OTalk

#OTalk 28th September 2021 – Thermoregulation for wheelchair users: preventing problems with heat and moisture

This #OTalk is hosted by @WheelAir_

Overheating, over-sweating and excessive moisture build-up are common complaints among wheelchair users. Either due to a medical condition or restrictive seating configurations, many wheelchair users struggle to control heat and moisture levels in the seat contact areas.

At WheelAir, we feel that there is a general lack of understanding and awareness of how heat and moisture complications manifest and how serious an issue thermoregulation can be for wheelchair users.

Overheating

The body uses four mechanisms to maintain thermoregulation: conduction, convection, radiation and evaporation. However, for people with sweating dysfunction, caused by a spinal cord injury for example, no evaporation heat loss can take place. Such overheating drastically heightens the risk of developing heat stress or fatigue, as well as other issues such as heat-induced seizures and muscle spasms. Having to “just deal with” overheating and warm environments can, therefore, be very dangerous for wheelchair users if precautions aren’t taken.

Over-sweating and moisture build-up

Similarly, over-sweating or excessive moisture build-up can have serious consequences for wheelchair users. This is because the skin microclimate – that is, the temperature, humidity and airflow next to the skin surface – is an indirect pressure ulcer risk factor. Temperature and humidity affects the structure and function of the skin, lowering possible damage thresholds for the skin and underlying soft tissues. Even for people who are unable to sweat, such as those with a complete SCI, excessive moisture build-up is a problem. Even when not sweating, the skin releases moisture automatically through a much more passive process called transepidermal water loss (TWL). This is an unavoidable process and, of course, TWL increases when someone is sitting all day.

Research on heat and moisture

The team at WheelAir has spent the past 5 years researching heat and moisture to better understand how to recognise symptoms. We have now created a clinical assessment toolkit to improve the efficiency of evaluating heat and moisture risks for wheelchair users. The toolkit is designed to better inform and educate those involved in the decision-making and reimbursement processes, such as OTs, about the prevention or treatment of heat and moisture related complaints, such as pressure injuries or skin rash.

We want to facilitate OTalk to discuss these newly devised clinical tools and hear from OTs about their experiences of handling heat and moisture issues for wheelchair users.

About WheelAir

The WheelAir system is the first temperature control system designed to fit any wheelchair. All of our products are designed to disperse air evenly across the wheelchair contact area to lower the user’s core temperature and keep the skin dry and clean.

The very first WheelAir was brought to life in 2015 by our Managing Director, Corien Staels, as her final university project during her textiles degree after her university tutor, who was a wheelchair user, told Corien of the problems associated with overheating. Intrigued, Corien wanted to know more and discovered that overheating in a wheelchair is not only very uncomfortable, but also potentially dangerous. She learned that people were using ice-packs and water sprays to keep cool and it seemed ridiculous to her that in this day and age, there wasn’t a technological solution. And so she came up with the WheelAir concept – a simple idea that has already made a lot of impact. Ultimately, WheelAir’s vision is to create a world where every wheelchair user feels comfortable and in control of their temperature.

QUESTIONS:

1. We have had a very hot summer, what symptoms have you seen for wheelchair user clients in the past few months? How have they been managing staying cool and avoiding overheating?

2. Similarly, have moisture related issues been more of a challenge during the hot summer months? Are people struggling with sweating too much, skin issues like rashes, and finding it difficult to stay cool and dry?

3. In general, what types of symptoms do you see with heat and moisture related issues for wheelchair users? How often do you see these as issues for wheelchair users?

4. If a client has heat and/or moisture related symptoms, what do you usually suggest for solutions?

5. How can training about overheating, sweat, and microclimate management improve for Occupational Therapists that work with wheelchair users?

POST CHAT 

Host:  @WheelAir_

Support on OTalk Account:  @colourfulot

Evidence your CPD. If you joined in this chat you can download the below transcript as evidence for your CPD, but remember the HCPC are interested in what you have learnt.  So why not complete one of our reflection logs to evidence your learning?

HCPC Standards for CPD.

  • Maintain a continuous, up-to-date and accurate record of their CPD activities.
  • Demonstrate that their CPD activities are a mixture of learning activities relevant to current or future practice.
  • Seek to ensure that their CPD has contributed to the quality of their practice and service delivery.
  • Seek to ensure that their CPD benefits the service user.
  • Upon request, present a written profile (which must be their own work and supported by evidence) explaining how they have met the Standards for CPD.

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