Contributions of posture and deformity to the body-seat interface conditions of a person with spinal cord injuries

Over the last two decades research emphasis has been placed on studying the effects of pressure on the buttock tissues of individuals with spinal cord injury. It is evident that the prolonged application of pressures above certain threshold levels will initiate a pathological process in the tissues that can lead to necrosis and ulceration. The exact mechanics of the process is not clearly understood. There is also evidence which suggests that a number of additional factors could be involved in the formation of pressure sores. For example, shear stresses and tissue distortion, repeated loadings, impact stress, temperature and humidity, metabolic stress, nutritional status, age, body stature, and psychological factors have all been implicated as possible contributing factors. In spite of this extensive research effort very few clear quantitative measures and guideline have been developed that can be used for clinical decision-making. That is, there are still missing pieces to the pressure sore problem. This study investigates the possible contributions of pelvic and spinal deformity and body posture to the variables occurring at body-seat interface. Four variables were investigated involving two study groups; a normal control group and a group of individuals with spinal cord injury. The variables are: spinal/pelvic alignment, pressures across the buttock support area, tangential shear at the support surface, and locations of centre of gravity. The latter three variables where measured for both groups in nine standardized postures commonly assumed while sitting in a wheelchair. Spinal/pelvic alignment involved a radiographic series taken in three of the nine sitting postures. The results indicate that pressure distribution and tangentially-induced shear forces are highly influenced by body posture. The results also indicate differences between the study groups in pelvic alignment and movement of the ischial tuberosities during changes of body posture. It is proposed that these findings have important implications relative to the design of future seating devices and in the clinical practice of pressure sore management.

Name dc:type.qualificationname

phd

Level dc:type.qualificationlevel

doctoral-pg

Grantor dc:publisher.institution

University of Strathclyde

Year dc:date.issued

1988

Author dc:creator

• Hobson, Douglas A.

DOI

10.48730/ygpv-qk68

Identifier

uk.bl.ethos.445679
T6356

OAI identifier oai:identifier

oai:strathclyde:5999n342c