Effect of durations of wheelchair tilt-in-space and recline on skin perfusion over the ischial tuberosity in people with spinal cord injury.

Abstract

To compare the efficacy of various durations of wheelchair tilt-in-space and recline on enhancing skin perfusion over the ischial tuberosity in people with spinal cord injury (SCI). Repeated-measures, intervention and outcomes measure design. University research laboratory. Power wheelchair users with SCI (N=9). Three protocols of various durations (3min, 1min, and 0min) of wheelchair tilt-in-space and recline were randomly assigned to the participants. Each protocol consisted of a baseline 15-minute sitting, a duration of 0- to 3-minute reclined and tilted, a second 15-minute sitting, and a 5-minute recovery. The position at the baseline and the second sitting was no tilt/recline of the participant and at the reclined and tilted and recovery was at 35° tilt-in-space and 120° recline. Skin perfusion response to tilt and recline was assessed by laser Doppler and was normalized to mean skin perfusion at the baseline sitting. The results showed that mean skin perfusion during recovery at the 3-minute duration was significantly higher than that at the 1-minute duration (P<.017) and mean skin perfusion was not significantly different between the 1-minute and 0-minute durations (not significant). Skin perfusion during the second sitting was significantly higher at the 3-minute duration than at the 1-minute and 0-minute durations (P<.017). Our findings suggest that performing the 3-minute duration of wheelchair tilt-in-space and recline is more effective than the 1-minute duration in enhancing skin perfusion of weight-bearing soft tissues.