Clinical assessment, design and performance testing of mobile shower commodes for adults with spinal cord injury: an exploratory review

Abstract

Purpose: The purpose of this article is to explore evidence concerning clinical assessment, design and performance testing of mobile shower commodes used by adults with spinal cord injury (SCI). Method: Searches of electronic databases, conference proceedings and key journals were undertaken with no restriction on language or study design. Keywords included spinal cord injury, lesion, sanichair, sanitary chair, shower chair, bowel chair and commode. Results: A total of 20 publications were included in this review. Common approaches to clinical assessments were questionnaires and observational analysis to assess bowel care routines, function and skin integrity. Design features addressed access for bowel care, postural support, transfers, stability, use in wet environments and skin integrity. Objective performance measures addressed requirements for static stability, backward-sloping seat angles, arm supports and seat materials. Conclusions: Evidence reviewed was of low methodological quality and lacking in validated instruments to guide clinical practice. Further high-quality research is needed to identify bathing, showering and personal hygiene tasks affecting mobile shower commodes use and to develop validated clinical assessment tools. Performance testing to published standards is also needed.

Implications for Rehabilitation

• Adults with spinal cord injury (SCI) use mobile shower commodes for functional activities including transferring, propelling, bowel care and showering, and the interactions between an adult with SCI, their mobile shower commode, and the physical environment are not well understood.

• Current mobile shower commode designs may not facilitate functional activities and may contribute to falls and development of pressure ulcers.

• Standardised and validated clinical assessment tools are needed to guide clinical practice, and should include questionnaires and observational analysis of functional activities performed in mobile shower commodes across all environments of use.

Keywords::

• Assistive technology devices
• bathing
• bowel care
• mobile shower commode
• showering
• spinal cord injury

Declaration of interest

The authors report no conflict of interest.