Document Detail


Distribution of internal pressure around bony prominences: implications to deep tissue injury and effectiveness of intermittent electrical stimulation.
MedLine Citation:
PMID:  22354272     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The overall goal of this project is to develop interventions for the prevention of deep tissue injury (DTI), a form of pressure ulcers that originates in deep tissue around bony prominences. The present study focused on: (1) obtaining detailed measures of the distribution of pressure experienced by tissue around the ischial tuberosities, and (2) investigating the effectiveness of intermittent electrical stimulation (IES), a novel strategy for the prevention of DTI, in alleviating pressure in regions at risk of breakdown due to sustained loading. The experiments were conducted in adult pigs. Five animals had intact spinal cords and healthy muscles and one had a spinal cord injury that led to substantial muscle atrophy at the time of the experiment. A force-controlled servomotor was used to load the region of the buttocks to levels corresponding to 25%, 50% or 75% of each animal's body weight. A pressure transducer embedded in a catheter was advanced into the tissue to measure pressure along a three dimensional grid around the ischial tuberosity of one hind leg. For all levels of external loading in intact animals, average peak internal pressure was 2.01 ± 0.08 times larger than the maximal interfacial pressure measured at the level of the skin. In the animal with spinal cord injury, similar absolute values of internal pressure as that in intact animals were recorded, but the substantial muscle atrophy produced larger maximal interfacial pressures. Average peak internal pressure in this animal was 1.43 ± 0.055 times larger than the maximal interfacial pressure. Peak internal pressure was localized within a ±2 cm region medio-laterally and dorso-ventrally from the bone in intact animals and ±1 cm in the animal with spinal cord injury. IES significantly redistributed internal pressure, shifting the peak values away from the bone in spinally intact and injured animals. These findings provide critical information regarding the relationship between internal and interfacial pressure around the ischial tuberosities during loading levels equivalent to those experienced while sitting. The information could guide future computer models investigating the etiology of DTI, as well as inform the design and prescription of seating cushions for people with reduced mobility. The findings also suggest that IES may be an effective strategy for the prevention of DTI.
Authors:
Leandro R Solis; Adrian Liggins; Richard R E Uwiera; Niek Poppe; Enid Pehowich; Peter Seres; Richard B Thompson; Vivian K Mushahwar
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-02-22
Journal Detail:
Title:  Annals of biomedical engineering     Volume:  40     ISSN:  1573-9686     ISO Abbreviation:  Ann Biomed Eng     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-06-28     Completed Date:  2012-10-31     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  0361512     Medline TA:  Ann Biomed Eng     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1740-59     Citation Subset:  IM    
Affiliation:
Rehabilitation Science Program, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
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MeSH Terms
Descriptor/Qualifier:
Animals
Electric Stimulation
Electric Stimulation Therapy*
Female
Muscle, Skeletal* / pathology,  physiopathology
Pressure / adverse effects
Pressure Ulcer* / pathology,  physiopathology,  prevention & control
Spinal Cord* / pathology,  physiopathology
Spinal Cord Injuries* / pathology,  physiopathology,  prevention & control
Stress, Physiological*
Swine
Swine, Miniature
Grant Support
ID/Acronym/Agency:
//Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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