Have you learned how to relieve stress in a wheelchair?

Authors: Wu Airong, Niu Wenxin, Lin Peipei, Gao Dayong; Chief Judge: Zhai Hua

Unit: Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center)

This popular science work is one of the popular science materials in the series "Don't be afraid of spinal cord injuries, there are ways to prevent and rehabilitate them"

Life Tips

Anyone who has taken a long-distance bus or plane knows that if you sit in a fixed position for a long time, you will not only feel uncomfortable all over, but also feel pain in your buttocks and numbness in your legs. Once you feel this, you will involuntarily change your body position or stand up to adjust, and the discomfort will soon improve.

However, there is a group of people who have to live in wheelchairs for various reasons. Due to the lack of sensory and motor abilities, they will not feel pain in the hips, numbness in the legs, and other discomforts even if they sit in a wheelchair for a long time. Therefore, they often do not think of changing their body position or lifting their hips. So, is there any problem with this? The answer is yes, let's find out together.

Why reduce stress?

Do not underestimate these small movements such as changing body positions or standing up, which are very effective in preventing "pressure sores". We call these movements "decompression". If you sit in a wheelchair for a long time without decompression, "pressure sores" will come to you. This is because long-term sitting increases the pressure load on the sacrum and ischial tuberosity. If the "decompression" is not relieved in time, it will cause damage to the local skin and deep soft tissues, and "pressure sores" will occur.

Once a pressure sore occurs, it is undoubtedly a double whammy for paraplegic patients in wheelchairs. Not only is the treatment difficult, the nursing cycle is long, and the medical expenses are also expensive, but the key is that it will directly affect the patient's physical and mental health. Studies have shown that difficult-to-heal pressure sores have become one of the direct causes of death for paraplegic patients, accounting for about 7%-8% of all paraplegic patients.

1. Lifting the hips to relieve pressure: Relieve the pressure load on the sacrum and coccyx and ischial tuberosity

Method 1: Support the wheelchair armrests with both hands and lift your hips upwards once every 15-30 minutes for 15 seconds each time. You can count to 5 seconds in your mind or beat the rhythm: such as "1234,2234,3234.4234".

Method 2: Fix the wheelchair brakes, hold the fixed object with both hands, lean forward, and keep the sacrum and coccyx off the seat surface for 15 seconds to relieve stress.

Method 3: Lean your body to one side of the wheelchair, hold the tire on the near side with both hands to use the force to lift the other hip, hold for 15 seconds, and then switch to decompress.

2. Wheelchair Cushion Pressure Relief

Choosing a suitable wheelchair cushion can support the body, disperse body pressure, maintain posture and relieve tension. What is even more exciting is that the use of the latest flexible pressure sensor can monitor the soft tissue pressure of the buttocks in a sitting position in real time. Combined with artificial intelligence algorithms, it is expected to warn of the risk of pressure sores.

3. Wheelchair stress relief exercises

It is suitable for young paraplegic patients with good upper limb function and good physical strength. Doing it with music can increase the fun. It is suitable for home rehabilitation. It not only exercises the limbs, but also prevents pressure sores. Join us now.

4. Learn to self-examine your skin

Changes and abnormalities in the skin can be detected, and timely measures can be taken to prevent the occurrence of pressure sores.

(Some pictures in this article are from the Internet)

References:

[1] Yang Longfei, Song Bing, Ni Cuiping, Liu Yu, Lin Fengzhi. Updated interpretation of the 2019 edition of "Prevention and treatment of pressure injuries: clinical practice guidelines"[J]. Chinese Journal of Nursing Management, 2020, 20(12): 1849-1854.

[2]Chen YF, Shen YX, Wang K, Qi Y, Niu WX, Wang Y. Mechanical analysis of deep tissue injury during sitting in patients with spinal cord injury via parametric finite element model. Biomechanics and Modeling in Mechanobiology, 2022, https://doi.org/10.1007/s10237-022-01607-z.

[3]Wang K, Chen YF, Huang SJ, Wang LJ, Niu WX. Subcutaneous fat thickness remarkably influences contact pressure and load distribution of buttock in seated posture, Journal of Healthcare Engineering, 2021, 2021:4496416.

[4] Zhai Hua, Liu Jun, et al. A Guide to Rebuilding the Capacity of People with Spinal Cord Injury[M]. Shanghai: Shanghai Science and Technology Press, 2017: 110-120.