title: Factors influencing optimal seating pressure after spinal cord injury.
abstract: METHODS
  Retrospective, cross-sectional design.
  
  
  OBJECTIVE
  To identify factors that predict unsatisfactory seating pressure in spinal cord-injured (SCI) individuals.
  
  
  METHODS
  Seating Clinic at the University Hospital, Norway.
  
  
  METHODS
  All wheelchair users with traumatic SCI hospitalized between 1 January 2007 and 31 December 2010 were included. Individual assessment by a team was performed. To measure seating pressure, a computerized seating pad with sensing points 40 × 40 cm was used. Primary end points were defined as satisfactory or unsatisfactory seating position based on measured pressure (more or less 100 mm Hg), clinical findings and physical activity level. To explore possible risk factors for high seating pressure, both univariate and multivariate regression analysis were performed.
  
  
  RESULTS
  A total of 75 persons with SCI were assessed, 39 (52%) with unsatisfactory result. Statistical analysis revealed that use of manual wheelchair (odds ratio (OR)=6.86, confidence interval (CI) 1.77-26.63) and history of pressure ulcer (OR=8.47, CI 2.46-29.13) significantly increase the risk of unsatisfactory seating pressure. Paraplegia caused significantly higher risk (OR=2.5, CI 0.99-6.34) in the univariate model, probably because the SCI with tetraplegia do prefer electrically powered wheelchairs.
  
  
  CONCLUSIONS
  Use of manually driven wheelchairs and persons with previous pressure ulcer are at significant risk of high seating pressure and consequently developing new pressure ulcers. The patients from these subcategories need close follow-up regarding seating position and prevention of pressure ulcers.
authors.affiliation: Department of Occupational Therapy, Haukeland University Hospital, Bergen, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Taule
authors.forename: K
authors.initials: K
authors.lastname: Bergfjord
authors.forename: E E
authors.initials: EE
authors.lastname: Holsvik
authors.forename: T
authors.initials: T
authors.lastname: Lunde
authors.forename: B H
authors.initials: BH
authors.lastname: Stokke
authors.forename: H
authors.initials: H
authors.lastname: Storlid
authors.forename: M V
authors.initials: MV
authors.lastname: Sørheim
authors.forename: T
authors.initials: T
authors.lastname: Rekand
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009664:Norway; D017060:Patient Satisfaction; D011312:Pressure; D003668:Pressure Ulcer / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications*; D014910:Wheelchairs / Q000009:adverse effects