVENTIONS: Six combinations of wheelchair
tilt-in-space and recline angles were presented to participants in a random
order. The testing protocol consisted of a baseline 5 minutes sitting with no
tilt/recline and 5 minutes positioned in a tilted and reclined position at each
of 6 conditions, including: (1) 15 degrees tilt-in-space and 100 degrees recline,
(2) 25 degrees tilt-in-space and 100 degrees recline, (3) 35 degrees
tilt-in-space and 100 degrees recline, (4) 15 degrees tilt-in-space and 120
degrees recline, (5) 25 degrees tilt-in-space and 120 degrees recline, and (6) 35
degrees tilt-in-space and 120 degrees recline. MAIN OUTCOME MEASURES: Muscle and
skin perfusion were assessed by near-infrared spectroscopy and laser Doppler
flowmetry, respectively. RESULTS: Muscle perfusion was significantly increased at
25 degrees and 35 degrees tilt-in-space when combined with 120 degrees recline,
and skin perfusion was significantly increased at 3 tilt-in-space angles (15
degrees , 25 degrees , 35 degrees ) when combined with 120 degrees recline and at
35 degrees tilt-in-space when combined with 100 degrees recline (P<.05). Even in
the positions of increased muscle perfusion and skin perfusion (25 degrees and 35
degrees of tilt-in-space combined with 120 degrees of recline), the amount of
muscle perfusion change was significantly lower than the amount of skin perfusion
change (P<.05). CONCLUSIONS: Our results indicate that a larger angle of
tilt-in-space and recline is needed to improve muscle perfusion compared with
skin perfusion. A position of 25 degrees tilt-in-space combined with 120 degrees
recline is effective in enhancing muscle and skin perfusion of weight-bearing
soft tissues at the ischial tuberosities.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS