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Tilted seat position for non-ambulant individuals with neurological and neuromuscular impairment: a systematic review.

Michael SM, Porter D, Pountney TE - Clin Rehabil (2007)

Bottom Line: To determine the effects of tilt-in-space seating on outcomes for people with neurological or neuromuscular impairment who cannot walk.Search through electronic databases (MEDLINE, Embase, CINAHL, AMED).REVIEWER'S CONCLUSION: Posterior tilt can reduce pressures at the interface under the pelvis.

View Article: PubMed Central - PubMed

Affiliation: Medical Physics and Engineering, Leeds University Hospitals NHS Trust, Leeds, UK. smm@medphysics.leeds.ac.uk

ABSTRACT

Objective: To determine the effects of tilt-in-space seating on outcomes for people with neurological or neuromuscular impairment who cannot walk.

Data sources: Search through electronic databases (MEDLINE, Embase, CINAHL, AMED). Discussions with researchers who are active in field.

Review methods: Selection criteria included interventional studies that investigated the effects of seat tilt on outcome or observational studies that identified outcomes for those who had used tilt-in-space seating in populations with neurological or neuromuscular impairments. Two reviewers independently selected trials for inclusion, assessed quality and extracted data.

Results: Nineteen studies were identified which fulfilled the selection criteria. Seventeen of these were essentially before-after studies investigating the immediate effects of tilting the seating. All studies looked at populations with neurological impairment, and most were on children with cerebral palsy (n=8) or adults with spinal cord injury (n=8). REVIEWER'S CONCLUSION: Posterior tilt can reduce pressures at the interface under the pelvis.

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Related in: MedlinePlus

Forest plot showing results of studies investigating body/support interface pressure under the ischial tuberosities. The participants in the studies by Hobson520 and Vaisbuch et al.7 were sitting on foam seat cushions while the participants in the study by Henderson et al.25 remained sitting on their own personal cushions. Spijkerman et al.16 used dry flotation seat cushions and repeated measurements with the same participants sitting on cushions inflated to 20 mmHg (1), 30 mmHg (2) and 40 mmHg (3). Burns and Betz15 repeated measurements with participants sitting on a dry flotation seat cushion (1) and a gel seat cushion (2).
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Figure 2: Forest plot showing results of studies investigating body/support interface pressure under the ischial tuberosities. The participants in the studies by Hobson520 and Vaisbuch et al.7 were sitting on foam seat cushions while the participants in the study by Henderson et al.25 remained sitting on their own personal cushions. Spijkerman et al.16 used dry flotation seat cushions and repeated measurements with the same participants sitting on cushions inflated to 20 mmHg (1), 30 mmHg (2) and 40 mmHg (3). Burns and Betz15 repeated measurements with participants sitting on a dry flotation seat cushion (1) and a gel seat cushion (2).

Mentions: Figure 2 shows a forest plot for five of the six studies that investigated interface pressure under the ischial tuberosities.57151625 It was not possible to include Pellow's study6 as insufficient data were reported and there were only two participants. Spijkerman's16 unpublished data were used in the analysis and it was necessary to make a conservative calculation of the standard deviation from the reported significance level for Hobson's study.520 Multiple results shown for particular studies1516 relate to the use of different seat cushions. An inspection of Figure 2 suggests a reduction in interface pressure when participants were posterior tilted (between 20° and 45°) compared with upright.Figure 2


Tilted seat position for non-ambulant individuals with neurological and neuromuscular impairment: a systematic review.

Michael SM, Porter D, Pountney TE - Clin Rehabil (2007)

Forest plot showing results of studies investigating body/support interface pressure under the ischial tuberosities. The participants in the studies by Hobson520 and Vaisbuch et al.7 were sitting on foam seat cushions while the participants in the study by Henderson et al.25 remained sitting on their own personal cushions. Spijkerman et al.16 used dry flotation seat cushions and repeated measurements with the same participants sitting on cushions inflated to 20 mmHg (1), 30 mmHg (2) and 40 mmHg (3). Burns and Betz15 repeated measurements with participants sitting on a dry flotation seat cushion (1) and a gel seat cushion (2).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2630001&req=5

Figure 2: Forest plot showing results of studies investigating body/support interface pressure under the ischial tuberosities. The participants in the studies by Hobson520 and Vaisbuch et al.7 were sitting on foam seat cushions while the participants in the study by Henderson et al.25 remained sitting on their own personal cushions. Spijkerman et al.16 used dry flotation seat cushions and repeated measurements with the same participants sitting on cushions inflated to 20 mmHg (1), 30 mmHg (2) and 40 mmHg (3). Burns and Betz15 repeated measurements with participants sitting on a dry flotation seat cushion (1) and a gel seat cushion (2).
Mentions: Figure 2 shows a forest plot for five of the six studies that investigated interface pressure under the ischial tuberosities.57151625 It was not possible to include Pellow's study6 as insufficient data were reported and there were only two participants. Spijkerman's16 unpublished data were used in the analysis and it was necessary to make a conservative calculation of the standard deviation from the reported significance level for Hobson's study.520 Multiple results shown for particular studies1516 relate to the use of different seat cushions. An inspection of Figure 2 suggests a reduction in interface pressure when participants were posterior tilted (between 20° and 45°) compared with upright.Figure 2

Bottom Line: To determine the effects of tilt-in-space seating on outcomes for people with neurological or neuromuscular impairment who cannot walk.Search through electronic databases (MEDLINE, Embase, CINAHL, AMED).REVIEWER'S CONCLUSION: Posterior tilt can reduce pressures at the interface under the pelvis.

View Article: PubMed Central - PubMed

Affiliation: Medical Physics and Engineering, Leeds University Hospitals NHS Trust, Leeds, UK. smm@medphysics.leeds.ac.uk

ABSTRACT

Objective: To determine the effects of tilt-in-space seating on outcomes for people with neurological or neuromuscular impairment who cannot walk.

Data sources: Search through electronic databases (MEDLINE, Embase, CINAHL, AMED). Discussions with researchers who are active in field.

Review methods: Selection criteria included interventional studies that investigated the effects of seat tilt on outcome or observational studies that identified outcomes for those who had used tilt-in-space seating in populations with neurological or neuromuscular impairments. Two reviewers independently selected trials for inclusion, assessed quality and extracted data.

Results: Nineteen studies were identified which fulfilled the selection criteria. Seventeen of these were essentially before-after studies investigating the immediate effects of tilting the seating. All studies looked at populations with neurological impairment, and most were on children with cerebral palsy (n=8) or adults with spinal cord injury (n=8). REVIEWER'S CONCLUSION: Posterior tilt can reduce pressures at the interface under the pelvis.

Show MeSH
Related in: MedlinePlus