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Recommending Seating Supports for Agricultural Equipment

2014 AgrAbility Virtual National Training Workshop. 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

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Recommending Seating Supports for Agricultural Equipment

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  1. 2014 AgrAbility Virtual National Training Workshop 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

  2. Basic Webinar Instructions • Need speakers or headphones to hear the presentation. No phone connection. • Check sound via Meeting > Audio Setup Wizard • Questions about presentation • Type into chat window and hit return. • During the Q & A period, if you have a web cam/ microphone, click the “Raise Hand” icon to indicate that you have a question. We will enable your microphone

  3. Basic Webinar Instructions • 4 quick survey questions • Session recorded and archived with PowerPoint files at www.agrability.org/Online-Training/virtualntw along with resource materials • Problems: use chat window or email agrability@agrability.org

  4. Known Webinar Issues • Echo • Check to see if you are logged in twice • Disconnection with presenters • Hang on – we’ll reconnect as soon as possible • Disconnection with participants • Log in again

  5. 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

  6. 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.

  7. 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?

  8. 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

  9. 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

  10. 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.

  11. 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

  12. Lab Setting • Tractor seat on moveable platform • Procedures • Adjustments to seating

  13. Pressure Mapping

  14. Results-Clinical Image Examples

  15. Results-Clinical Image Examples

  16. Results-Statistical

  17. Results- Statistical

  18. Results-Statistical

  19. Examples-Statistical

  20. Examples-Statistical

  21. 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?)

  22. 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

  23. 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)

  24. 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.

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