Objective: To compare outcomes using a wheelchair back designed to support the natural seated spinal curves versus an upholstered back that promotes posterior pelvic tilt and thoracolumbar kyphosis.

Design: Cross-over intervention.

Setting: Two free-standing spinal cord injury (SCI) model system hospitals.

Participants: Fifty adults with motor complete SCI C6-T4, between the ages of 18–60 years who use a manual wheelchair for mobility were recruited from a convenience sample.

Intervention: Each participant’s wheelchair back support was removed and replaced by an upholstered back and a solid back in randomized order. Postural and functional outcomes, pain, and satisfaction were evaluated using each back.

Outcome measures: Seated postural measurements included pelvic angle, spinal angle of kyphosis and linear measurement of spine. Functional outcomes included vertical forward reach, one stroke push, timed forward wheeling, ramp ascent and descent. Numerical pain rating and a satisfaction survey provided input pertaining to both backs.

Results: The solid back demonstrated significance in seated postural measurements. Participants using the solid back trended to higher scores in functional outcome measures including vertical forward reach, one stroke push and timed ramp ascent. Participants reported increased satisfaction with comfort and stability with the solid back.

Conclusions: This pilot study demonstrated that a wheelchair back, which supports the seated spinal curves improves upright posture, functional reach, and wheelchair propulsion skills. Further research is necessary to demonstrate statistical findings as well as to assess back height and lateral support.

目的：比较使用旨在支持自然坐姿脊柱曲线的轮椅靠背与促进骨盆后倾和胸腰椎后凸的软垫靠背的结果。

设计：交叉干预。

设置：两个独立的脊髓损伤 (SCI) 模型系统医院。

参与者：从便利样本中招募了 50 名 18-60 岁、使用手动轮椅移动的运动完全性 SCI C6-T4 的成年人。

干预：移除每位参与者的轮椅靠背支撑，并以随机顺序替换为软垫靠背和实心靠背。使用每个背部评估姿势和功能结果、疼痛和满意度。

结果测量：坐姿测量包括骨盆角、脊柱后凸角和脊柱线性测量。功能结果包括垂​​直前伸、一击推动、定时向前转动、斜坡上升和下降。数字疼痛评级和满意度调查提供了与两个背部有关的输入。

结果：坚实的背部在坐姿测量中表现出显着性。使用坚实背部的参与者在功能结果测量中倾向于更高的分数，包括垂直前伸、一杆推和定时斜坡上升。参与者报告说，对坚实背部的舒适性和稳定性的满意度有所提高。

结论：这项试点研究表明，支撑坐姿脊柱曲线的轮椅靠背可以改善直立姿势、功能范围和轮椅推进技能。需要进一步的研究来证明统计结果以及评估背部高度和侧向支撑。