Comparison of muscle and skin perfusion over the ischial tuberosities in response to wheelchair tilt-in-space and recline angles in people with spinal cord injury

Yih Kuen Jan, Barbara A. Crane, Fuyuan Liao, Jeffrey A. Woods, William J. Ennis

Research output: Contribution to journalArticle

Abstract

Objective: To compare the efficacy of wheelchair tilt-in-space and recline on enhancing muscle and skin perfusion over the ischial tuberosities in people with spinal cord injury (SCI). Design: Repeated-measures and before-after trial design. Setting: University research laboratory. Participants: Power wheelchair users with SCI (N=20). Interventions: Six combinations of wheelchair tilt-in-space and recline angles were presented to participants in a random order. The testing protocol consisted of a baseline 5 minutes sitting with no tilt/recline and 5 minutes positioned in a tilted and reclined position at each of 6 conditions, including: (1) 15 tilt-in-space and 100 recline, (2) 25 tilt-in-space and 100 recline, (3) 35 tilt-in-space and 100 recline, (4) 15 tilt-in-space and 120 recline, (5) 25 tilt-in-space and 120 recline, and (6) 35 tilt-in-space and 120 recline. Main Outcome Measures: Muscle and skin perfusion were assessed by near-infrared spectroscopy and laser Doppler flowmetry, respectively. Results: Muscle perfusion was significantly increased at 25 and 35 tilt-in-space when combined with 120 recline, and skin perfusion was significantly increased at 3 tilt-in-space angles (15, 25, 35) when combined with 120 recline and at 35 tilt-in-space when combined with 100 recline (P<.05). Even in the positions of increased muscle perfusion and skin perfusion (25 and 35 of tilt-in-space combined with 120 of recline), the amount of muscle perfusion change was significantly lower than the amount of skin perfusion change (P<.05). Conclusions: Our results indicate that a larger angle of tilt-in-space and recline is needed to improve muscle perfusion compared with skin perfusion. A position of 25 tilt-in-space combined with 120 recline is effective in enhancing muscle and skin perfusion of weight-bearing soft tissues at the ischial tuberosities.

Original languageEnglish (US)
Pages (from-to)1990-1996
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume94
Issue number10
DOIs
StatePublished - Oct 1 2013

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Wheelchairs
Spinal Cord Injuries
Perfusion
Muscles
Skin
Laser-Doppler Flowmetry
Near-Infrared Spectroscopy
Weight-Bearing
Outcome Assessment (Health Care)

Keywords

  • Laser-Doppler flowmetry
  • Rehabilitation
  • Spectroscopy, near-infrared
  • Wheelchairs

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

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title = "Comparison of muscle and skin perfusion over the ischial tuberosities in response to wheelchair tilt-in-space and recline angles in people with spinal cord injury",
abstract = "Objective: To compare the efficacy of wheelchair tilt-in-space and recline on enhancing muscle and skin perfusion over the ischial tuberosities in people with spinal cord injury (SCI). Design: Repeated-measures and before-after trial design. Setting: University research laboratory. Participants: Power wheelchair users with SCI (N=20). Interventions: Six combinations of wheelchair tilt-in-space and recline angles were presented to participants in a random order. The testing protocol consisted of a baseline 5 minutes sitting with no tilt/recline and 5 minutes positioned in a tilted and reclined position at each of 6 conditions, including: (1) 15 tilt-in-space and 100 recline, (2) 25 tilt-in-space and 100 recline, (3) 35 tilt-in-space and 100 recline, (4) 15 tilt-in-space and 120 recline, (5) 25 tilt-in-space and 120 recline, and (6) 35 tilt-in-space and 120 recline. Main Outcome Measures: Muscle and skin perfusion were assessed by near-infrared spectroscopy and laser Doppler flowmetry, respectively. Results: Muscle perfusion was significantly increased at 25 and 35 tilt-in-space when combined with 120 recline, and skin perfusion was significantly increased at 3 tilt-in-space angles (15, 25, 35) when combined with 120 recline and at 35 tilt-in-space when combined with 100 recline (P<.05). Even in the positions of increased muscle perfusion and skin perfusion (25 and 35 of tilt-in-space combined with 120 of recline), the amount of muscle perfusion change was significantly lower than the amount of skin perfusion change (P<.05). Conclusions: Our results indicate that a larger angle of tilt-in-space and recline is needed to improve muscle perfusion compared with skin perfusion. A position of 25 tilt-in-space combined with 120 recline is effective in enhancing muscle and skin perfusion of weight-bearing soft tissues at the ischial tuberosities.",
keywords = "Laser-Doppler flowmetry, Rehabilitation, Spectroscopy, near-infrared, Wheelchairs",
author = "Jan, {Yih Kuen} and Crane, {Barbara A.} and Fuyuan Liao and Woods, {Jeffrey A.} and Ennis, {William J.}",
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T1 - Comparison of muscle and skin perfusion over the ischial tuberosities in response to wheelchair tilt-in-space and recline angles in people with spinal cord injury

AU - Jan, Yih Kuen

AU - Crane, Barbara A.

