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ItemBlood Flow and Pressure Changes That Occur With Tilt-in-Space(Georgia Institute of Technology, 2010-06) Sonenblum, Sharon Eve ; Sprigle, StephenThe objective of this study was to evaluate the biomechanical responses to tilt in persons with SCI. Changes in blood flow and loading at the ischial tuberosities (ITs) across different amounts of tilt were measured with Laser Doppler flowmetry and interface pressure. Pressure reduction at the IT was not present at 15°, but did occur with tilts to 30° and greater. Unlike pressure, blood flow increased with all tilts from an upright position. Only 4 of 11 participants had a considerable increase (≥10%) in blood flow at 30° tilt, whereas 9 participants did during maximum tilt (i.e., 45°-60°). Based on the results of this study, tilting for pressure reliefs as far as the seating system permits is recommended to maximize the potential for significant blood flow increases and pressure relief. The use of interim small tilts is also supported, as they also provide some benefit.
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ItemBlood Flow and Pressure Changes That Occur With Tilt-in-Space(Georgia Institute of Technology, 2009) Sonenblum, Sharon Eve
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ItemBlood Flow and Pressure Changes That Occur With Tilt-in-space(Georgia Institute of Technology, 2009) Sonenblum, Sharon Eve ; Sprigle, Stephen
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ItemDynamic Response of Wheelchair Cushions to the ISO Impact Damping Test(Georgia Institute of Technology, 2009) Chung, B. M.The International Organization for Standardization defines tests that characterize the properties of wheelchair cushions (ISO 16840-2). The impact damping test (IDT) characterizes cushions' abilities to reduce impact loading on tissues and to help maintain postural stability. The ISO test reports the number of rebounds greater than 10% of the peak impact acceleration and the ratio of the second to first rebound acceleration in order to determine the damping properties. We performed IDTs on three different wheelchair cushions: 3" elastic foam (EF), 3" viscoelastic foam (VEF), and a 3" laminar cushion (LC); a viscous fluid bladder on the top of an elastic foam. The LC had two rebounds greater than 10 % of the peak acceleration while the EF and VEF had one. The LC had high-est ratio (0.48) followed by the EF (0.29) and the VEF (0.25). According to ISO, these results indicate that EF and VEF dampen impacts quicker than LC and have superior abilities to help maintain postural stability. Based upon this analysis, three critical issues about the ISO IDT have been identified. The first is the ISO should incorporate impact magnitude in the analysis, since impact loading on tissues is a stated purpose. The second is the ISO should use impact instead of re-bound accelerations. Results show that nonlinear responses are evident in rebounds in all three cushions. The third issue is that oscillation from impact is not a simple second order damped harmonic. Analysis showed that three to five natural frequencies are embedded in the damped harmonic oscillation, so simple ratios of accelerations do not represent the damping properties of cushions. In conclusion, the ISO IDT should utilize impact accelerations and employ more complex analysis to better characterize the damping properties of wheelchair cushions.
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ItemUnderstanding Wheelchair Use Patterns: Tilt-in-Space(Georgia Institute of Technology, 2008-03) Sonenblum, Sharon Eve ; Sprigle, Stephen ; Harris, Frances ; Maurer, Chris
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ItemImpact of Tilt-in-Space Power Wheelchairs on Health, Activity, and Participation(Georgia Institute of Technology, 2008) Harris, Frances ; Sonenblum, Sharon Eve ; Sprigle, Stephen ; Maurer, Christine L.This paper reports the results of a pre-post outcomes study on the impact of tilt-in-space power wheelchairs on the health, activity, and participation of 5 subjects. Using a methodology which combines traditional self-reports and activity monitoring technology, subjects who had previously used an upright power wheelchair were monitored at baseline and 3 months following receipt of a new tilt-in-space power wheelchair. Subjects visited similar numbers of destinations pre and post. However, wheelchair use metrics - including occupancy time, distance wheeled, and number of bouts - varied pre and post, without a consistent direction of change. Quality of life measured as self-perceived health status increased in all subjects. Although subject population is too small to generalize results, this study illustrates the complexity of participation measurement and the utility of this methodology to provide insights into the relationship between wheelchair use and activity and participation.
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ItemKinematics of Lateral Transfers: A Pilot Study(Georgia Institute of Technology, 2005) Sonenblum, Sharon Eve ; Sprigle, Stephen ; VanHiel, Leslie ; Maurer, Chris ; Whittaker, EricPeople with spinal cord injuries (SCI) must transfer many times daily. Despite the importance of proper transfers, researchers have not completely described the kinematics of lateral transfers. Nyland et al identified transfer technique as a risk-factor for upper extremity degeneration and cited the need for quantitative measures of transfers and additional transfer research [1]. The purpose of this pilot study was to collect kinematic data on lateral transfers and identify different transfer strategies.