Effect of Power Seat Function Usage on Tissue Viability in Wheelchair Users with

描述（由申请人提供）：压疮显著影响轮椅使用者脊髓损伤（SCI）的生活质量和整体医疗保健费用。目前的临床实践包括使用轮椅动力座椅功能（PSF）来获得特定的坐位角度、持续时间或频率，以减少轮椅使用者的座位界面压力。PSF包括倾斜（在保持椅背角度的同时改变椅背角度）和倾斜（椅背角度的改变）。然而，在什么角度和时间使用PSF可以提供足够的压力释放，以增强皮肤血流量和软组织活力尚不清楚。本研究的长期目标是确定最佳的PSF使用模式，以提高软组织活力，这可能有助于进一步推进PSF使用预防压疮的临床指南。具体目的1是研究不同倾斜和倾斜角度下PSF使用的急性血流反应。使用PSF已被证明可以减少轮椅使用者的座位界面压力。然而，使用PSF对皮肤血流量和软组织活力的影响需要进一步澄清。常见的临床建议倾斜（15度，30度和45度）和倾斜（100度和120度）将被检查。在本研究中，反应性充血反应的总皮肤血流量将用于评估软组织活力（缺血）。具体目的2是检查在不同的持续时间和频率下使用PSF对长时间坐着引起的负荷的反应性充血反应的影响。将比较使用PSF的时间（30或60秒）和频率（15或30分钟）的常见临床建议，以确定提高轮椅使用者软组织活力的适当设置。反应性充血反应的恢复时间将用于评估PSF设置缓解负重组织的有效性。

DESCRIPTION (provided by applicant): Pressure ulcers significantly affect quality of life and overall healthcare costs of wheelchair users with spinal cord injury (SCI). Current clinical practice includes using wheelchair power seat function (PSF) to attain specific seating angles, durations, or frequencies that have been shown to reduce seating interface pressure in wheelchair users. PSF includes tilt (a change of seat angle orientation while maintaining the seat-to-back angle) and recline (a change of the seat-to-back angle). However, at what angle and timing PSF usage provides adequate pressure relief for enhancing skin blood flow and soft tissue viability is not clear. The long-term goal of this study is to determine the optimal PSF usage pattern for enhancing soft tissue viability, which may then help further advance the clinical guidelines of PSF usage for preventing pressure ulcers. Specific aim 1 is to investigate the acute blood flow response to PSF usage at various settings of tilt and recline angles. PSF usage has been demonstrated to reduce seating interface pressure in wheelchair users. However, the impact of PSF usage on skin blood flow and soft tissue viability requires further clarification. Common clinical recommendations of tilt (15, 30, and 45 degrees) and recline (100 and 120 degrees) angles will be examined. Total skin blood flow of a reactive hyperemic response will be used to assess soft tissue viability (ischemia) in this study. Specific aim 2 is to examine the effects of PSF usage at various settings of duration and frequency on the reactive hyperemic response to prolonged sitting-induced loads. Common clinical recommendations of duration (30 or 60 seconds) and frequency (15 or 30 minutes) of PSF usage will be compared to determine a proper setting for enhancing soft tissue viability in wheelchair users. Time to recovery of a reactive hyperemic response will be used to assess the effectiveness of PSF settings for relieving weight-bearing tissues. This study will demonstrate the feasibility of using skin blood flow to evaluate the effectiveness of PSF usage in enhancing tissue viability. The PIs' method will provide insight into the mechanism of blood flow response to PSF usage settings. Results from this study will provide objective evidence to support the use of PSF for needed pathological populations.