Presentation on theme: "Recommending Seating Supports for Agricultural Equipment Carla Wilhite, University of New Mexico-Occupational Therapy Kevin Sullivan, University of New."— Presentation transcript:
Recommending Seating Supports for Agricultural Equipment Carla Wilhite, University of New Mexico-Occupational Therapy Kevin Sullivan, University of New Mexico-OT Graduate Student Mark Jaramillo, University of New Mexico-OT Graduate Student Funded Research-Southwest Center for Agricultural Health, Injury Prevention, and Education, NIOSH-2U540H007541, CFDA # 93. 262 No other financial disclosures 2014 AgrAbility Virtual National Training Workshop
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AgrAbility: USDA-sponsored program that assists farmers, ranchers, and other agricultural workers with disabilities. – Partners land grant universities with disability services – Organizations. Currently 20 state projects – National AgrAbility Project: Led by Purdue’s Breaking New Ground Resource Center. Partners include: Goodwill of the Finger Lakes The Arthritis Foundation, Heartland Region University of Illinois at Urbana-Champaign Colorado State University – More information available at www.agrability.org www.agrability.org
Introduction Agricultural machinery technology is rapidly evolving. Design of seating, seat materials, and management of seated pressure largely unchanged. Current seating may not conform to the needs of people who vary by size, weight, posture, gender, or health status (ergonomics of difference). People with ergonomics of difference may have to incorporate after-market accommodations to fit themselves to the seating conditions. No research on risks/benefits of changing the dynamics of the seating system.
Example: AgrAbility Farmers with spinal cord injuries (SCI) – Access machinery with fabricated man-lifts and operate machinery with hand controls – Paralysis create changes in sensation, motor function, circulation, and tissue health that can pre-dispose the person to skin tears, lacerations, and pressure-related ulcers – Most farmers with SCI select additional cushioning materials (WC cushions, egg-crate foam, sheepskins, etc.) – AgrAbility Specialists may make recommendations based on experience and knowledge of seating issues – What are pros/cons of selecting cushions in this way?
Research Start-Up Purpose: – Test feasibility of mapping seated pressure on an average original equipment foam contour tractor seat, with and without intervention wheelchair cushions The University of New Mexico- Health Sciences Center Institutional Review Board (#13- 129) approved the research. Funded by the SW Center for Agricultural Health, Injury Prevention, and Education
Research Methods – Mixed methods, single- subjects with repeated measures Instruments – FSA Pressure Mapping System by Vista Medical – Simulation Platform – Braden Scale pressure ulcer risk questionnaire – Likert Scale Seat Ratings – Postural photographs
Participants People with paraplegia in the University of New Mexico Health Sciences service area, including from rural and agricultural communities. Located by “word of mouth” from the informal spinal cord injury / paralysis community. No specific individual, service provider, or agency was used to locate subjects.
SubAgeGender Height (in.) Weight (lb) ConditionHx DUCurrent CushionBraden Scale Sub 135M73280C7-Incomplete Abrasion- healed Stimulite18 Sub 232M70160C4-IncompleteNoneJay 218 Sub 358F64125T8, complete 1-small IT abrasion Foam 2"14 Sub 428M73190CP-ParaplegiaNoneStimulite21 Sub 552M70145T12-Incomplete Hx Multiple DU's; s/p skin flap ROHO (high quadtro)19 Sub 656M65198 T-4 paraplegia complete DB 6 years post, s/p skin flap High Profile ROHO16 Sub 756F64190T12-Incomplete DU 2 years post, DU 2006 High Profile ROHO14 Sub 859F67170T-12-Incomplete, s/p C3-7 fusion None current, past Hx High Profile ROHO12
Cushion Conditions Original tractor seat cushion 2 inch reticulated foam WC cushion Low profile air bladder WC cushion Mid profile air bladder WC cushion High profile air bladder WC cushion
Lab Setting Tractor seat on moveable platform Procedures Adjustments to seating
Limitations Laboratory vs. field conditions Small sample size, non-homogenous Only one tractor seat, five conditions Limited number of cushion sizes and makes Only seated pressures measured Experience of investigator; not blinded to results Procedural issues (arms supported on armrests, feet raised for support, wrinkles on mat, converting data from cm to inches, pressure sensor sensitivity: throwing out “noise” or data?)
