Article

Randomized, within-in participant cross-over study. The
purpose of this study was to determine the effect on comfort and pressure of
lying with the shoulders and bed in different positions for people with
tetraplegia.
Setting:Rehabilitation hospital.
Methods:Twenty people with
tetraplegia were tested lying supine with the shoulders and bed in seven
different positions. The positions used a combination of three arm and two bed
positions. Six of the positions reflected what is commonly recommended in acute
spinal cord injury units including a crucifix-type position. The seventh position
was selected by participants and reflected their preferred sleeping position.
There were five outcomes: general comfort, shoulder comfort, participant choice
of preferred position, peak pressure under the shoulders and areal pressure under
the shoulders. Pressure was measured using a pressure mapping system and comfort
using a visual analogue scale (VAS).Results:The participants reported
significantly higher (P<0.01) general comfort and shoulder comfort in their
self-selected position compared with all other positions. There was no
statistical difference in peak pressure (P=0.15) or areal pressure (P=0.08) under
the shoulders between the seven positions. Most participants indicated that they
preferred to lie with their shoulders adducted and internally rotated and the
hands either by their sides or on their stomachs.
Conclusion:The position of the
shoulders has little effect on pressure but a notable effect on comfort.
Participants preferred to sleep with their arms beside their bodies, not with
their arms in a crucifix position as commonly advocated.

Langue : ANGLAIS