National foreword

This Published Document is the UK implementation of ISO/TR 16840‑9:2015.

The UK participation in its preparation was entrusted to Technical Committee CH/173/1, Wheelchairs.

A list of organizations represented on this committee can be obtained on request to its secretary.

This publication does not purport to include all the necessary provisions of a contract. Users are responsible for its correct application.

Compliance with a British Standard cannot confer immunity from legal obligations.

This Published Document was published under the authority of the Standards Policy and Strategy Committee on 31 July 2015.

Foreword

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The committee responsible for this document is ISO/TC 173, Assistive products for persons with disability, Subcommittee SC 1, Wheelchairs.

ISO 16840 consists of the following parts, under the general title Wheelchair seating:

Part 1: Vocabulary, reference axis convention and measures for body segments, posture and postural support surfaces
Part 2: Determination of physical and mechanical characteristics of devices intended to manage tissue integrity — Seat cushions
Part 3: Determination of static, impact and repetitive load strengths for postural support devices
Part 4: Seating systems for use in motor vehicles
Part 6: Simulated use and determination of the changes in properties of seat cushions
Part 9: Clinical interface pressure mapping guidelines for seating [Technical Report]
Part 10: Resistance to ignition of non-integrated seat and back support cushions — Requirements and test methods
Part 11: Determination of perspiration dissipation characteristics of seat cushions intended to manage tissue integrity [Technical Specification]
Part 12: Apparatus and method for cushion envelopment testing [Technical Specification]

Introduction

The purpose of this Technical Report is to provide information as to where interface pressure mapping (IPM) can fit into a clinical assessment of an individual and their seating system, to highlight what can be achieved, and bring awareness of the limitations.

The use of IPM in the clinic is increasingly used to support clinicians in the evaluation of individual seating systems for individual clients. To get the best value from IPM requires a knowledge of the basic concepts of the interface pressure distribution (see Clause 2), the ability to define and apply a correct protocol for the application of IPM (see Clause 4), the ability to prepare correct documentation of the IPM (see Clause 5), and the skill in interpreting the collected data (see Clause 6).

The aim of an IPM test session can be different in a clinical or rehabilitation environment. In some cases, it can be a tool to compare the behaviour of different pressure care or postural cushions. It can also be used to support the clinician in finding the best match between cushion and client. Various applications looking at the broader picture are covered in Clause 3. Whichever the application, the main objective behind using an IPM needs to be clear from the beginning.

1 Scope

This Technical Report has been produced to guide users in the performance of the tasks that are directly involved in the clinical use of interface pressure mapping (IPM) or are synergistic with its use in a comprehensive wheelchair seating evaluation.

This Technical Report does not cover other aspects of the clinical assessment process (e.g. taking a medical history), nor the prescription or treatment process which might arise from an assessment. These guidelines are not meant to be a substitute for clinical reasoning and judgement within the context of a complete assessment.

This Technical Report refers to the state of the art of IPM experiences in a seating scenario. Most of the principles covered can be extrapolated to whole body (in bed) or to foot assessments, for example.

2 Definitions and glossary

2.1 Calibration

2.2 Coefficient of Variation (CoV)

2.3 Conformity

2.4 Contact area

2.5 Creep

2.6 Dispersion Index (DI)

2.7 Envelopment

2.8 Fomite

2.9 Hysteresis error

2.10 Immersion

2.11 Pressure, stresses, and forces

2.12 Sensor saturation

3 Applications

3.1 Cushion comparison

3.2 Wheelchair set-up

3.3 Client/caregiver education

3.4 Dynamic activity

3.5 Relevance to activities of daily living

4 Test protocol in a clinic

4.1 Infection control

4.2 Setting up

4.3 Transferring the client and getting the client into position

4.4 Introducing pressure mapping to the client

4.5 Capturing data

5 Documentation

5.1 File naming protocol

5.2 File location

5.3 Make notes immediately

5.4 Reporting

5.5 Photo documentation

5.6 Data back-up

6 Interpretation

6.1 An unexpected image

6.2 An image that is not ideal

6.3 The image shows nothing abnormal

6.4 IPM views and metrics

7 Limitations

7.1 Prediction of pressure injuries

7.2 Microclimate

7.3 Clothing

7.4 Repeatability and relative values

7.5 Influence of posture

7.6 Sampling frequency

Bibliography

PD ISO/TR 16840-9:2015

Wheelchair seating - Clinical interface pressure mapping guidelines for seating

Current

Published:

31 Jul 2015