Spinal Cord Injury and Pressure Ulcer Prevention: Using Functional Activity in Pressure Relief
Nursing Research and Practice, 2013 · DOI: http://dx.doi.org/10.1155/2013/860396 · Published: March 6, 2013
Simple Explanation
People with spinal cord injuries are at high risk of developing pressure ulcers due to sitting for long periods. Regular movements to relieve this pressure are often not done well. This study looks at whether incorporating these movements into daily tasks, like using a computer, can help reduce pressure. The study involved observing how people with spinal cord injuries currently relieve pressure while using computers. It also tested a modified computer setup that encouraged forward reaching to see if it could lower pressure on the seated area. The study found that a forward reach significantly redistributed pressure, which helps to prevent pressure ulcers. Most normal movements didn't reduce pressure enough.
Key Findings
- 1The majority of movements participants performed during normal computer use yielded less than a 25% reduction in interface pressure compared to normal sitting, indicating low effectiveness for pressure relief.
- 2Reaching forward by 150% of arm length during an adapted computer activity significantly reduced dispersion index (DI), angle of trunk tilt, and peak pressure index (PPI) for both ischial tuberosity regions compared to normal sitting.
- 3A 150% forward reach incorporated into a computer activity significantly decreased interface pressure by approximately 52% at the ischial region.
Research Summary
Practical Implications
Clinical Practice
Healthcare professionals should encourage clients at risk of pressure ulceration to perform pressure relieving movements frequently.
Intervention Design
Incorporation of pressure relieving movements, such as leaning/reaching forward, into everyday daily activities should be explored in an effort to improve client concordance with national pressure relieving recommendations.
Future Research
Further work is needed to investigate other methods of improving performance and concordance with repositioning methods among at risk populations.
Study Limitations
- 1The small sample size (𝑁= 14) may affect generalisability of the results.
- 2“normal sitting behaviour” was recorded over a relatively short duration, thus the results for movement frequency during the 1 hour period may be over inflated.
- 3During strand B, the varying methods of reaching, including shoulder protraction and rotation, may have confounded results.