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Practice Management, Leadership, and Quality Improvement

Exploration of diagnostic accuracy of body anthropometrics to identify increased pressure during power wheelchair pressure relief maneuvers.

(Scientific Session) Exploration of Diagnostic Accuracy of Body Anthropometrics to Identify Increased Pressure During Power Wheelchair Pressure Relief Maneuvers

Saturday, November 18, 2023
10:45 AM – 12:00 PM CT

    Primary Author(s)

  • Tanvee Sinha, Other

    MD/MPH Student at the University of Alabama at Birmingham
    University of Alabama At Birmingham
    Birmingham, Alabama

    • Co-Author(s)

  • Cathy Carver, PT, Other

    Physical Therapist
    UAB Spain Rehabilitation Center
    Birmingham, Alabama

  • RC

    Rachel E. Cowan, PhD

    Assistant Professor
    University of Alabama At Birmingham
    Birmingham, Alabama

Background and/or Objectives: To examine the accuracy of various body anthropometrics to predict if a person experiences pressure increase during pressure relieving maneuvers.

Design: Cross Sectional.

Setting: Wheelchair clinic.

Participants: 15 adults with chronic spinal cord injury/dysfunction (>1 year) who used a power wheelchair with tilt and recline functions (N=6 females, N=9 males). Participants were (mean ± standard deviation) aged 55±17 years old, weighed 168±32 lbs, had been using a wheelchair for 17±12 years and had a BMI of 24.9±3.9 kg/m².

Interventions: Pressure mapping studies. Peak pressure index (PPI, mmhg) and tilt and recline angles (deg) were recorded for preferred upright (PU) and preferred pressure relief (PPR) positions.

Main Outcome Measures: Difference in PPI between PU and PPR, classified as increased (PPR-PU≥Δ10%) or no change/decreased (PPR-PU≤Δ10%). Candidate body anthropometric classifiers: abominable girth (inches), arm length (in)/abdominal girth (in) ratio, BMI kg/m², and weight (lb). Receiver operator curve analysis was used to generate sensitivity, specificity and area under the curve. Cutoff values that provided adequate sensitivity and specificity were selected.

Results: Six individuals (60%) had increased PPI during PPR. There was no differences in anthropometric or demographics between groups (Mann-Whitney U & 𝛘2, all p≥0.169). Area under the curve (∓standard error) for abdominal girth, weight, BMI, and arm length/abdominal girth ratio, was 0.792±0.117, 0.833±0.105, 0.640±0.169, and 0.475±0.155, respectively. Cutoff values (variable, cutoff value, sensitivity, specificity) included: abdominal girth, 46 inches, 60%, 100%; weight, 169 lbs, 70%, 100%; BMI, 23 kg/m², 90%, 40%; and arm length/abdominal girth ratio, 0.44, 60%, 67%.

Conclusions: Although weight had the highest area under the curve, we prefer abdominal girth as a classifier because of ease of collection. We will continue to test these variables in a more diverse set of individuals to further explore their diagnostic accuracy.