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.
- Laser-Doppler flowmetry
- Spectroscopy, near-infrared
ASJC Scopus subject areas
- Physical Therapy, Sports Therapy and Rehabilitation