Power wheelchair users with ALS: Impact of an alerting system on complications with prolonged sitting and power feature utilization

An interventional technology called Virtual Seating Coach (VSC) provided alerts via an app to perform pressure redistribution using power wheelchair seat functions. The objective was whether alerts can contribute to more function utilization and thereby reduce pressure injuries and pain. Thirty-nine individuals with Amyotrophic Lateral Sclerosis (ALS) participated, 14 consented to use VSC, and 25 controls. The duration of the study was 27 months, with follow-up at 1 month or 3 months. Due to multiple technological and disease-related difficulties, three of those consented for the VSC received alerts once per hour to move into prescribed positions for one minute. These participants were able to use the VSC through the study end, and two of the three adhered to performing pressure redistribution after receiving alerts. The three using the VSC did not report pressure injuries; 12 of 21 controls reported development of a pressure injury. Furthermore, those using VSC noted a decrease in pain; most controls showed an increase during the same time period. The study thus highlighted the potential for such alerting technology while at the same time revealing many limitations due to disease progression and diminishing access to wheelchair controls.