Article

OBJECTIVE: To investigate the effectiveness and interactions of 2 methods of
pressure ulcer prevention, wheelchair cushions and pressure relief maneuvers, on
interface pressure (IP) and blood flow of the buttocks.
DESIGN: Within-subject repeated measures.
SETTING: Rehabilitation center. PARTICIPANTS:
Wheelchair users
with a spinal cord injury or disorder (N=17).
INTERVENTIONS: Participants
performed 3 forward leans and 2 sideward leans with different degrees of lean
while seated on each of 3 different wheelchair cushions. MAIN OUTCOME MEASURES:
IP measured with a custom sensor and blood flow measured with laser Doppler
flowmetry were collected at the ischial tuberosity.
RESULTS: Pressure relief
maneuvers had a significant main effect on the ischial IP (P<.001); all maneuvers
except for the small frontward lean resulted in a significant reduction in IP
compared with upright sitting. Blood flow significantly varied across postures
(P<.001) with flow during upright sitting and small forward leans being
significantly lower than during the full and intermediate leans in both the
forward and sideward directions. CONCLUSIONS: The results of the study highlight
the importance of positioning wheelchair users in a manner that facilitates
in-seat movement. Regardless of the cushion being used, the pressure relief
maneuvers resulted in very large reductions in IPs and significant increases in
buttock blood flow. Only the small frontward lean was shown to be ineffective in
reducing pressure or increasing blood flow. Because these pressure relief
maneuvers involved postural changes that can occur during functional activities,
these pressure relief maneuvers can become a part of volitional pressure relief
and functional weight shifts. Therefore, clinical instruction should cover both
as a means to impart sitting behaviors that may lead to better tissue health.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.
- Coussins

Langue : ANGLAIS