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Effects of conventional and alternating cushion weight-shifting in persons with spinal cord injury

This study investigates the effects of alternating-pressure air cushion (APAC) use compared to independent pressure relief (IPR) in individuals with SCI. The results highlight the benefits of APAC activation in dynamically altering pressure distribution for sustained positive tissue health effects.

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Effects of conventional and alternating cushion weight-shifting in persons with spinal cord injury

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  1. Effects of conventional and alternating cushion weight-shifting in persons with spinal cord injury Gary A. Wu, PhD; Kath M. Bogie, DPhil

  2. Aim • Determine whether alternating-pressure air cushion (APAC) use, compared with independent pressure relief (IPR), provides reliable, effective pressure relief for individuals with spinal cord injury (SCI). • Relevance • Effective wheelchair cushion is essential to maximize tissue health, prevent pressure ulcer development, and maintain functionally appropriate posture.

  3. Method • Subjects were 13 adult full-time wheelchair users with SCI. • Used APAC for 2 wk every 3 mo for 18 mo. • IPR was assessed at recruitment. • Measures: • Bilateral mean ischial interface pressure (IP). • Transcutaneous oxygen tension (TcPO2). • Unilateral laser Doppler blow flow. • Determined using short-time Fourier transform [STFT]-based spectral analysis.

  4. Results • IPR weight-shifting: • Decreased mean ischial IP and increased mean TcPO2. • All variables rapidly returned to preintervention levels except cardiac component of blood flow. • APAC-induced weight-shifting: • Decreased mean ischial IP. • Mean TcPO2 increased and was higher than for IPR. • STFT analysis: • Quiet sitting after APAC-induced weight-shifting produced higher neurogenic component of blow flow than IPR.

  5. Conclusion • IPR: • Positively affects multiple aspects of tissue health. • But produces transient improvements and must be repeated regularly. • APAC activation: • Dynamically and continuously alters IP distribution with more sustained positive tissue health effects.

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