Relationship of Spine Deformity and Pelvic Obliquity on Sitting Pressure Distributions and Decubitus Ulceration

Drummond, Denis S.; Breed, Alan L.; Narechania, Rajesh G.

doi:10.1097/01241398-198507000-00002

Cited by 86 publications

(42 citation statements)

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“…Indirect measures, specifically interface pressures, comprise the bulk of studies on cushions [13][14][15][16]. Researchers have shown tha t high seated interface pressures were associated with PU occurrence [17][18][19]. Therefore, despite the limita tions in IPM as a less accurate representation of localized loading [5,[20][21][22], it can be useful in selecting cushions.…”

Section: Support Surfacesmentioning

confidence: 99%

Assessing evidence supporting redistribution of pressure for pressure ulcer prevention: A review

Sprigle¹,

Sonenblum²

2011

JRRD

102

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Abstract-The formation and underlying causes of p ressure ulcers (PUs) are quite complex, with multiple influencing factors. However, by definition pressure ulcers cannot form without loading, or pressure, on tissue. Clinical interventions typically target the magnitude and/or duration of loading. Pressure magnitude is managed by the selection of support surfaces and postural supports as well as body posture on supporting surfaces. Duration is addressed via turning and weight shifting frequency as well as with th e use of dynamic s urfaces that actively redistribute pressure on the body surfaces. This article shows that preventative interventions must be targeted to both magnitude and duration and addresses the rationale behind several common clinical interventions-some with more scientific evidence than others.

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Section: Support Surfacesmentioning

confidence: 99%

Assessing evidence supporting redistribution of pressure for pressure ulcer prevention: A review

Sprigle¹,

Sonenblum²

2011

JRRD

102

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“…Given that there is a risk of ulceration when pressure on the sacrococcygeal area exceeds 11%, 4 the pressure resulting from 15° tilt (where loading is 6.89%) appears to present little risk of ulceration, whereas there is such risk starting at 20° tilt (where loading is 11%). If horizontal force on the ischial tuberosity and sacrococcygeal areas causes pressure ulcer development, then such risk will be minimized at a posterior pelvic tilt angle of 15°, where horizontal force on the ischial tuberosity and sacrococcygeal areas is near 0 (0.2% on the ischial tuberosity area and 0% on the sacrococcygeal area).…”

Section: Discussionmentioning

confidence: 99%

“…In comparison with the ischial tuberosity region, which features a considerable amount of surface soft tissue to support body weight loading, the sacral area, by nature, is not pressure resistant, and body weight loading can lead to pressure ulcer development. 2 There is currently disagreement between researchers regarding specific threshold values at which pressure presents the risk of pressure ulcer development, 3 but Drummond et al 4 suggest that there is pressure ulcer risk when pressure on the sacrococcygeal area exceeds 11% of the body weight, based on sitting pressure distributions in 16 patients with paraplegia (9 with pressure ulcer and 6 without).…”

Section: Introductionmentioning

confidence: 99%

Force on the sacrococcygeal and ischial areas during posterior pelvic tilt in seated posture

Kemmoku

Furumachi

Shimamura

2013

Prosthetics &Amp; Orthotics International

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Background: Most posture problems encountered in persons who use wheelchairs in a seated posture for extended periods are related to sacral sitting due to posterior pelvic tilt. Posterior pelvic tilt places pressure and shearing force on the sacrococcygeal area that can lead to pressure ulcers, but the relationship between pelvic tilt and force applied to the sacrococcygeal and ischial tuberosity areas has not yet been investigated. Objective: To investigate the relationships of posterior pelvic tilt in a seated posture with vertical force and horizontal force on the sacrococcygeal and ischial tuberosity areas. Study Design: Repeated measures design. Methods: Thirty male and female subjects aged ≥60 years sat in a measurement chair at varying pelvic tilt angles, and force on the sacrococcygeal and ischial tuberosity areas was measured. Results: The pressure on the sacrococcygeal area increased with pelvic tilt in all subjects, with vertical force averaging 19% of the body weight at a pelvic tilt angle of 30°. The horizontal force on the sacrococcygeal area increased in 93% of the subjects, with an average increase equal to 3% of the body weight. Conclusions: We confirmed changes in vertical and horizontal forces on the sacrococcygeal and ischial tuberosity areas with a change in seated posture (pelvic tilt). Clinical relevanceWe propose guidelines for rehabilitation practitioners working with wheelchair users to suggest improved ways of sitting in wheelchairs that avoid pelvic tilt angles that might promote pressure ulcers on the buttocks.

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“…Pelvic fixation is occasionally needed at the pediatric age for the treatment of high-grade spondylolisthesis, congenital lumbosacral scoliosis, and as part of a growing rod construct for managing early-onset scoliosis [2][3][4][5][6][7]. A progressive pelvic obliquity with an unbalanced spine deformity adversely affects sitting balance, pressure, and quality of life [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Pelvic fixation for neuromuscular scoliosis deformity correction

Dayer¹,

Ouellet

Saran

2012

Curr Rev Musculoskelet Med

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Pelvic fixation is most frequently indicated in the pediatric population for the treatment of neuromuscular scoliosis with significant pelvic obliquity. Neuromuscular scoliosis surgery is associated with a high risk of complications, and this is further increased by extension of fusion to the sacrum. Numerous techniques have been described for pelvic fixation associated with a long spine fusion each with its own set of specific benefits and risks. This article reviews the contemporary surgical techniques of pelvic fixation used to extend a spine fusion to the sacrum and pelvis focusing on the management of neuromuscular scoliosis, including their biomechanical rationale, results, and complications.

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Relationship of Spine Deformity and Pelvic Obliquity on Sitting Pressure Distributions and Decubitus Ulceration

Cited by 86 publications

References 0 publications

Assessing evidence supporting redistribution of pressure for pressure ulcer prevention: A review

Assessing evidence supporting redistribution of pressure for pressure ulcer prevention: A review

Force on the sacrococcygeal and ischial areas during posterior pelvic tilt in seated posture

Pelvic fixation for neuromuscular scoliosis deformity correction

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