Article

Prolonged high ischial tuberosities pressure (IT pressure), decreased
regional blood flow (BF) and oxygenation (%SO2) are risk factors for developing
pressure ulcers (PUs) in patients with spinal cord injury (SCI). Electrical
stimulation (ES)-induced gluteal and hamstring muscle activation may improve
pressure distribution by changing the shape of the buttocks while sitting and
also increase BF and %SO2. OBJECTIVE: To compare acute effects of ES-induced
gluteal and hamstring muscle activation with pressure relief movements (PRMs) on
IT pressure, BF and %SO2. PARTICIPANTS AND METHODS: Twelve men with SCI performed
PRMs - push-ups, bending forward and leaning sideward - and received surface ES
(87+/-19 mA) to the gluteal and hamstring muscles while sitting in their
wheelchair. Ischial tuberosities pressure was measured using a pressure mapping
system; (sub)cutaneous BF and %SO2 were measured using reflection spectroscopy
and laser Doppler, respectively. RESULTS: Compared with rest (156+/-26 mm Hg), IT
pressure was significantly lower during all other conditions (push-ups 19+/-44;
bending forward 56+/-33; leaning sideward 44+/-38; ES 67+/-45 mm Hg). For the
whole group, all PRMs significantly augmented BF (+39 to -96%) and %SO2 (+6.0 to
-7.9%-point), whereas ES-induced muscle activation did only for peak BF. In all,
63% of the participants showed an increased BF (average 52%) with ES. CONCLUSION:
PRMs acutely reduced IT pressure and improved oxygenation and BF in SCI. The
currently used ES method cannot replace PRMs, but it may be used additionally.
ES-induced muscle activation is not as effective for acute pressure relief, but
the frequency of stimulation is much higher than the performance of PRMs and can
therefore be more effective in the long term.

Langue : ANGLAIS