Snoek Thom, Haarler Annelaura, van Orsouw Ludwine, Janssen Thomas W J, de Groot Sonja, Kouwijzer Ingrid
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands.
Disabil Rehabil Assist Technol. 2025 May;20(4):1094-1103. doi: 10.1080/17483107.2024.2434912. Epub 2024 Nov 29.
The main aim of this study was to compare sitting pressure (peak pressure index (PPI) and peak pressure gradient (PPG)) between a daily wheelchair and fixed-frame handcycle, thereby assessing the effect of handcycle backrest angle, movement intensity and cushion type. Twenty able-bodied participants performed static and dynamic (two intensities) tests in a wheelchair and handcycle. A honeycomb wheelchair cushion and standard foam handcycle cushion were used. Handcycle backrest angles were 45° and 60°. The PPI and PPG at the sacro-coccygeal (SC) and ischial tuberosity (IT) regions were determined with a pressure mat. PPI at the IT-region was higher in the 60° handcycle condition than in the wheelchair ( = 0.04), while PPG at the IT-region did not differ significantly between the wheelchair and handcycle conditions ( > 0.05). PPI and PPG were higher at the 45° handcycle SC-region compared to the wheelchair IT-region ( < 0.03). PPI and PPG at the IT-region were higher with the 60° than with the 45° backrest angle ( < 0.01), while at the SC-region PPI was higher with the 45° backrest angle ( = 0.047). No clear influence of movement intensity was found. PPI and PPG at the IT-region and PPI of the SC-region in the handcycle were significantly lower with the wheelchair cushion than with the handcycle cushion ( < 0.01). Overall, sitting pressure was higher in the handcycle compared to the daily wheelchair. For handcyclists using an upright position, it is recommended to use a cushion designed to redistribute pressure, thereby reducing internal tissue pressure and shear.
本研究的主要目的是比较日常轮椅与固定框架手摇车之间的坐姿压力（峰值压力指数（PPI）和峰值压力梯度（PPG）），从而评估手摇车靠背角度、运动强度和坐垫类型的影响。20名身体健全的参与者在轮椅和手摇车上进行了静态和动态（两种强度）测试。使用了蜂窝状轮椅坐垫和标准泡沫手摇车坐垫。手摇车靠背角度为45°和60°。通过压力垫测定骶尾（SC）和坐骨结节（IT）区域的PPI和PPG。在60°手摇车条件下，IT区域的PPI高于轮椅（=0.04），而轮椅和手摇车条件下IT区域的PPG无显著差异（>0.05）。与轮椅IT区域相比，45°手摇车SC区域的PPI和PPG更高（<0.03）。IT区域的PPI和PPG在60°靠背角度时高于45°靠背角度（<0.01），而在SC区域，45°靠背角度时PPI更高（=0.047）。未发现运动强度有明显影响。手摇车中，IT区域的PPI和PPG以及SC区域的PPI在使用轮椅坐垫时显著低于使用手摇车坐垫时（<0.01）。总体而言，与日常轮椅相比，手摇车中的坐姿压力更高。对于使用直立姿势的手摇车使用者，建议使用旨在重新分配压力的坐垫，从而降低内部组织压力和剪切力。
