The impact of activities of daily living on seating interface pressures

Abstract

Even though the prevention of pressure ulcers is a priority area for healthcare agencies globally (Dunn & Stander, 2008; Graves et al., 2005; Russo & Exilhauser, 2006), these challenging wounds continue to trouble individuals with impaired sensation, prolonged immobility, or advanced age. The purpose of this thesis was to investigate the effectiveness of integrating pressure redistributing activities into everyday life for reducing interface pressures for individuals at risk of ulceration. The first study reviewed the literature and found that the majority of individuals at risk of developing pressure ulcers do not adhere with the pressure relieving frequency currently recommended. It also highlighted that there is no known magnitude of movement currently recommended to relieve interface pressure. In order to measure magnitude of seated movement, the second study explored the effect of anatomical positioning of the Activpal3 accelerometer. The most stable measurement came from the accelerometer placed at the sternum. The third study investigated the effect of duration and magnitude of forward reach on body seat interface pressures of able bodied subjects sitting in a wheelchair. Reaching forward significantly redistributed pressure at the seating interface, as demonstrated by the change in dispersion index and contact area compared to upright sitting. The fourth study investigated the time that older adults spend in sitting while on a rehabilitation ward and how frequently they engage or are assisted to engage in repositioning movements when sitting. The older adults spent the majority of their time in a seated position and did not perform seated movements at a magnitude large enough to redistribute seating interface pressures. The final study investigated the pressure relieving behaviours of SCI individuals during everyday computer use, and the application of an ergonomically adapted computer-based activity to reduce seating interface pressures. The majority of movements performed by participants in this study had minimal effect on interface pressures, yet many of the participants believed they performed frequent pressure reliefs. This thesis evidences the need for individual assessments and pressure relieving strategies, and introduces a novel concept of integrating pressure relief within everyday activities.

Date of Award	May 2014
Original language	English
Sponsors	Department of Employment and Learning
Supervisor	May Stinson (Supervisor), Alison Porter-Armstrong (Supervisor) & Stephen Sprigle (Supervisor)