Dynamic changes in seating pressure gradient in wheelchair users with spinal cord injury

Chi Wen Lung, Tim D. Yang, Ben Yi Liau, Waifong Catherine Cheung, Sanjiv Jain, Yih Kuen Jan

Research output: Contribution to journalArticlepeer-review


Pressure ulcer interventions are commonly assessed with measures of seating interface pressure, such as peak pressure gradients (PPGs). Decreases in PPG magnitudes may reduce pressure ulcer risk by decreasing tissue deformation and increasing tissue perfusion of at-risk weight-bearing tissues. Changes in PPG directions, which have previously been overlooked in the seating pressure literature, may provide a transient increase in blood flow to at-risk tissues, even if the PPG magnitude and location remain the same. The purpose of this study was to assess both PPG components in response to combinations of wheelchair tilt and recline angles. Thirteen power wheelchair users were recruited into the study. Six combinations of wheelchair tilt (15°, 25°, and 35°) and recline (10° and 30°) were tested in random order. Each combination was tested with 5-min upright sitting, 5-min tilt and recline, and 5-min maximal pressure relief recovery. Changes in PPG magnitudes and PPG directions under the left ischial tuberosity were computed for the six angle combinations. The findings in this study suggested that when combining wheelchair tilt and recline, the recline function may be particularly useful in reducing PPG magnitudes, while the tilt function may be particularly useful in manipulating PPG directions.

Original languageEnglish (US)
Pages (from-to)277-286
Number of pages10
JournalAssistive Technology
Issue number5
StatePublished - Sep 2 2020


  • peak pressure gradient
  • pressure ulcers
  • recline
  • seating pressures
  • spinal cord injury
  • tilt
  • wheelchair

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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