Therapists’ Roles in Pressure Ulcer Management in Persons With Spinal Cord Injury

J Spinal Cord Med, 2009 · DOI: · Published: November 1, 2009

Spinal Cord Injury Rehabilitation Dermatology

Simple Explanation

This study investigates the roles of physical therapists (PTs) and occupational therapists (OTs) in managing and preventing pressure ulcers (PrUs) in veterans with spinal cord injury (SCI). The study found that while both PTs and OTs are involved in PrU management, their specific roles and practices can vary, particularly in direct wound care. The research highlights the need for more standardized protocols and further study to determine the clinical outcomes of therapist interventions in preventing PrUs and their recurrence.

Study Duration

Not specified

Participants

39 therapists: 24 Physical Therapists (PTs) and 15 Occupational Therapists (OTs)

Evidence Level

Cross-sectional survey

Key Findings

1
PTs are more frequently involved in direct wound care, including tissue mobilization and electrical stimulation, while OTs are not routinely involved in direct wound care.
2
Both PTs and OTs are actively involved in determining the cause of pressure ulcers, although the specific assessment methods vary and are not standardized.
3
After tissue healing, both PTs and OTs are consistently involved in progressive range of motion exercises, remobilization, assessing skin tolerance, and educating patients on pressure relief techniques and safe transfers.

Research Summary

This study aimed to identify and report the practices of SCI therapists in pressure ulcer (PrU) management to better understand the variability observed in patient outcomes. A cross-sectional survey was administered to physical therapists (PTs) and occupational therapists (OTs) attending a conference of the Therapy Leadership Council in SCI. The results indicated that therapist involvement in wound care is often initiated by physician orders or postsurgery protocols. Common practices after tissue healing included progressive range of motion, remobilization, assessment of skin tolerance, instruction in pressure relief, and safe transfers. Prevention strategies focused on education and evaluation of seating posture and positioning. The study concluded that there are varying practices among therapists in VA SCI centers and MSCIS centers, but also consistency in post-tissue healing care and prevention of new ulcers. The findings suggest a need for more standardized protocols to improve patient outcomes.

Practical Implications

Standardized Protocols

Develop standardized protocols for PTs and OTs in PrU management to ensure consistent and effective care.

Interdisciplinary Collaboration

Encourage better interdisciplinary collaboration to optimize the unique skill sets of PTs and OTs and reduce potential redundancy in care.

Further Research

Conduct further research to assess the clinical outcomes of specific therapy interventions in preventing PrUs and recurrence.

Study Limitations

1
The study's sample size was small.
2
The study could not determine whether the centers were the same or different for OT and PT respondents.
3
The survey was anonymous, making it impossible to ascertain how many respondents were from the same facility or the impact of state practice acts.

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