Monitoring standing wheelchair use after spinal cord injury: a case report

Abstract

Purpose: An important issue in spinal cord injury (SCI) research is whether standing can yield positive health benefits. However, quantifying dose of standing and establishing subject compliance with a standing protocol is difficult. This case report describes a method to monitor dose of standing outside the laboratory, describes the standing patterns of one subject, and describes this subject's satisfaction with the standing protocol.

Method: A man with T-10 complete paraplegia agreed to have his commercially available standing wheelchair instrumented with a custom-designed logging device for a 2-year period. The micro-controller-based logger, under custom software control, was mounted to the standing wheelchair. The logger recorded date, duration, angle of standing, and start/stop times.

Results: The client exceeded a suggested minimum dosage of standing per month (130.4% of goal), choosing to stand for short bouts (mean = 11.57 min) at an average angle of 61 degrees, on an average 3.86 days per calendar week. He was generally very satisfied with the standing device and provided subjective reports of improved spasticity and bowel motility.

Conclusion: This case report describes a standing and surveillance system that allow quantification of standing dose. Future controlled studies are needed to evaluate whether standing can be beneficially affect secondary complications after SCI.

Figures

Figure 1

Representative examples of the pattern of use of the standing wheelchair. A: Time is given in military units. Bouts starting between 00:00:00 and 02:00:00 were carry-overs from standing sessions beginning just before midnight on the previous date (the logger clock rolled over to 00:00:00 at midnight). B: Mr R often stood at various angles within a single bout. For each bout, average angle appears on the vertical axis.

Figure 2

Compliance with standing recommendations, expressed as percentage of the goal of standing for each month. Average percent compliance was 130.4%. Data for June 2001 and for September 2001 through January 2002 were not collected. Mr. R did no standing during March 2002 due to removal of his Harrington rods.