title: Wheelchair configuration and postural alignment in persons with spinal cord injury.
abstract: OBJECTIVE
  To determine whether postural alignment and shoulder flexion range differ for persons with spinal cord injury (SCI) seated in wheelchairs with standard configurations versus wheelchairs with posterior seat inclination and a low backrest set perpendicular to the floor.
  
  
  METHODS
  Prospective repeated-measures study.
  
  
  METHODS
  Outpatient SCI clinic.
  
  
  METHODS
  Fourteen subjects with C6-T10 motor-complete SCI.
  
  
  METHODS
  Subjects sat in 3 manual wheelchairs: standard setup E&J Premier (S1), standard setup Quickie Breezy (S2), and test configuration Quickie TNT (T) with posterior seat inclination and a low backrest set perpendicular to the floor.
  
  
  METHODS
  Shoulder and neck alignment and pelvic tilt were determined from sagittal plane digital photographs at rest and with maximal vertical reach.
  
  
  RESULTS
  At rest, T produced less shoulder protraction than either standard configuration (difference between the mean values, S1: 1.6 cm, P=.048; S2: 1.2 cm, P=.013). S1 and S2 showed a greater head-forward position than T (differences between the mean values, S1: 6.5 degrees, P=.008; S2: 6.3 degrees, P=.013). T allowed greater humeral flexion than S2 (difference between the mean values: 3.7 degrees, P=.036) and greater vertical reach above the seat plane than either conventional configuration (differences between the mean values, S1: 4.7 cm, P=.005; S2: 4.1cm, P=.002). The indirect pelvic tilt measurement showed a trend (P=.06) toward greater posterior pelvic tilt with S1 and S2.
  
  
  CONCLUSIONS
  The alternate configuration produces more vertical postural alignment and greater reach ability versus the standard factory setup wheelchairs.
authors.affiliation: Spinal Cord Injury Service, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. jhastings@ups.edu
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Hastings
authors.forename: Elaine Rogers
authors.initials: ER
authors.lastname: Fanucchi
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Burns
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D011187:Posture / Q000502:physiology*; D011446:Prospective Studies; D012782:Shoulder / Q000502:physiology; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D014910:Wheelchairs