A Systematic Review of Outcomes Measured Following New Wheelchair and Seating-Prescription Interventions in Adults.

Objectives: To determine the outcomes and outcome-measurement tools currently used during the prescription of new wheelchairs and/or seating systems. A systematic review of studies was performed to identify outcome-measurement tools.

Data Sources: MEDLINE, CINAHL, EMBASE, and PsycINFO were searched from earliest available to March 2022.

A Primary Care Provider's Guide to Wheelchair Prescription for Persons With Spinal Cord Injury.

The wheelchair is an essential tool for individuals with spinal cord injury (SCI). When the capacity and fit of a wheelchair is matched to the needs and abilities of an individual with SCI, health, function, community participation, and quality of life are maximized. Throughout an individual's life, function and health status can decline (or improve), necessitating a new wheelchair and/or seating components (eg, cushions and backrests).

Manufacturing custom-contoured wheelchair seating: A state-of-the-art review.

Background: Custom-contoured wheelchair seating lowers risk of pressure injury and postural deterioration while custom-contoured wheelchair seating lowers risk of pressure injury and postural deterioration while increasing the stability and functional activity of the wheelchair occupant. Producing custom-contoured seating systems has historically been a labour-intensive process custom-contoured seating systems is historically labour-intensive.

Objectives: Evaluate the strengths and limitations of current manufacturing processes for custom-contoured wheelchair seating to suggest potential future manufacturing processes.

Developing a process for assessing equivalency of wheelchair cushion pressure redistribution performance.

For wheelchair users who are at risk for developing pressure ulcers, cushion prescription seeks to address tissue integrity. Because many designs of wheelchair cushions exist, a need exists to estimate their performance in supporting the body. The objective of this research was to develop an approach to assess the equivalency of cushions with respect to their pressure redistribution performance.

Clinical features of children and adults with a muscular dystrophy using powered indoor/outdoor wheelchairs: disease features, comorbidities and complications of disability.

Purpose: To describe the clinical features of electric powered indoor/outdoor wheelchair users with a muscular dystrophy, likely to influence optimal prescription; reflecting features of muscular dystrophies, conditions secondary to disability, and comorbidities impacting on equipment provision.

Methods: Cross-sectional retrospective case note review of recipients of electric powered indoor/outdoor wheelchairs provided by a specialist regional wheelchair service. Data on demography, diagnostic/clinical, and wheelchair prescription were systematically extracted.

An air-cell-based cushion for pressure ulcer protection remarkably reduces tissue stresses in the seated buttocks with respect to foams: finite element studies.

A sitting-acquired pressure ulcer (PU) is a common injury in wheelchair-bound patients. Preventative measures for the post spinal cord injury (SCI) population include prescription of a supportive thick cushion on the wheelchair, in order to better distribute loads between the buttocks and support surface (which are quantifiable using interface pressure measurements), and potentially, to minimize internal soft tissue loads (which are typically unknown). Information about the biomechanical efficacy of commercially-available structured cushion designs such as air-cell-based (ACB) cushions, gel, and honeycomb-like cushions is sparse.

Development of clinical guidelines for the prescription of a seated wheelchair or mobility scooter for people with traumatic brain injury or spinal cord injury.

Background/aim: Providing a wheelchair or scooter is a complex therapy intervention aimed at enhancing the person's functioning. The research and experience has shown that a wheelchair which is poorly matched to the individual, adversely affects potential activities and participation, lifestyle goals, health status and can be costly. The development of an evidence-based clinical guideline will provide a synthesis of the evidence and recommendations for best practice.

The impact of abnormal muscle tone from hemiplegia on reclining wheelchair positioning: a sliding and pressure evaluation.

Background: Little is known about the influence of existing muscle tone abnormality on the sitting posture of stroke patients in reclining wheelchairs.

Aim: To investigate the impact of muscle tone abnormality from hemiplegia on the forward sliding and pressure of stroke patients while sitting in reclining wheelchairs.

Design: Experimental study.

Patient satisfaction with telerehabilitation assessments for wheeled mobility and seating.

Wheeled mobility and seating assessments for individuals with mobility impairments living in rural or distant locations are problematic due to the lack of expertise and available resources. The objective of this study was to measure satisfaction based on one's evaluation and prescription as well as comfort level when being evaluated by telerehabilitation (TR). Patient satisfaction data from real-time interactive TR clinical consultations between an expert practitioner located at least 125 miles away and four remote wheelchair clinics set up by the research team were collected and evaluated.

Electric powered wheelchairs for those with muscular dystrophy: problems of posture, pain and deformity.

Purpose: To identify areas of difficulty encountered by a regional wheelchair service in providing Electric Powered Indoor/outdoor wheelchairs (EPIOCs) to those with muscular dystrophy (MD) in the early years of their provision--particularly posture, pain and deformity.

