Abstract
A B S T R A C T
Aim: To establish a research approach for describing how different wheelchair cushion designs impact buttocks
tissue deformation during sitting.
Materials and methods: The buttocks of 4 individuals with spinal cord injury and significant atrophy were
scanned sitting in a FONAR Upright MRI. Scans were collected with the individuals' buttocks fully suspended
without pelvic support, and seated on 3 different commercially available wheelchair cushions. Multi-planar
scans were analyzed to provide 3D renderings and measurements of tissue thickness and shape.
Results: Bulk tissue thicknesses at the ischium, which rarely included muscle, were reduced by more than 60%
on enveloping cushion designs studied (i.e., Roho HP and Matrx Vi), and more variably (23–60%) on an orthotic
off-loading design (i.e., Java). Adipose was typically displaced posterior and superior from the unloaded condition,
with more lateral displacement on the Roho HP and Matrx Vi and more medial displacement present on
the Java. Large changes in angle at the sacro-coccygeal joint indicated significant loading on the region.
Deformation at the greater trochanter was more consistent across surfaces. Greater interface pressures tended to
be associated with greater deformation, but the relationship varied by individuals and was highly non-linear.
Conclusions: The buttocks in this study all deformed significantly, but at different locations and in different
manners across all 3 surfaces. Attention needs to be paid to the regions of greatest deformation. A future metric
of shape compliance should consider cushion performance at all high risk regions, and changes to the amount
and shape of tissue in the regions of interest.
Aim: To establish a research approach for describing how different wheelchair cushion designs impact buttocks
tissue deformation during sitting.
Materials and methods: The buttocks of 4 individuals with spinal cord injury and significant atrophy were
scanned sitting in a FONAR Upright MRI. Scans were collected with the individuals' buttocks fully suspended
without pelvic support, and seated on 3 different commercially available wheelchair cushions. Multi-planar
scans were analyzed to provide 3D renderings and measurements of tissue thickness and shape.
Results: Bulk tissue thicknesses at the ischium, which rarely included muscle, were reduced by more than 60%
on enveloping cushion designs studied (i.e., Roho HP and Matrx Vi), and more variably (23–60%) on an orthotic
off-loading design (i.e., Java). Adipose was typically displaced posterior and superior from the unloaded condition,
with more lateral displacement on the Roho HP and Matrx Vi and more medial displacement present on
the Java. Large changes in angle at the sacro-coccygeal joint indicated significant loading on the region.
Deformation at the greater trochanter was more consistent across surfaces. Greater interface pressures tended to
be associated with greater deformation, but the relationship varied by individuals and was highly non-linear.
Conclusions: The buttocks in this study all deformed significantly, but at different locations and in different
manners across all 3 surfaces. Attention needs to be paid to the regions of greatest deformation. A future metric
of shape compliance should consider cushion performance at all high risk regions, and changes to the amount
and shape of tissue in the regions of interest.
Original language | English |
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Pages (from-to) | 162-172 |
Number of pages | 11 |
Journal | Journal of Tissue Viability |
Volume | 27 |
Issue number | 3 |
Early online date | 9 May 2018 |
DOIs | |
Publication status | Published (in print/issue) - 31 Aug 2018 |
Keywords
- Pressure ulcer
- Wheelchair cushion
- MRI
- Buttocks
- Multi-planar
- Tissue deformation
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John Cathcart
- School of Health Sciences - Senior Lecturer School of Health Science
- Faculty Of Life & Health Sciences - Senior Lecturer
Person: Academic