Work technique of nurses in patient transfer tasks and associations with personal factors.
(17/377)
OBJECTIVES: Back disorders among nursing personnel are associated with the worktask of assisting patients during transfers. The objectives of the study were to explore the work technique applied by nursing personnel in patient transfer tasks and to determine whether different personal factors were associated with work technique safety. METHODS: The work technique used by 102 nurses to perform two common patient transfer tasks in orthopedic wards, transfer higher up in bed and transfer from bed to wheelchair, was examined with the use of video recordings and an observation instrument. A work technique score was calculated for each performed transfer. It indicated the level of musculoskeletal safety and hazard for the nurse. The participants also filled out a questionnaire concerning different personal factors. RESULTS: A variety of strategies was used by the nurses to perform the transfer tasks. Being older and suffering from low-back symptoms were factors associated with the use of poor work technique in both tasks. There was also an association between male gender and poor technique in transferring patients from bed to wheelchair. CONCLUSIONS: The results indicate an association between poor work techniques and low-back symptoms. Special attention should be paid to older nurses, nurses with low-back problems, and possibly also to male nurses when training programs on patient transfer technique are designed, as these groups seem to apply comparatively poor work techniques in patient transfer tasks. (+info)
Effect of seat inclination on seated pressures of individuals with spinal cord injury.
(18/377)
BACKGROUND AND PURPOSE: Manual wheelchair configurations commonly include "squeezing" the wheelchair frame to improve balance for users with spinal cord injuries. This squeezing is achieved by lowering the rear portion of the seat relative to the front of the seat while maintaining the same back angle. The study's purpose was to examine the effect of increasing posterior seat inclination on buttock interface pressures. SUBJECTS: Nine male and 5 female subjects (mean age=37 years, SD=11.2, range=19-55) with complete thoracic or lumbar spinal cord injury were tested. METHODS: Subjects sat on a pressure mat placed over a foam cushion. Pressure readings were taken at seat angles reflecting seat height decreases of 0, 5.1, 7.6, and 10.2 cm (0, 2, 3, and 4 in) of the rear of the seat relative to the front of the seat. An analysis of variance and a Duncan multiple range test were used for data analysis. RESULTS: No meaningful differences were found in measurements of interface pressure (dispersion index, contact area, and seat pressure index), total force on seat, or peak pressure index with posterior seat inclination. DISCUSSION AND CONCLUSION: The data indicate no meaningful evidence that squeezing a wheelchair frame increases seat interface pressures. (+info)
New wheelchair keeps people on the move.
(19/377)
The iBOT 3000 Mobility System allows users to move around at an elevated height. The system uses the I-Balance Technology to actively maintain stability by driving the wheels to stay under the user. (+info)
Development of a functional assessment measure for manual wheelchair users.
(20/377)
This investigation developed the Wheelchair Users Functional Assessment (WUFA). Because no functional outcome tools exist that include many of the daily activities that are needed to be independent by individuals using manual wheelchairs, development of an appropriate tool was deemed important. Although the Functional Independence Measure (FIM) can be used to assess disability in those using a wheelchair, it only measures some aspects of basic activities of daily living (ADLs) and does not measure community independence. Therefore, both basic activities and community activities were included in the new tool. A panel of six rehabilitation experts, with input from manual wheelchair users, determined content of the instrument. The resulting WUFA scale includes 13 items. Interrater reliability and stability were established with the calculation of an intraclass correlation coefficient (ICC). ICC for interrater reliability was 0.96 and ICC for stability was 0.78. Further analysis was performed on the internal consistency of the 13-item tool using a sample of 101 tested subjects. This analysis was done using a Cronbach's Alpha. Results indicated excellent internal consistency of the 13 items. The standardized coefficient alpha was 0.96. The WUFA was shown to have content validity, promising interrater reliability and stability, and good internal consistency. Further research is warranted to determine the tool's sensitivity and capability to discriminate between levels of functional independence. (+info)
Appropriate protection for wheelchair riders on public transit buses.