Method: Wheelchair service records of all users between April 1997 and March 2000 were reviewed retrospectively and issues relating to weakness, pain/discomfort, deformities, other medical issues, weight change, function, posture and driving were documented on a purpose-designed proforma. Adjustments and modifications were documented over the 2-year period following chair delivery.

Development of a service delivery protocol used for remote wheelchair consultation via telerehabilitation.

The purpose of this paper is to explain the development, methodology, and implementation of an assistive technology (AT) service delivery protocol using a telerehabilitation consultation model for evaluation of remote wheelchair prescriptions. The provision of wheeled mobility and seating interventions can be complex when considering people with intricate seating and positioning needs, environmental factors, and wide array of product interventions. The availability of qualified practitioners with specialty expertise in this area is limited, especially outside of urban areas.

Measuring wheelchair intervention outcomes: development of the wheelchair outcome measure.

Purpose: Provision of a wheelchair has immediate intuitive benefits; however, it can be difficult to evaluate which wheelchair and seating components best meet an individual's needs. As well, funding agencies now prefer evidence of outcomes; and therefore measurement upon prescription of a wheelchair or its components is essential to demonstrate the efficacy of intervention. As no existing tool can provide individualized goal-oriented measure of outcome after wheelchair prescription, a research project was undertaken to create the Wheelchair Outcome Measure (WhOM).

Critical review of the research literature of seating interventions: a focus on adults with mobility impairments.

An expanding area in rehabilitation practice is the prescription of seating interventions for clients with mobility impairments. The goal of this intervention is to enhance comfort and functional performance. The purpose of this paper is to review the body of knowledge from the research literature concerning the effectiveness or impact of seating interventions for adults who have mobility impairments.

A randomized control trial to evaluate pressure-reducing seat cushions for elderly wheelchair users.

Objective: To determine if the use of pressure-reducing wheelchair cushions for elderly nursing home resident wheelchair users who are at high risk for developing sitting-acquired pressure ulcers would result in a lower incidence rate of pressure ulcers, a greater number of days until ulceration, and lower peak interface pressures compared with the use of convoluted foam cushions over a 12-month period. To determine the feasibility of conducting a subsequent full-scale definitive trial to evaluate the use of pressure-reducing seat cushions for elderly nursing home resident wheelchair users.

Design: Randomized control trial

Setting: 2200-bed skilled nursing facilities (1 suburban and 1 urban academic medical center)

Patients: 32 male and female at-risk nursing home residents who were wheelchair users > or = 65 years of age.

Comparative biomechanical evaluation of different wheelchair seat cushions.

The aim of the present study was to perform a comparative biomechanical analysis of four antidecubitus wheelchair cushions. Thirty wheelchair users were considered divided into three groups: paraplegic subjects (with no cutaneous sensation), neurologic subjects (with intact cutaneous sensation), and elderly subjects. The biomechanical evaluation was performed using a piezoresistive sensor matrix system to quantify parameters referred to pressure distribution, seating surface and posture.

Seating assessment and planning.

The primary mobility for persons with spinal cord injury (SCI) is seated. This article addresses ways to maximize the SCI patient's functional mobility with proper prescription of seating. Critical components of seating are defined and goals for seating are identified.

Prototype development and comparative evaluation of wheelchair pressure mapping system.

Wheelchair pressure mapping devices used in the prescription of seat cushions and postural supports have been limited in durability, data presentation, and/or clinical efficiency. This project sought to establish the ideal specifications for clinically useful pressure mapping systems, and to use these specifications to influence the design of an innovative wheelchair pressure mapping system (Tekscan "Seat"). Technology, previously developed for measurement of forces of dental occlusion and of the foot during gait, was applied to wheelchair seat mapping.

Prescription and positioning: evaluating the physically disabled individual for wheelchair seating.

Within the past 10 years, technology has provided members of the seating team with new approaches in dealing with severely physically disabled children and adults. Positioning is often the first step in overall provision of technical aids. Before physically disabled individuals can operate augmentative communication devices, computer keyboards or other assistive or rehabilitative devices, they should be provided with the optimum seated posture from which to operate.

Evaluating the client with physical disabilities for wheelchair seating.

Positioning through wheelchair seating allows many severely physically disabled individuals to use their motor skills to access technical aids. In the last 10 years, many products relating to wheelchair seating have been developed and are now being used. This article outlines evaluation and prescription guidelines that lead to the accompanying recommendations for seating.

Wheelchair cushion modification and its effect on pressure.

Prevention of pressure sores is a major objective in the rehabilitation of individuals with paraplegia and quadriplegia. Wheelchair cushions made of polyurethane foam are frequently prescribed to relieve pressure and reduce the risk of ulceration for persons seated in wheelchairs. Because no cushion uniformly distributes pressure for all diagnostic groups, it may become necessary to modify a commercial cushion to provide protection against the effects of pressure.