Reducing iliotibial band contractures in patients with muscular dystrophy using custom dry floatation cushions.

Abstract

Custom dry floatation cushions were used to potentially reduce iliotibial band (ITB) contractures in long-term wheelchair users. Time-series with repeated measures pretreatment and posttreatment with follow-up at 6 and 12 months. Community wheelchair users seen in private office. A volunteer sample of nine subjects diagnosed with Duchenne's or limb-girdle muscular dystrophy, nonambulatory at least 3 years, and able to lie prone were included. One subject dropped out owing to adverse effects, one for technical reasons. Seven subjects completed the study and were contacted 6 months later; two were evaluated 1 year later. The participants ranged in age from 9 to 69 years, were nonambulatory an average of 7 years, and spent 12 to 16 hours a day in their wheelchairs. Subjects used custom dry floatation (ROHO) wheelchair cushions for 9 weeks. The cushions were designed with a sunken middle portion and separately inflated lateral portions, providing adduction to the thighs. ITB contractures were measured using goniometry every 3 weeks, twice before and three times after cushion delivery. After 9 weeks, a 13 degrees average decrease in ITB contracture was noted, representing a 34% change from baseline (p < .001, 99% confidence intervals, paired one-tailed t test). Using a custom dry floatation cushion for 9 weeks reduced ITB contractures in nonambulatory muscular dystrophy patients by an average 34%. Patients with large initial ITB contractures benefited the most. Such a cushion could be used to reduce ITB contractures in similar patient populations.