For wheelchair users who are at risk for developing pressure ulcers, cushion prescription seeks to address tissue integrity. Because many designs of wheelchair cushions exist, a need exists to estimate their performance in supporting the body. The objective of this research was to develop an approach to assess the equivalency of cushions with respect to their pressure redistribution performance. Two instrumented compliant buttock models, differing in form, were used in the evaluation. Stress and strain parameters were used to characterize load-bearing performance. A cohort of 8 wheelchair cushions was compared to a standard reference material, HR45 foam. Each cushion was measured using both models under two loading conditions. The use of compliant buttock models that are capable of measuring both stress and strain parameters offer greater capability in measuring load-bearing performance compared to previously described methods. The proposed approach was able to evaluate cushion performance and use a logic-based approach to define whether or not a cushion was equivalent to the HR45 material. Additional study is needed to further validate the approach and to define the thresholds and criteria used to define cushion equivalency.

Completion of all required components earns .2 IACET CEUs.

Seat-elevating devices (SEDs) allow vertical movement of the seat of a power wheelchair (PWC), so users can perform activities of daily living including transferring and reaching. RESNA’s position papers on SEDs and the wheelchair provision process highlight the benefits of SEDs and the need for outcome measurement. The Functional Mobility Assessment (FMA) is a satisfaction measure to carry out specific tasks including transferring and reaching. The purpose of this retrospective study was to evaluate the relationship between the use of SEDs on the FMA and uniform dataset (UDS) with a sample of 1,733 PWC users. Independent-samples t-tests and Mann–Whitney U tests were used to compare total FMA and individual FMA item scores between those with and without an SED. A univariate linear regression model was used to control for confounding variables and determine if SEDs were a predictor of variance in FMA. Those with SEDs had significantly higher total FMA percentage score (mean = 76.7 ± 20.9) than those without SEDs (mean = 59.6 ± 24.7; t = 11.9, p < 0.001). Those with SEDs had significantly higher reach (U = 99849.0, p < 0.001) and transfer (U = 140587.0, p < 0.001) scores. The functional, vocational, and safety benefits of SEDs should be considered when determining coverage for SEDs.

Sport with a disability has progressed from undertaking physical activity for recreation to one of a high performance environment at competitions such as the Paralympic Games. There is currently limited information and guidance to help inform stakeholders as to how to develop the high performance technology of elite athletes who possess limb absence. In this manuscript, a conceptual framework for high performance prosthetic limb creation is presented. This utilizes a synthesis between contemporary product design theory and a review of existing case studies. This proposed framework is then applied to a case study. Ultimately, the framework provides an indicative guide to the creation of prosthetic limbs that emphasize technological performance enhancement over that of mere sporting participation.

Completion of all required components earns .2 IACET CEUs.