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Craig Hospital Study on Wheelchair Back Support Published in Journal of Spinal Cord Medicine

Study finds positive outcomes for spinal cord injury patients using a solid backrest, including faster propulsion and increased push distance.

Englewood, Colo. (December 4, 2020) – A study on wheelchair back support, conducted by a team at Craig Hospital, a world-renowned neurorehabilitation hospital for people who have sustained spinal cord and/or brain injuries, in collaboration with a team from the Center for Rehabilitation Outcomes Research at the Shirley Ryan AbilityLab, was published in The Journal of Spinal Cord Medicine.

For people living with spinal cord injury, a wheelchair is an essential part of their independence. Complex rehab technology (CRT) refers to adaptive equipment for people with disabilities that is medically necessary and individually configured. This includes manual and power wheelchair systems, adaptive seating systems, alternative positioning systems, and other mobility devices that require evaluation, fitting, configuration, adjustment, or programming. CRT is important because with an appropriate wheelchair and seating components, there can be immense improvement in one's ability to be healthy, independent, and live a happy and fruitful life.

Having researched how wheelchair components support the best functionality and mobility outcomes for patients with limitations, a team from Craig Hospital – along with professionals from the Shirley Ryan AbilityLab, both Model Systems centers for spinal cord injury – developed a study to evaluate 50 adults between the ages of 18 and 60 living with complete spinal cord injury and who use a manual wheelchair for mobility.

Participants were provided two types of wheelchair backs – one upholstered wheelchair back cushion and one of solid material – and then evaluated for postural and functional outcomes, pain, and satisfaction with each. While most participants predicted that the soft back would provide better comfort and functionality, the study found that the more rigid backrests have the greatest benefits, including increasing vertical reach, aiding a stronger push, improving posture, and providing more comfort.

"At Craig, our daily approach to patient care, including involvement in research, is focused on improving quality of life for patients and helping them get back to being as independent as possible after their injury," said Maggie Dahlin, Craig Hospital physical therapist. "To prove that minor things make a big difference in a person's daily life – like the material of the wheelchair back – is really fulfilling. We take these findings directly to our patients and get to see the benefits in real life."

The study found five key positive outcomes from using a solid backrest:

  • More upright posture: Posterior pelvic tilt, or "sacral sitting," was reduced by an average of 9.16 degrees.
  • Improved upward reach: Vertical forward reach increased by an average of 2.04 inches, which is twice as much as what this outcome measure considers a meaningful change.
  • Increased push distance: One-stroke push test distance increased by an average of 9.69 inches, which is twice as much as what this outcome measure considers a meaningful change.
  • Faster propulsion up a ramp: Ramp ascent was faster by an average of 6.82 seconds.
  • Better overall satisfaction: Participants overall reported the solid backrest was favorable, with 85% reporting they would choose to use it on a daily basis (compared to only 4% for the upholstery back).

The full study can be found online: "Wheelchair backs that support the spinal curves: Assessing postural and functional changes"