AU - Liao, Fuyuan

AU - Woods, Jeffrey A.

AU - Ennis, William J.

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Objective: To compare the efficacy of wheelchair tilt-in-space and recline on enhancing muscle and skin perfusion over the ischial tuberosities in people with spinal cord injury (SCI). Design: Repeated-measures and before-after trial design. Setting: University research laboratory. Participants: Power wheelchair users with SCI (N=20). Interventions: Six combinations of wheelchair tilt-in-space and recline angles were presented to participants in a random order. The testing protocol consisted of a baseline 5 minutes sitting with no tilt/recline and 5 minutes positioned in a tilted and reclined position at each of 6 conditions, including: (1) 15 tilt-in-space and 100 recline, (2) 25 tilt-in-space and 100 recline, (3) 35 tilt-in-space and 100 recline, (4) 15 tilt-in-space and 120 recline, (5) 25 tilt-in-space and 120 recline, and (6) 35 tilt-in-space and 120 recline. Main Outcome Measures: Muscle and skin perfusion were assessed by near-infrared spectroscopy and laser Doppler flowmetry, respectively. Results: Muscle perfusion was significantly increased at 25 and 35 tilt-in-space when combined with 120 recline, and skin perfusion was significantly increased at 3 tilt-in-space angles (15, 25, 35) when combined with 120 recline and at 35 tilt-in-space when combined with 100 recline (P<.05). Even in the positions of increased muscle perfusion and skin perfusion (25 and 35 of tilt-in-space combined with 120 of recline), the amount of muscle perfusion change was significantly lower than the amount of skin perfusion change (P<.05). Conclusions: Our results indicate that a larger angle of tilt-in-space and recline is needed to improve muscle perfusion compared with skin perfusion. A position of 25 tilt-in-space combined with 120 recline is effective in enhancing muscle and skin perfusion of weight-bearing soft tissues at the ischial tuberosities.

AB - Objective: To compare the efficacy of wheelchair tilt-in-space and recline on enhancing muscle and skin perfusion over the ischial tuberosities in people with spinal cord injury (SCI). Design: Repeated-measures and before-after trial design. Setting: University research laboratory. Participants: Power wheelchair users with SCI (N=20). Interventions: Six combinations of wheelchair tilt-in-space and recline angles were presented to participants in a random order. The testing protocol consisted of a baseline 5 minutes sitting with no tilt/recline and 5 minutes positioned in a tilted and reclined position at each of 6 conditions, including: (1) 15 tilt-in-space and 100 recline, (2) 25 tilt-in-space and 100 recline, (3) 35 tilt-in-space and 100 recline, (4) 15 tilt-in-space and 120 recline, (5) 25 tilt-in-space and 120 recline, and (6) 35 tilt-in-space and 120 recline. Main Outcome Measures: Muscle and skin perfusion were assessed by near-infrared spectroscopy and laser Doppler flowmetry, respectively. Results: Muscle perfusion was significantly increased at 25 and 35 tilt-in-space when combined with 120 recline, and skin perfusion was significantly increased at 3 tilt-in-space angles (15, 25, 35) when combined with 120 recline and at 35 tilt-in-space when combined with 100 recline (P<.05). Even in the positions of increased muscle perfusion and skin perfusion (25 and 35 of tilt-in-space combined with 120 of recline), the amount of muscle perfusion change was significantly lower than the amount of skin perfusion change (P<.05). Conclusions: Our results indicate that a larger angle of tilt-in-space and recline is needed to improve muscle perfusion compared with skin perfusion. A position of 25 tilt-in-space combined with 120 recline is effective in enhancing muscle and skin perfusion of weight-bearing soft tissues at the ischial tuberosities.

KW - Laser-Doppler flowmetry

KW - Rehabilitation

KW - Spectroscopy, near-infrared

KW - Wheelchairs

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