Pressure relief behaviour and the prevention of pressure ulcers in wheelchair users in the community

Stockton, Lesley; Parker, Dianne

doi:10.1016/s0965-206x(02)80031-6

Cited by 58 publications

(39 citation statements)

References 7 publications

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“…MWUs spent almost 9 h a day sitting in their own wheelchair and performed a pressure relief movement once in an average of every 1-2 h. These findings were consistent with previous studies. [10][11][12] Bloemen-Vrencken et al 13 found that individuals with SCI in the community did not frequently engage in pressure relief movements when sitting/driving in their wheelchair. Only 20.9% of the 410 responders always did some type of pressure relief every 30 min.…”

Section: Discussionmentioning

confidence: 99%

Remote monitoring of sitting behaviors for community-dwelling manual wheelchair users with spinal cord injury

et al. 2008

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Study design: A case series study. Objectives: To describe the sitting behaviors in community-dwelling manual wheelchair users (MWUs) with spinal cord injury (SCI) by using a custom data logger and to compare the sitting time parameters between the groups with paraplegia and tetraplegia. Setting: Data were collected from the MWUs living in the community area of Kaohsiung, Taiwan. Methods: A custom data logger with six force sensor resistors was designed and installed on a personal daily-use wheelchair. Twenty MWU participants were instructed to disregard the activation of data logger and pursue their regular activities of daily living. Cumulative sitting time, averaged uninterrupted sitting time, lift-off frequency, and the symmetry ratio of sitting weight distribution for 24 h per day over a 1-week period were recorded. Results: Manual wheelchair users spent an average of 9.2 h (median 9.7, range 3.2-12.2 h) per day in their own wheelchair. They sat for an average of 97 min (median 62, range 24-284 min) without displaying any lift-off behavior. The average lift-off frequency was 9.4 times (median 9.2, range 2-20 times) per day. During sitting, the median value of symmetrical right-left and front-rear weight distribution ratio was 0.9 (range 0.5-1.4), and 0.5 (range 0.01-1.6), respectively. There was no significant difference in sitting time parameters between MWUs with paraplegia and those with tetraplegia. Conclusion: Community-dwelling MWUs spent long periods of time in their wheelchairs and did not engage frequently in pressure relief activities. Regardless of their neurological levels, education on the pressure relief activity is still a core component for all MWUs.

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Section: Discussionmentioning

confidence: 99%

Remote monitoring of sitting behaviors for community-dwelling manual wheelchair users with spinal cord injury

et al. 2008

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“…However, two studies have measured the posture shift frequency of individuals that use a wheelchair for their mobility, and it was concluded that there is a wide variety in pressure relief intervals between subjects and that sitting times exceed the AHRQ guidelines. 3,4 As individuals with spinal cord injury lack the sensory ability to register the need to reposition and the motor function to reposition, they are often dependent on nursing staff to reposition them. This is a time-consuming and costineffective activity.…”

Section: Introductionmentioning

confidence: 99%

Effects of dynamic sitting interventions on tissue oxygenation in individuals with spinal cord disorders

et al. 2009

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Study Design: An explorative cross-sectional study. Objectives: The objective of this study was to investigate the possibility of imposing dynamic sitting behavior on individuals with spinal cord disorders by using the Dynasit chair and to investigate its effect on the (sub-)cutaneous tissue oxygenation. Setting: Rehabilitation Centre het Roessingh, Enschede, the Netherlands. Subjects: Ten male subjects with a spinal cord disorder. Methods: The Dynasit chair, an experimental simulator chair, containing mechanical concepts for postural adjustments, regulation of tuberal load and pelvic rotation, was developed to allow individuals with a spinal cord disorder to sit in a dynamic way. An experiment was carried out in which a dynamic sitting pattern was imposed. The sitting pattern consisted of series of actuated changes in posture, tuberal load and pelvic orientation. Effects of these changes on (sub-)cutaneous buttock tissue oxygenation were investigated by transcutaneous measurement of tissue oxygenation. Results: Nonparametric statistical analyses were carried out on nine subjects that completed the study. Results showed significant positive effects (Po0.05) of actuated changes in tuberal load on the cutaneous and subcutaneous tissue oxygenation. Conclusion: The Dynasit chair is effective in imposing dynamic sitting behavior in individuals with a spinal cord disorder and consequently might reduce the chance of tissue degradation.

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“…Conclusive figures are difficult to determine because of the differences in data collection, but most studies agree on a prevalence of around 9 to 21 percent in acute care and 9 to 27 percent in long-term care [1,8,[16][17]. Annual treatment costs of pressure ulcers in the United States exceed U.S. $1 billion [8,[18][19], and in the United Kingdom, they are around 300 million pounds [20]. Avoiding a single pressure ulcer may save as much as U.S. $151,700 in treatment of complications and advanced injuries [8].…”

Section: Introductionmentioning

confidence: 99%

Toward real-time detection of deep tissue injury risk in wheelchair users using Hertz contact theory

Agam

Gefen²

2008

JRRD

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Abstract-This study assessed the suitability of a new portable system that is based on Hertz's contact theory for evaluating internal gluteal muscle stresses under the ischial tuberosities of wheelchair users in real-time as a risk indicator for a deep tissue injury. Sitting in a wheelchair was monitored and processed with the portable system for six control subjects and five individuals with paraplegia. We compared the resultant internal peak and average muscle stresses and stress integrals over time (stress doses) of the control subjects with those of the subjects with paraplegia and validated the results against previously published subject-specific finite element (FE) stress data for the same subjects. Individuals with paraplegia were characterized by peak muscle compression stresses (mean +/-standard deviation = 109 +/-41 kPa) that were 2.4-fold higher than in control subjects (p < 0.03). A Bland-Altman comparison indicated that stresses recorded by the present system were in satisfactory agreement with previous subject-specific magnetic resonance imaging-FE analyses. We conclude that the present stress monitoring system has the potential to be a practical means for evaluating internal muscle stresses during everyday life of individuals with paraplegia.

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Pressure relief behaviour and the prevention of pressure ulcers in wheelchair users in the community

Cited by 58 publications

References 7 publications

Remote monitoring of sitting behaviors for community-dwelling manual wheelchair users with spinal cord injury

Remote monitoring of sitting behaviors for community-dwelling manual wheelchair users with spinal cord injury

Effects of dynamic sitting interventions on tissue oxygenation in individuals with spinal cord disorders

Toward real-time detection of deep tissue injury risk in wheelchair users using Hertz contact theory

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