Spinal Cord Injury and Pressure Ulcer Prevention: Using Functional Activity in Pressure Relief

Background. People with spinal cord injury (SCI) are at increased risk of pressure ulcers due to prolonged periods of sitting. Concordance with pressure relieving movements is poor amongst this population, and one potential alternative to improve this would be to integrate pressure relieving movemen...

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Main Authors: May Stinson, Rachel Schofield, Cathy Gillan, Julie Morton, Evie Gardner, Stephen Sprigle, Alison Porter-Armstrong
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Nursing Research and Practice
Online Access:http://dx.doi.org/10.1155/2013/860396
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author May Stinson
Rachel Schofield
Cathy Gillan
Julie Morton
Evie Gardner
Stephen Sprigle
Alison Porter-Armstrong
author_facet May Stinson
Rachel Schofield
Cathy Gillan
Julie Morton
Evie Gardner
Stephen Sprigle
Alison Porter-Armstrong
author_sort May Stinson
collection DOAJ
description Background. People with spinal cord injury (SCI) are at increased risk of pressure ulcers due to prolonged periods of sitting. Concordance with pressure relieving movements is poor amongst this population, and one potential alternative to improve this would be to integrate pressure relieving movements into everyday functional activities. Objectives. To investigate both the current pressure relieving behaviours of SCI individuals during computer use and the application of an ergonomically adapted computer-based activity to reduce interface pressure. Design. Observational and repeated measures design. Setting. Regional Spinal Cord Injury Unit. Participants. Fourteen subjects diagnosed with SCI (12 male, 2 female). Intervention.Comparing normal sitting to seated movements and induced forward reaching positions. Main Outcome Measures. Interface pressure measurements: dispersion index (DI), peak pressure index (PPI), and total contact area (CA). The angle of trunk tilt was also measured. Results. The majority of movements yielded less than 25% reduction in interface pressure compared to normal sitting. Reaching forward by 150% of arm length during an adapted computer activity significantly reduced DI (P<0.05), angle of trunk tilt (p<0.05), and PPI for both ischial tuberosity regions (P<0.001) compared to normal sitting. Conclusion. Reaching forward significantly redistributed pressure at the seating interface, as evidenced by the change in interface pressures compared to upright sitting.
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spelling doaj-art-32a7d3e825a14640a71213d6b64df2bf2025-02-03T05:46:35ZengWileyNursing Research and Practice2090-14292090-14372013-01-01201310.1155/2013/860396860396Spinal Cord Injury and Pressure Ulcer Prevention: Using Functional Activity in Pressure ReliefMay Stinson0Rachel Schofield1Cathy Gillan2Julie Morton3Evie Gardner4Stephen Sprigle5Alison Porter-Armstrong6School of Health Sciences, Centre for Health and Rehabilitation Technologies, University of Ulster, Jordanstown BT37 0QB, IrelandSchool of Health Sciences, Centre for Health and Rehabilitation Technologies, University of Ulster, Jordanstown BT37 0QB, IrelandBelfast Health & Social Care Trust, Musgrave Park Hospital, Belfast BT9 7JB, IrelandBelfast Health & Social Care Trust, Musgrave Park Hospital, Belfast BT9 7JB, IrelandSchool of Health Sciences, Centre for Health and Rehabilitation Technologies, University of Ulster, Jordanstown BT37 0QB, IrelandCentre for Assistive Technology and Environmental Access, Georgia Institute of Technology, Atlanta, GA, USASchool of Health Sciences, Centre for Health and Rehabilitation Technologies, University of Ulster, Jordanstown BT37 0QB, IrelandBackground. People with spinal cord injury (SCI) are at increased risk of pressure ulcers due to prolonged periods of sitting. Concordance with pressure relieving movements is poor amongst this population, and one potential alternative to improve this would be to integrate pressure relieving movements into everyday functional activities. Objectives. To investigate both the current pressure relieving behaviours of SCI individuals during computer use and the application of an ergonomically adapted computer-based activity to reduce interface pressure. Design. Observational and repeated measures design. Setting. Regional Spinal Cord Injury Unit. Participants. Fourteen subjects diagnosed with SCI (12 male, 2 female). Intervention.Comparing normal sitting to seated movements and induced forward reaching positions. Main Outcome Measures. Interface pressure measurements: dispersion index (DI), peak pressure index (PPI), and total contact area (CA). The angle of trunk tilt was also measured. Results. The majority of movements yielded less than 25% reduction in interface pressure compared to normal sitting. Reaching forward by 150% of arm length during an adapted computer activity significantly reduced DI (P<0.05), angle of trunk tilt (p<0.05), and PPI for both ischial tuberosity regions (P<0.001) compared to normal sitting. Conclusion. Reaching forward significantly redistributed pressure at the seating interface, as evidenced by the change in interface pressures compared to upright sitting.http://dx.doi.org/10.1155/2013/860396
spellingShingle May Stinson
Rachel Schofield
Cathy Gillan
Julie Morton
Evie Gardner
Stephen Sprigle
Alison Porter-Armstrong
Spinal Cord Injury and Pressure Ulcer Prevention: Using Functional Activity in Pressure Relief
Nursing Research and Practice
title Spinal Cord Injury and Pressure Ulcer Prevention: Using Functional Activity in Pressure Relief
title_full Spinal Cord Injury and Pressure Ulcer Prevention: Using Functional Activity in Pressure Relief
title_fullStr Spinal Cord Injury and Pressure Ulcer Prevention: Using Functional Activity in Pressure Relief
title_full_unstemmed Spinal Cord Injury and Pressure Ulcer Prevention: Using Functional Activity in Pressure Relief
title_short Spinal Cord Injury and Pressure Ulcer Prevention: Using Functional Activity in Pressure Relief
title_sort spinal cord injury and pressure ulcer prevention using functional activity in pressure relief
url http://dx.doi.org/10.1155/2013/860396
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