Remote monitoring of sitting behaviors for community-dwelling manual wheelchair users with spinal cord injury

Study design: A case series study. Objectives: To describe the sitting behaviors in community-dwelling manual wheelchair users (MWUs) with spinal cord injury (SCI) by using a custom data logger and to compare the sitting time parameters between the groups with paraplegia and tetraplegia. Setting: Data were collected from the MWUs living in the community area of Kaohsiung, Taiwan. Methods: A custom data logger with six force sensor resistors was designed and installed on a personal daily-use wheelchair. Twenty MWU participants were instructed to disregard the activation of data logger and pursue their regular activities of daily living. Cumulative sitting time, averaged uninterrupted sitting time, lift-off frequency, and the symmetry ratio of sitting weight distribution for 24 h per day over a 1-week period were recorded. Results: Manual wheelchair users spent an average of 9.2 h (median 9.7, range 3.2-12.2 h) per day in their own wheelchair. They sat for an average of 97 min (median 62, range 24-284 min) without displaying any lift-off behavior. The average lift-off frequency was 9.4 times (median 9.2, range 2-20 times) per day. During sitting, the median value of symmetrical right-left and front-rear weight distribution ratio was 0.9 (range 0.5-1.4), and 0.5 (range 0.01-1.6), respectively. There was no significant difference in sitting time parameters between MWUs with paraplegia and those with tetraplegia. Conclusion: Community-dwelling MWUs spent long periods of time in their wheelchairs and did not engage frequently in pressure relief activities. Regardless of their neurological levels, education on the pressure relief activity is still a core component for all MWUs.