Crytzer Theresa M, Hong Eun-Kyoung, Dicianno Brad E, Pearlman Jon, Schmeler Mark, Cooper Rory A
Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, United States ; Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, PA, United States.
Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, United States ; Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, PA, United States ; Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Med Eng Phys. 2016 Sep;38(9):999-1007. doi: 10.1016/j.medengphy.2016.06.017. Epub 2016 Jul 15.
Spinal deformities are common in people who require the use of a wheelchair for mobility as a result of spinal cord injuries and other disabilities. Sitting positions vary between individuals with disabilities who use wheelchairs and individuals without disabilities. In individuals with spinal cord injury, spinal deformities can result in the development of back contours that deviate from the shape of standard rigid back support shells. The purpose of this study was to distinguish and classify various back contours of wheelchair users by utilizing digital anatomic scanning technology in order to inform the future development of back supports that would enhance postural support for those with spinal deformities. The three dimensional (3D) locations of bony landmarks were digitized when participants were in position, using a mechanical wand linked to the FastScan(tm) system commonly used to measure surface contours. Raw FastScan(tm) data were transformed according to bony landmarks. A total of 129 individuals participated in this study. A wide range of back contours were identified and categorized. Although participant characteristics (e.g., gender, diagnosis) were similar amongst the contour groups; no one characteristic explained the contours. Participants who were seated in a forward lean position had a higher amount of pelvic obliquity compared to those seated in an upright position; however, participants' back contour was not correlated with pelvic obliquity. In conclusion, an array of different back shapes were classified in our cohort through 3D laser scanning technology. The methods and technology applied in this study could be replicated in future studies to categorize ranges of back shapes in larger populations of people with spinal cord injuries. Preliminary evidence indicates that customized postural support may be warranted to optimize positioning and posture when a standard rigid shell does not align with contours of a person's back. To optimize positioning, a range of contoured rigid backrests as well as height and angle adjustability are likely needed.
脊柱畸形在因脊髓损伤和其他残疾而需要使用轮椅行动的人群中很常见。使用轮椅的残疾人和非残疾人的坐姿各不相同。在脊髓损伤患者中，脊柱畸形会导致背部轮廓的发展偏离标准刚性背部支撑壳的形状。本研究的目的是利用数字解剖扫描技术区分和分类轮椅使用者的各种背部轮廓，以便为未来背部支撑的开发提供信息，从而增强对脊柱畸形患者的姿势支撑。当参与者处于相应位置时，使用与常用于测量表面轮廓的FastScan(tm)系统相连的机械棒对骨标志点的三维(3D)位置进行数字化处理。原始的FastScan(tm)数据根据骨标志点进行转换。共有129人参与了这项研究。识别并分类了多种背部轮廓。尽管轮廓组之间的参与者特征(如性别、诊断)相似，但没有一个特征能够解释这些轮廓。与坐姿直立的参与者相比，前倾坐姿的参与者骨盆倾斜度更高；然而，参与者的背部轮廓与骨盆倾斜度并无关联。总之，通过3D激光扫描技术，我们在队列中分类出了一系列不同的背部形状。本研究中应用的方法和技术可在未来研究中复制，以对更大规模脊髓损伤人群的背部形状范围进行分类。初步证据表明，当标准刚性外壳与人体背部轮廓不匹配时，定制姿势支撑可能有助于优化体位和姿势。为了优化体位，可能需要一系列有轮廓的刚性靠背以及高度和角度可调节性。