(21/377)
Securement of wheelchairs and occupant restraint for wheelchair riders on buses is one of the most difficult problems facing transit providers. The primary findings of this literature review show that (1) very little information has been published regarding transit bus safety and crash environment; (2) the focus of most reported wheelchair incidents involved noncollision events, in which inappropriate wheelchair securement or rider restraint resulted in minor injuries; and (3) studies spanning 30 years indicate that the large transit bus is an exceedingly safe form of transportation, so that wheelchair riders do not face undo risk of injury in this transportation environment. Further study is required to characterize the rare-occurring severe transit bus crashes. The resulting information is needed to establish an appropriate level of crash protection so that the next generation of U.S. wheelchair securement and occupant restraint systems not only are reasonably safe but also are easy to use and acceptable to wheelchair riders and transit bus operators. (+info)
The effects of wheelchair-seating stiffness and energy absorption on occupant frontal impact kinematics and submarining risk using computer simulation.
(22/377)
Many wheelchair users must travel in motor vehicles while seated in their wheelchairs. The safety features of seat assemblies are key to motor vehicle occupant crash protection. Seating system properties such as strength, stiffness, and energy absorbance have been shown to have significant influence on risk of submarining. This study investigated the effects of wheelchair seat stiffness and energy absorption properties on occupant risk of submarining during a frontal motor vehicle 20 g/30 mph impact using a validated computer crash simulation model. The results indicate that wheelchair-seating stiffness and energy absorption characteristics influence occupant kinematics associated with the risk of submarining. Softer seat surfaces and relatively high energy absorption/permanent deformation were found to produce pelvis excursion trajectories associated with increased submarining risk. Findings also suggest that the current American National Standards Institute/Rehabilitation Engineering and Assistive Technology Society of North America (ANSI/RESNA) WC-19 seating integrity may not adequately assess submarining risk. (+info)
Improved upper-body endurance following a 12-week home exercise program for manual wheelchair users.
(23/377)
This study determined if a 12-week monitored home exercise program would improve cardiorespiratory endurance in a heterogeneous group of manual wheelchair users, which incorporated subsets of individuals with and without upper-limb impairment. Twenty-seven subjects made up two groups of manual wheelchair users: 20 without upper-limb impairment and 7 with upper-limb impairment. Subjects completed wheelchair ergometer tests using a 1 min JUMP protocol that resulted in volitional exhaustion in 6 to 12 min. Following a recovery period (time > 30 min), subjects completed subsequent constant work rate endurance tests to exhaustion at a power output corresponding to 60% of the maximum attained on the JUMP test. Subjects then underwent 12 weeks of simulated wheelchair rolling exercise using elastic straps positioned to mimic the motion of propulsion. JUMP and constant work rate tests were performed before training and after 6 and 12 weeks of exercise. Oxygen consumption (VO2) increased from rest to peak exercise in both groups and was significantly (p < 0.016) higher at peak for subjects without upper-limb impairment than for those with upper-limb impairment. Heart rate (HR) responses between the groups were similar. No significant differences in peak VO2, anaerobic threshold, or peak HR were observed at 6 or 12 weeks of the training program. Substantial improvement (p < 0.001) in maximum constant work rate tests time (10.37 +/- 2.79 min) was noted at 6 and 12 weeks, with no significant difference between 6 and 12 weeks and no significant intergroup difference. Results of this study indicated that simulated propulsion exercise endurance was improved as a result of the home exercise program. (+info)
Assistive positioning as a control parameter of social-communicative interactions between students with profound multiple disabilities and classroom staff.
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This study examined the effects of assistive positioning on social-communicative interactions between 10 students, 6 to 12 years of age, with profound multiple disabilities, and their classroom staff. Interactions were videotaped in the students' classrooms when each student was positioned using a wheelchair, a sidelyer, and a mat on the floor. Data were analyzed by repeated-measures analysis of variance. During unstructured interactions, adults initiated communication at higher rates when students were positioned in their wheelchairs. During structured interactions, when students were given standardized opportunities for interaction, students functioning at lower levels of communication development were more communicative when they were supine on a mat than when in their wheelchairs or a sidelyer. In dynamic systems terms, position served as a control parameter of both adult and student communicative behaviors, which should be considered when recommending use of assistive positioning equipment for students with severe disabilities. (+info)