Evaluation of seating intervention effect for patient at Toulouse University Hospital's wheelchair seating clinic (WSC).

OBJECTIVE: The seating intervention for wheelchair users intends to achieve a comfortable and functional position and to limit the risk of complications due to long sitting period (pain and discomfort, skin disorders, orthopedic, respiratory, digestive diseases). Few scientific papers about seating intervention in adults are published. The objective of the present study is to assess the objective and subjective effects of wheelchair seating intervention for patients at Toulouse University Hospital's WSC.

PATIENTS AND METHODS: A cohort study of patients cared at the Toulouse University Hospital's WSC between April 2014 and April 2016. The main criterion is the evaluation of patient's seating goal at 3 months of delivery of the equipment by the Goal Attainment Score (GAS). Other criterions are the evaluation of pain by visual analog scale (VAS), the comfort of the Assessment Tool Wheelchair Comfort (TAWC), the seating time (hours per day) and the sitting posture [Seated Postural Control Measure for Adults (SPCMA)].

RESULTS: Preliminary results show with 40 patients (mean 51 years±17): among them, 11 have spinal cord injury, 7 stroke. The most common deficiency is tetraplegia (20). Seventeen patients have cognitive impairment. Thirty-six patients have at least one complication of postural control disorder with 19 painful patients. Twenty-six patients completed the positioning care. GAS at 3 month improves: median +2 (min: 0/max: 3). The SPCMA improves: median +8/56 points (min: 0/max: 26). This improvement is statistically significant (Wilcoxon: P<0.001). The pain and discomfort decreased significantly (EVA Wilcoxon: P=0.005; TAWC Wilcoxon: P=0.03). The sitting time is not modified.

DISCUSSION/CONCLUSION: These preliminary results show the effectiveness of seating intervention on posture, pain and discomfort. Patient's goals are the most often reached. These preliminary results show the efficiency of WSC for patients, not only to improve posture.