Abstract:Introduction: Pressure relief done by a spinal cordinjured patient is of utmost importance in order to prevent pressuresore formation. Some pressure-relieving techniques are describedin previous literature, but their effectivity has not yet been deter-mined on different wheelchair cushions.Null Hypothesis (H0): The null hypothesis (H0) stated for thistudy is that there is no difference in the effectivity of forwardleaning and forward leaning towards the left as pressure relievingtechniques for quadriplegic whe… Show more
“…As with the studies on bed positioning, there was significant heterogeneity of methods and outcomes of seated positioning and pressure relief maneuvers, precluding aggregation of study results. Study designs were primarily case series [51‐57], cohort [44,58‐63], or cross‐sectional [64‐72]. There was one N‐of‐1 study and one RCT [73,64].…”
Section: Resultsmentioning
confidence: 99%
“…Most studies (19) were conducted in a laboratory setting [44,51‐63,68‐72]. Six studies [64‐66,73] were conducted in the clinic, and two of these studies [67,74] were with community‐dwelling subjects. The total number of subjects examined across the 25 identified studies was 1148.…”
Section: Resultsmentioning
confidence: 99%
“…Of these subjects, 321 were able‐bodied individuals, 137 had paraplegia, 100 had tetraplegia, and the level of injury was not specified for 590 subjects with SCI. Nine studies examined seated pressures exclusively in able‐bodied persons [51‐57,70,71], and a like number of studies examined persons with SCI exclusively [64‐69,72‐74]. The remaining 7 studies examined both able‐bodied persons and those with SCI [44,58‐63].…”
Section: Resultsmentioning
confidence: 99%
“…The ischium was an anatomic site of interest in 17 studies [44,52,55,56,58,59,61,62,64‐71,73]. The next most common sites examined were the seating interface as a whole [51,53,54,57,60,63,72,74] and the buttocks.…”
Section: Resultsmentioning
confidence: 99%
“…The next most common sites examined were the seating interface as a whole [51,53,54,57,60,63,72,74] and the buttocks. The thighs [58,62,65] and the sacrum [57] received less focus. Pelvic rotation was the focus of 2 studies [55,56].…”
Although there is no clear optimal positioning or turning frequency in bed, the evidence suggests avoiding the 90° lateral position because of high pressures and PU risk over the trochanters. During sitting, pressures are linearly redistributed from the sitting area during recline and tilt; however, reclining carries with it an increased risk of shear forces on this skin. The evidence does not support conclusive guidelines on positioning or repositioning techniques for PU prevention in bed or during sitting. We conclude that PU risk is highly individualized, with the SCI population at a higher risk, which demands flexible PU prevention strategies for bed/seated positioning and pressure relief maneuvers. Education has and will remain our most powerful ally to thwart this pervasive public health problem.
“…As with the studies on bed positioning, there was significant heterogeneity of methods and outcomes of seated positioning and pressure relief maneuvers, precluding aggregation of study results. Study designs were primarily case series [51‐57], cohort [44,58‐63], or cross‐sectional [64‐72]. There was one N‐of‐1 study and one RCT [73,64].…”
Section: Resultsmentioning
confidence: 99%
“…Most studies (19) were conducted in a laboratory setting [44,51‐63,68‐72]. Six studies [64‐66,73] were conducted in the clinic, and two of these studies [67,74] were with community‐dwelling subjects. The total number of subjects examined across the 25 identified studies was 1148.…”
Section: Resultsmentioning
confidence: 99%
“…Of these subjects, 321 were able‐bodied individuals, 137 had paraplegia, 100 had tetraplegia, and the level of injury was not specified for 590 subjects with SCI. Nine studies examined seated pressures exclusively in able‐bodied persons [51‐57,70,71], and a like number of studies examined persons with SCI exclusively [64‐69,72‐74]. The remaining 7 studies examined both able‐bodied persons and those with SCI [44,58‐63].…”
Section: Resultsmentioning
confidence: 99%
“…The ischium was an anatomic site of interest in 17 studies [44,52,55,56,58,59,61,62,64‐71,73]. The next most common sites examined were the seating interface as a whole [51,53,54,57,60,63,72,74] and the buttocks.…”
Section: Resultsmentioning
confidence: 99%
“…The next most common sites examined were the seating interface as a whole [51,53,54,57,60,63,72,74] and the buttocks. The thighs [58,62,65] and the sacrum [57] received less focus. Pelvic rotation was the focus of 2 studies [55,56].…”
Although there is no clear optimal positioning or turning frequency in bed, the evidence suggests avoiding the 90° lateral position because of high pressures and PU risk over the trochanters. During sitting, pressures are linearly redistributed from the sitting area during recline and tilt; however, reclining carries with it an increased risk of shear forces on this skin. The evidence does not support conclusive guidelines on positioning or repositioning techniques for PU prevention in bed or during sitting. We conclude that PU risk is highly individualized, with the SCI population at a higher risk, which demands flexible PU prevention strategies for bed/seated positioning and pressure relief maneuvers. Education has and will remain our most powerful ally to thwart this pervasive public health problem.
[Purpose] The purpose of this study was to compare the interface pressure redistribution
when sitting after applying three different types of cushions and on a firm surface in
individuals in their 20s and those older than 60 years old. [Subjects and Methods] Healthy
100 elderly (60 years and older) subjects and 111 college students participated in this
study. Interface pressure redistribution while sitting on a firm surface or honeycomb,
air, and memory foam cushions, examined in that order. [Results] For all groups,
significant differences were found in the total pressure mean among sitting states. When
the hip and thigh interface pressure among sitting states were compared within each group,
significant differences were found in the mean right hip pressure, mean left hip pressure,
peak right hip pressure, peak left hip pressure, right hip pressure ratio, and left hip
pressure ratio. [Conclusion] Our data indicated that the type of cushion should be
considered and fit for individuals when recommending appropriate interface pressure
redistribution cushions.
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