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Spinal Cord. 2019 Jul;57(7):603-613. doi: 10.1038/s41393-019-0272-6. Epub 2019 Apr 15.

Experienced sitting-related problems and association with personal, lesion and wheelchair characteristics in persons with long-standing paraplegia and tetraplegia.

Author information

1
Research & Development, Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands. l.valent@heliomare.nl.
2
Spinal Cord Injury Department, Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands. l.valent@heliomare.nl.
3
Research & Development, Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands.
4
Spinal Cord Injury Department, Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands.
5
Rehabilitation Centre Tolbrug, Den Bosch, The Netherlands.
6
Seating Solutions LL, Boulder, USA.
7
Faculty of Behavioural and Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
8
Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, The Netherlands.
9
Center for Human Movement Sciences, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, The Netherlands.
10
University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, The Netherlands.
11
Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.

Abstract

STUDY DESIGN:

Cross-sectional study.

OBJECTIVES:

To describe experienced sitting-related health and stability problems among persons with paraplegia (PP) or tetraplegia (TP) and to investigate associations with personal, lesion and wheelchair characteristics as well as satisfaction with sitting posture.

SETTING:

Dutch community.

METHODS:

A self-report questionnaire on seating was developed and completed by wheelchair-users living with Spinal Cord Injury (SCI) for ≥10 years (N = 264). Sitting-related problems and satisfaction with sitting posture were compared between participants with PP and TP using Chi-square and t-tests. Logistic regression analyses were performed to investigate associated characteristics.

RESULTS:

Reported sitting-related problems comprised: sitting to be tiring (regularly to always) (33%), sitting to be painful (28%), pressure ulcers in the last three months (29%), instability while sitting (8%) and instability during reaching (33%). Except for instability during reaching, no differences in occurrence of sitting-problems were found between lesion-group. Persons with TP were more dissatisfied with their sitting posture than persons with PP: 51% vs 36% (p = 0.022) and 51% and 47% respectively thought their sitting posture could be improved (p = 0.670). 'Experienced lack of support in the wheelchair' was associated with most sitting-problems. Pain and instability were associated with dissatisfaction with sitting posture.

CONCLUSION:

Sitting-related problems and dissatisfaction with sitting posture were frequently reported by persons with long-standing SCI. Sitting problems appeared to associate with lacking support in the wheelchair/seating. A comprehensive feedback from the wheelchair user and a stability check (reach task), as part of the wheelchair/seating-user fitting, may contribute to prevention of sitting-related problems.

PMID:
30988398
DOI:
10.1038/s41393-019-0272-6

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