Dr. Jennifer Hastings PT, PhD, NCS
Adaptive sports are promoted for individuals with spinal cord injury to increase overall health and prevent cardiovascular and metabolic diseases, but the potential risk of pressure ulcer development with adaptive equipment (AE) is a concern. Current research has found seated pressures in AE that exceed clinically accepted values but no studies have measured pressure with a padded short to assess for its potential pressure reducing effects.
Our study sought to evaluate average and peak seating pressure in both static and dynamic sport-specific positions, with and without the presence of three types of over-the-counter padded bicycle shorts, in multiple types of adaptive equipment (AE): Hand cycle, quad rugby, basketball, and mountain hand cycle.
Part One. Pre/Post test design with subjects as their own control. Eight adults with SCI (C5-T6) were pressure mapped under static and dynamic conditions in their daily use wheelchair (WC) and AE. Three conditions were mapped: Daily WC, AE without bicycle shorts, and AE with shorts. AE included: Hand-cycle, quad rugby, basketball, and mountain hand-cycle.
Part Two. Static pressure readings in a hand-cycle were taken on 16 able-bodied subjects with and without an impact short and a full-coverage padded short.
Part three. Single subject with T5 SCI was pressure mapped in static and dynamic conditions with and without the full-coverage padded short in a basketball chair and mountain hand-cycle.
Average pressure (AP) and peak pressure (PP) recordings were taken for 60 seconds (400 frames) using the TekScan Pressure Mapping System. For static recordings the participants were instructed to sit still, while for dynamic recordings participants simulated sport or activity specific movements.
Part 1. Significant differences were found between the daily chair and AE for both AP and PP in the static condition (p < 0.05), as well as AP in the dynamic condition (p
Part 2. The impact short significantly increased static PP and AP (p0.05).
Part 3. The full-coverage padded short increased AP and PP in the basketball chair, decreased AP in the mountain hand cycle and increased PP in the mountain hand cycle.
Pressure differences between daily WC and AE in static conditions suggests that athletes who are not moving or sitting on the sidelines in their AE may be at greater risk of tissue breakdown than athletes who are playing and experiencing pressure-relieving positions during movement. Padded shorts as a method to reduce PP and AP yielded variable results which may have been influenced by type of AE and posture in the AE. Thus seated posture may influence the pressure relieving capabilities of a padded short.
Conclusion: Donning a padded short as a method of skin protection yields highly variable changes in PP and AP and pressure mapping should be performed prior to use in AE by the SCI population.
- Berthold, J., Dicianno, B.E. & Cooper, R.A. (2013). Pressure mapping to assess seated pressure distributions and the potential risk for skin ulceration in a population of sledge hockey players and control subjects. Disability and Rehabilitation. Assistive Technology, 8(5), 387-39http://doi.org/10.3109/17483107.2013.769123
- Darrah, S.D., Dcianno, B.E., Berthold, J., McCoy, A., Haas, M., & Cooper, R.A. (2016). Measuring static seated pressure distributions and risk for skin pressure ulceration in ice sledge hockey players. Disability and Rehabilitation. Assistive Technology, 11(3), 241-246. http://doi.org/10.3109/17483107.2014.921939
University of Puget Sound
Anderson, Torey M. BA, SPT; McKirgan, Kaitlynn L.C. BS, SPT; and Hastings, Dr. Jennifer PT, PhD, NCS, "Comparing seated pressures in daily wheelchair and sports equipment and investigating the skin protective effects of padded shorts." (2017). Physical Therapy Research Symposium. 35.