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Purpose: This study aimed to investigate the effect of the shape of the back support adjustment on the shear force applied to the buttocks when tilt-in-space and reclining functions are combined in wheelchairs., Materials and Methods: Fourteen healthy adult men were included in the study. The force plate was used to measure the parallel force as shear force. The measurement posture, leaning against the back support of an experimental chair, was a comfortable sitting posture. The tilt-in-space angle was set to 15°. The back support was inclined at increasing angles, starting from the upright position (IUP), proceeding to a fully reclined position (FRP), and returning to the upright position (RUP). The experimental conditions were as follows: adjusting the back-support shape (aBS) and non-adjusting the back support shape (non-aBS)., Results: Positive values indicate a parallel force applied to the buttocks posteriorly. The average values in the aBS condition were 3.4 ± 2.3, 13.6 ± 2.2, and -7.1 ± 2.4% body weight in the IUP, FRP, and RUP, respectively. The average values in the non-aBS condition were 3.8 ± 2.5, 11.4 ± 2.1, and -6.2 ± 3.1% body weight in the IUP, FRP, and RUP, respectively. There were significant differences between the two conditions in FRP ( p  < 0.01)., Conclusion: These findings suggest that the shape of the back support adjustment function increased the shear force applied to the buttocks posteriorly when the back support was inclined backwards using both the tilt-in-space and reclining functions.

Purpose: This purpose was to investigate developed seat-cover assemblies' effect on decreasing the fluctuation of the shear force exerted onto the buttocks as the factors causing decubitus ulcers when the back-support was inclined., Materials and Methods: The participants were 10 wheelchair users. The force plate was used to measure the horizontal force as the shear force. The back-support was inclined at increasing angles, starting from the upright position (IUP), then proceeding to a fully reclined position (FRP), and returning to the upright position (RUP). The experimental conditions were two conditions; the seat-cover assembly conditions and without the seat-cover assembly as the control conditions., Results: The average values in the seat-cover assembly condition were 14.4 ± 3.3, 13.9 ± 2.3, and 17.3 ± 3.3% body weight in the IUP, FRP, and RUP, respectively. The average values in the control condition were 14.8 ± 2.6, 11.4 ± 1.7, and 24.0 ± 6.7% body weight in the IUP, FRP, and RUP, respectively. In the FUP and the RUP, there were significant differences between two conditions ( p < .01)., Conclusion: These results suggested that the shear force exerted onto the buttocks may to be decreased by using novel seat-cover assembly.Implications for rehabilitationIt is possible to decrease the fluctuations in the shear force by moving the body up and down according the novel seat-cover assembly attached the back-support incline.Disabled, older individuals can be provided with a comfortable life on a reclining wheelchair while preventing decubitus ulcers.

Purpose: The purposes of this study were to construct a real-time acceleration gait analysis system equipped with software to analyse real-time trunk acceleration during walking and to examine the intra-rater and inter-rater reliabilities of the this system., Methods: This system has been comprised of an accelerometer, an acceleration amplifier, a transmitter, two foot switches, a receiver and a personal computer installed with the real-time acceleration analysis software. The acceleration signals received were analysed using the real-time acceleration analysis software, and gait parameters were calculated. The subjects were 20 healthy individuals and two raters. The intra-rater and inter-rater reliabilities of the measurement results obtained from this system were examined by performing intraclass correlation coefficients (ICC) and Bland-Altman analysis., Results: The intra-rater and inter-rater ICCs ranged from 0.61 to 0.92 in any gait parameters. In the Bland-Altman analysis, neither fixed nor proportional bias was found in any of the gait parameters., Conclusions: From the ICC and Bland-Altman analysis results, the gait measurement using this system clearly demonstrates that the intra-rater and inter-rater measurements had good reproducibility. Owing to this system, we can improve the clinical efficiency of gait analysis and gait training for physiotherapy. Implication for Rehabilitation This study focused on the advantage of a gait analysis method using an accelerometer and constructed a gait analysis system that calculates real-time gait parameters from trunk acceleration measurements during walking. The gait analysis using this system has good intra-rater and inter-rater reliabilities, and using this system can improve the clinical efficiency of gait analysis and gait training.

Purpose: The purpose of this study was to investigate the mechanism of the fluctuation in the shear force applied to the buttocks., Method: The subjects were 11 healthy adult men without leg or trunk diseases. The amount of force applied to the buttocks was measured by using a force plate, and a pressure and shear force sensor was used to measure the timing of the force applied to the back support., Results: The average value of the shear force applied to the buttocks was 9.4 ± 2.4 (%BW) in the initial upright position (IUP), 9.3 ± 1.2 (%BW) in the fully reclined position (FRP), and 15.0 ± 2.9 (%BW) in the returning to an upright position (RUP). Significant differences appeared between the RUP and the other positions., Conclusions: The results of this study suggested that the adjustment of the axes of rotation of the back support and trunk-pelvis and the release of the remaining shear force after the back support is reclined are important for the prevention of decubitus ulcers.