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

描述（由申请人提供）：压疮显著影响脊髓损伤（SCI）轮椅使用者的生活质量和总体医疗费用。目前的临床实践包括使用轮椅电动座椅功能（PSF），以获得特定的座椅角度，持续时间或频率，已被证明可以减少轮椅使用者的座椅界面压力。PSF包括倾斜（在保持座椅靠背角度的同时改变座椅角度方向）和后倾（改变座椅靠背角度）。然而，在何种角度和时机使用PSF提供足够的压力释放以增强皮肤血流和软组织活力尚不清楚。本研究的长期目标是确定增强软组织活力的最佳PSF使用模式，这可能有助于进一步推进PSF使用预防压疮的临床指南。具体目标1是研究在各种倾斜和后倾角设置下对PSF使用的急性血流反应。PSF的使用已被证明可以减少轮椅使用者的座椅界面压力。然而，PSF使用对皮肤血流和软组织活力的影响需要进一步澄清。将检查倾斜（15、30和45度）和后倾（100和120度）角度的常见临床建议。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）。具体目标2是检查PSF使用在各种设置的持续时间和频率的反应性充血反应的影响，以延长坐姿引起的负荷。将比较PSF使用的持续时间（30或60秒）和频率（15或30分钟）的常见临床建议，以确定增强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设置缓解承重组织的有效性。 本研究将证明使用皮肤血流量来评估PSF使用在增强组织活力方面的有效性的可行性。PI的方法将提供对PSF使用设置的血流响应机制的深入了解。本研究的结果将提供客观证据，支持将PSF用于所需的病理人群。

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.