Wheelchair backs that support the spinal curves: Assessing postural and functional changes

Abstract

Objective: To compare outcomes using a wheelchair back designed to support the natural seated spinal curves versus an upholstered back that promotes posterior pelvic tilt and thoracolumbar kyphosis.

Design: Cross-over intervention.

Setting: Two free-standing spinal cord injury (SCI) model system hospitals.

Participants: Fifty adults with motor complete SCI C6-T4, between the ages of 18–60 years who use a manual wheelchair for mobility were recruited from a convenience sample.

Intervention: Each participant’s wheelchair back support was removed and replaced by an upholstered back and a solid back in randomized order. Postural and functional outcomes, pain, and satisfaction were evaluated using each back.

Outcome measures: Seated postural measurements included pelvic angle, spinal angle of kyphosis and linear measurement of spine. Functional outcomes included vertical forward reach, one stroke push, timed forward wheeling, ramp ascent and descent. Numerical pain rating and a satisfaction survey provided input pertaining to both backs.

Results: The solid back demonstrated significance in seated postural measurements. Participants using the solid back trended to higher scores in functional outcome measures including vertical forward reach, one stroke push and timed ramp ascent. Participants reported increased satisfaction with comfort and stability with the solid back.

Conclusions: This pilot study demonstrated that a wheelchair back, which supports the seated spinal curves improves upright posture, functional reach, and wheelchair propulsion skills. Further research is necessary to demonstrate statistical findings as well as to assess back height and lateral support.

Keywords:

• Manual wheelchair
• Wheelchair back supports
• Functional outcomes manual wheelchair

Acknowledgements

We would like to express our thanks to Judy Rowley and Stephanie Tanguay from Motion Concepts, who provided initial funding of $20,000.00 and $7000.00 worth of back supports in various sizes and heights. Dr. Rick Leiber, Chief Scientific Officer of the Shirley Ryan Ability Lab and the Neilsen Infrastructure grant provided an additional $20,000, and Dr. Susie Charlifue, Interim Director of Research at Craig Hospital Foundation matched the grant with $20,000. The funding and support allowed us to complete the pilot project and present our work at various conferences in the United States, Canada, and Ireland. This translational research outlines outcome measures, which can be used when determining a back support, illustrates the benefits of an appropriate back to third party payers, and is the basis for a larger study.

Disclaimer statements

Contributors None.

Funding This work was supported by Motion Concepts: [Grant Number 1]; Shirley Ryan AbilityLab Infrastructure grant; Craig Foundation: [Grant Number 1].

Conflicts of interest None of the authors has any conflict of interest to report in regards to the research performed.