We know that unrelieved pressure upon weight-bearing tissues can produce lesions and the prevalence is high - up to 28% for the elderly living in care facilities and between 50% and 80% of persons with a spinal cord injury will develop a pressure injury at some point in their life. Other factors, both intrinsic and extrinsic, also predispose load-bearing tissue to mechanical damage; friction, heat, moisture, incontinence, and less than optimal nutrition can impact skin health and need to be considered. Sitting without position change is also strongly correlated to discomfort, pain, and postural asymmetries. The body just doesn't cope well with sitting for long stretches of time.
Typically, for full-time power wheelchair users, we look to power seat functions to reduce skin risk, create rest, provide relief, and increase comfort. But how do we know what to recommend to our clients? The research tells us a few key facts:
However, we also know that many clients do not use their power seat functions as we prescribe - in either frequency or amount of position change. Studies find that typical use is somewhat less than desirable:
I'm a firm believer that to create a behavior change three elements are involved:
Research has also told us that information alone isn't enough; we need reminders and motivators in order to substantially change a behavior.
Providing timely cues, accessible instructions, and feedback were critical to facilitating desired health behavior.
Power wheelchair electronics now allow us to program either visual or auditory reminders for position change. Program the position, frequency, and duration of the position change - a nice "reminder" that they've been in one position for too long! Link this to one of the programmed Memory Positions and latch it! Now that's action!
We can also use the electronics as a "FitBit®" of sorts - an app has been developed to connect the wheelchair electronics and a client's smartphone. This app can be used by the client to analyze and track their seat function use, so they can independently manage and improve their comfort, skin health, and well-being. This app, "Remote Seating" uses Bluetooth® connectivity and can be linked to other heath care management plans - sent to the therapy team and used with other outcome measuring tools. Usage data, compliance, and thresholds can all be analyzed. This data can then be correlated with other health indicators.
If you would like more information regarding Memory Positions or Remote Seating Technology, please visit our website or speak with your local rehab technology provider.
Amy Bjornson, PT, Physio, ATP, SMS
Clinical Education Manager
Sunrise Medical Australia
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