Tissue shape and deformation as a characterization of the seating interface

Levine, Simon P.; Kett, R L

doi:10.1109/iembs.1989.96016

Cited by 4 publications

(6 citation statements)

References 1 publication

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“…Levine et al investigated dynamic changes in seat interface pressure using surface functional electrical stimulation (FES) of the gluteus maximus [15][16][17]. Interestingly, these results indicated that FES could change the shape of loaded buttocks and thereby significantly reduce pressure under the ITs and redistribute it over other parts of the seat interface.…”

Section: Introductionmentioning

confidence: 99%

Interface pressure and cutaneous hemoglobin and oxygenation changes under ischial tuberosities during sacral nerve root stimulation in spinal cord injury

Liu

Nicholson²,

Knight³

et al. 2006

JRRD

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Abstract-Noninvasive functional magnetic stimulation (FMS)of the sacral nerve roots can activate gluteal muscles. We propose the use of sacral anterior root stimulator (SARS) implants to prevent ischial pressure ulcers in the spinal cord injury (SCI) population. In this study, we (1) investigated the acute effects of sacral FMS on ischial pressure, skin blood content, and oxygenation changes in people with SCI and demonstrated the utility of FMS as an assessment tool, and (2) showed that similar effects are possible with electrical stimulation via a SARS implant. Results indicated that sacral nerve root stimulation, either by FMS or implanted electrical stimulation, induced sufficient gluteus maximus contraction to significantly change subjects' ischial pressures and cutaneous hemoglobin and oxygenation during sitting. In addition to these beneficial acute effects, chronic stimulation via a SARS implant may build gluteal muscle bulk and prevent or reduce pressure ulcers in the SCI population.

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Section: Introductionmentioning

confidence: 99%

Interface pressure and cutaneous hemoglobin and oxygenation changes under ischial tuberosities during sacral nerve root stimulation in spinal cord injury

Liu

Nicholson²,

Knight³

et al. 2006

JRRD

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“…Bogie et al [3] described an on-off ES duty cycle of 1:1 s in a 3 min period, with a 17 min interstimulation interval, approximating the frequency of weight shifting recommended for wheelchair users at risk of tissue breakdown [3,8,10]. This duty cycle has not been compared with other protocols; therefore, it is not clear whether this is the optimal ES-rest ratio.…”

Section: Discussionmentioning

confidence: 99%

“…Future research has also revealed the possible additional effects of surface ES on reduction of muscle atrophy. Levine et al [6][7]17] and Levine and Kett [8] already showed that tissue shape changed and muscle hypertrophy occurred after muscle ES.…”

Section: Discussionmentioning

confidence: 99%

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Prolonged electrical stimulation-induced gluteal and hamstring muscle activation and sitting pressure in spinal cord injury: Effect of duty cycle

Smit

Legemate²,

Koning³

et al. 2013

J Rehabil Res Dev

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Abstract-Pressure ulcers (PUs) are highly prevalent in people with spinal cord injury (SCI). Electrical stimulation (ES) activates muscles and might reduce risk factors. Our objectives were to study and compare the effects of two duty cycles during 3 h of ES-induced gluteal and hamstring activation on interface pressure distribution in sitting individuals with SCI and study the usability of a newly developed electrode garment (ES shorts). Ten individuals with SCI participated in this study, in which two ES protocols with different duty cycles (1:1 s vs 1:4 s on-off) were applied in counterbalanced order using a custom-made garment with built-in electrodes. Outcome variables included interface pressure of the ischial tuberosities (ITs) and pressure gradient. A questionnaire was used to determine usability of the ES shorts. In both protocols, ES caused a significant decrease in average IT pressure compared with rest (no ES); on average, 35% for protocol 1:4 and 13% for protocol 1:1. The ES on-off duty cycle of protocol 1:4 showed less muscle fatigue. In general, participants scored the usability of the ES shorts as satisfactory. In this study, the application of ES resulted in a significant decrease in IT pressure. The ES on-off duty cycle of 1:4 s is recommended because of the less fatiguing effect. ES of the hamstrings and gluteal muscles might be a promising method in preventing PUs, but further study is needed.

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“…A method to potentially prevent the recurrence of PU is activating the paralysed muscles using electrical stimulation (ES). ES has been found to markedly improve PU risk factors by improving paralysed muscle mass and local circulation of skin and muscle [6,[24][25][26][27][28][29][30]. However, randomized controlled trials (RCTs) to confirm the effect of ES on reduction of PU recurrence are lacking and the cost-effectiveness of ES in individuals with SCI is unknown.…”

Section: Electrical Stimulationmentioning

confidence: 99%

Electrical stimulation to prevent recurring pressure ulcers in individuals with a spinal cord injury compared to usual care: the Spinal Cord Injury PREssure VOLTage (SCI PREVOLT) study protocol

Wijker

Groot

Dongen

et al. 2022

Trials

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Background Pressure ulcers (PUs) on the buttocks are among the most common secondary complications in individuals with chronic spinal cord injury (SCI). PUs can result from sitting for extended periods, disuse atrophy, increased sitting pressure and reduced circulation. Compared with usual care, activation of paralysed muscles using electrical stimulation (ES) has been shown to markedly increase paralysed muscle mass, improve circulation of skin and muscle and improve sitting pressure distribution. ES might therefore be a useful method to reduce PU incidence. Methods A multicentre randomized controlled trial (SCI PREVOLT) will be conducted with an economic and process evaluation alongside. One hundred participants with a SCI in the chronic phase and a minimal incidence of 1 PU in the last 5 years will be recruited from rehabilitation centres across the Netherlands. Participants will be stratified by centre and age and randomized to the intervention or control group. The intervention group will use ES at least 1 h/day during at least 4 times a week for 1 year next to usual care. The control group will only receive usual care. The primary outcome is the incidence of PUs, measured by a blinded person assessing the presence or absence of a PU on the buttocks on a photo made by the participant or his/her caregiver. The incidence of a PU will be evaluated every 2 weeks. Secondary outcomes include interface pressure distribution, blood flow in the profunda femoris artery, muscle thickness of the hamstrings and gluteal muscles and questionnaires about different dimensions of life, e.g. participation and quality of life. Secondary outcomes will be measured at baseline and 3, 6, 9 and 12 months after randomization. Discussion This study will assess if electrical stimulation is a (cost-)effective method to prevent PUs and reduce the risk factors of getting PUs. If ES is effective and cost-effective compared with usual care, ES could be implemented in daily treatment of individuals with a SCI. Trial registration Netherlands Trials Register NTR NL9469. Registered on 26 May 2021.

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Tissue shape and deformation as a characterization of the seating interface

Cited by 4 publications

References 1 publication

Interface pressure and cutaneous hemoglobin and oxygenation changes under ischial tuberosities during sacral nerve root stimulation in spinal cord injury

Interface pressure and cutaneous hemoglobin and oxygenation changes under ischial tuberosities during sacral nerve root stimulation in spinal cord injury

Prolonged electrical stimulation-induced gluteal and hamstring muscle activation and sitting pressure in spinal cord injury: Effect of duty cycle

Electrical stimulation to prevent recurring pressure ulcers in individuals with a spinal cord injury compared to usual care: the Spinal Cord Injury PREssure VOLTage (SCI PREVOLT) study protocol

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