Analysis of the influence of the seat foam density in the posture of hemiplegic wheelchair users using computerized phot
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Analysis of the influence of the seat foam density in the posture of hemiplegic wheelchair users using computerized photogrammetry Caroline L. G. de Abreu1 · Eduardo L. M. Naves1 · Angela A. R. de Sá1 · Deny Gomes de Freitas1 Received: 13 May 2020 / Accepted: 1 October 2020 © Springer Nature Switzerland AG 2020
Abstract The use of a wheelchair after a stroke is often necessary, and this device can assist in support and proper positioning in sitting posture. However, there is not much scientific evidence proving the benefits of adaptations in wheelchairs for individuals with a motor and sensory impairments, mainly those with hemiplegia. The aim of this study is to assess whether adaptation with foam of different densities is effective in improving the sitting posture of hemiplegic wheelchair users. The study was carried out on 18 participants (seven female and eleven male), hemiplegics, wheelchair users and with an average age = 61. The computerized photogrammetry technique was used to analyze the posture of the participants sitting in foams of different densities. In order to perform the statistical analysis, the Shapiro–Wilk hypothesis test was used to assess the normality of the data. The results highlight the improvement not only in pelvic alignment, but also the trunk and head using different combinations of density foam seats. In addition, the results suggest that the use of densities 33 kg/m3 and 40 kg/m3 is sufficient to have a better body alignment. Keywords Seating · Sitting posture · Hemiplegia
1 Introduction The use of a wheelchair may be essential in the process of rehabilitation of individuals with neurological impairment. This equipment can be considered an orthotic device for sitting posture, as its use promotes user comfort (pressure relief and body support) and can increase the individual’s performance and quality of life.[1]. However, in many cases, depending on the user’s needs, some adjustments in the wheelchair seat are required. This process requires the use of specific equipment and knowledge in different areas and, mainly, in the biomechanical concepts of sitting posture. An adequate sitting posture for people with poor postural control can prevent the worsening of the clinical condition and prevent motor deficits [2, 3]. Individuals with hemiplegia due to a cerebrovascular accident (CVA) usually need some posture adjustment.
Hemiplegia has as a consequence a lower control of the trunk and less automatic postural control. Thus, these people seek compensatory strategies to maintain stability, such as slipping in the wheelchair seat, sitting asymmetrically and seeking support in one of the two arms [4, 5]. The studies by Genthon et al. and Pelmutter et al. [6, 7] showed that the sitting posture of hemiplegic individuals is quite asymmetric. In these studies, they found greater displacement of the center of pressure of the hemiplegic individuals, when compared to a healthy group. Moreover, some studies have evaluated the efficiency of different foams to compensate for the adverse effects
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