The off-loading posture system An aid in the development of treatment for pressure ulcers in people with SCI? Prospective observational study
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Abstract
introduction
The problem of pressure ulcers (PU) in the people with spinal cord injury is very common.
The specific preventive measures, first of all the trunk-pelvis posture system, have important relevance as regards the prevention and / or treatment of PUs, in people who use the wheelchair as the main device for their own mobility so these postural devices need specific study in terms of choice, identification and correct use in order to prevent more effectively one of the main causes of hospitalization.
For many wheelchair users, the risk of PUs can be reduced by choosing an optimal seat cushion.
objective
To measure the effectiveness of the off-loading posture system, as an aid for healing of stage I-II-III PUs in people with SCI.
design
Prospective observational study. This study is for exploratory purposes only.
setting
PTs were hospitalized at the spinal unit over 8 months in 2019.
participants
15 people with SCI, from 14 to 72 years old without active movement under the lesion level.
intervention
Pressure sensor technology system was used to measure the pressures generated while sitting in the wheelchair.
Main outcome measures: the forces and pressures exerted by the patient in various situations were
measured
Static sitting/dynamic sitting during the push phase both on the backrest and the wheelchair seat; EPUAP scale to evaluate the skin’s state of health in the areas subject to PUs.
results
The posture system with the load-relieving cushion brought benefits for the treatment of ischial PUs: all of them healed by the end of the study and no recurrence occurred.
conclusion
If we consider that a high lesion level leads to less postural stability and less trunk balance: the shape of the cushion combined with the support of a properly installed backrest had a positive effect both on posture and on the treatment of PUs.
The load-relieving cushion can promote the healing of stage I-II ischial PUs in less than 8 weeks, in people with SCI and at high risk of developing PUs.
Maybe the cushion is therefore a valid alternative to the traditional communicating air-cell cushion.
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