Analysis Take-aways Can say with confidence: – A tractor seat alone is not sufficient cushioning for an individual with paralysis – Foam and air cushions used in the study were significantly better for all users than tractor seat alone Cannot say with statistical confidence: – Whether air cushion is better than foam Must carefully clinically evaluate, not statistically evaluate: – Look at the pressure mapping image, regard client lifestyle, health factors, seating needs, other seating supports needs – Make a decision
Conclusions It is feasible to investigate the problem of seating support surfaces in tractors Need to move research into the tractor Begin investigations into other factors related to farmers acquiring DU’s Improve procedures Select instrument with greater precision for sensitive data (below 5 mmHg)
References Armstrong, R., Hall, B. J., Doyle, J., and Waters, E. (2011). Cochrane update: ‘Scoping the scope’ of a Cochrane review. Journal of Public Health, 33(1), 147-150. doi: 10.1093/pubmed/dr015 Balasubramanian, K., Burks, T. F., Lehtola, C. J., & Lee, W.S. (2006). Shock and vibration data acquisition system for off-road vehicle operator health and safety assessment. Journal of Agricultural Safety and Health, 12(4), 293−313. Bergstrom, N., Braden, B. J., Laguzza, A., & Holman, V. (1987). The Braden Scale for predicting pressure sore risk. Nursing Research, 36(4), 205-210. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/3299278 Des Jarlais, D. C., Lyles, C., Crepaz, N. (2004). Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND statement. American Journal of Public Health, 94, 361-366. Donati, P. (2002). Survey of technical preventative measures to reduce whole body vibration effects when designing mobile machinery. Journal of Sound and Vibration, 253(1), 169-183. doi:10.1006/jsvi.2001.4254 Eslami, V., Saadat, S., Habibi-Arejan, Vaccaro, A. R., Ghodsi, S. M., & Rahimi-Movaghar, V. (2012). Factors associated with the development of pressure ulcers After spinal cord injury. Spinal Cord, 50, 899–903. doi.org/10.1038/sc.2012.75 Gefen, A. (2007). The biomechanics of sitting-acquired pressure ulcers in patients with spinal cord injury or lesions. International Wound Journal, 4(3), 222-231. Hostens, I., Papaioannou, G., Spaepen, A., & Ramon, H. (2001). Buttock and back pressure distribution tests on seats of mobile agricultural machinery. Applied Ergonomics, 32, 347-355. Retrieved from Elsevier at http://www.elsevier.com/locate/apergo Hunter, I. A., & Sakar, R. (2011). Managing pressure sores. Surgery, 29(2), 518-522. Kroemer, K. H. E. (2006). Extra-ordinary ergonomics: How to accommodate small and big persons, the disabled and elderly, expectant mothers, and children. New York, NY: Taylor & Francis. Linder-Ganz, E., Shabshin, N., Itzchak, Y., Yizhar, Z., Siev-Ner, I., & Gefen, A. (2008). Strains and stresses in sub-dermal tissues of the buttocks are greater in paraplegics than in healthy during sitting. Journal of Biomechanics, 41, 567–580. doi.org/10.1016/j.jbiomech.2007.10.011 Minkel, J. L. (2000). Seating and mobility considerations for people with spinal cord injury. Physical Therapy, 80(7), 701-709. Retrieved from http://ptjournal.apta.org National Pressure Ulcer Advisory Panel (2009). International guideline: Prevention of pressure ulcers quick reference guide. Retrieved from http://www.npuap.org Portnoy, L. G., & Watkins, M. P. (2000). Foundations of clinical research: Applications to practice (2nd ed.). Upper Saddleback, NJ: Prentice-Hall. Vista Medical. (2022). User manual for Boditrack and FSA Systems (1st ed.). Winnipeg: Vista Medical, LTD. Wilkinson, T. L. & Field, W.E. (1987). Modified agricultural equipment: Agricultural manlifts for farmers and ranchers with physical handicaps. West Lafayette, IN: Breaking New Ground. Yoder, A., Stoller, N., & Field, W.E. (2000). Plowshares #8: New concepts in lift attachments for tractors and combines. West Lafayette, IN: Breaking New Ground.