Wu Gary A, Bogie Kath M
Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, Cleveland, OH; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH; and Advanced Platform Technology Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH;
J Rehabil Res Dev. 2014;51(8):1265-76. doi: 10.1682/JRRD.2014.01.0009.
A repeated-measures study of 13 adult full-time wheelchair users with spinal cord injury (SCI) was carried out to determine whether alternating-pressure air cushion (APAC) use compared with independent pressure relief (IPR) provides reliable, effective pressure relief for individuals with SCI. Bilateral mean ischial interface pressure (IP), transcutaneous oxygen tension (TcPO2), and unilateral laser Doppler blood flow were evaluated. Blood flow component contributions were determined using short-time Fourier transform (STFT)-based spectral analysis. IPR assessment was carried out at recruitment. Study participants then used an APAC for 2 wk every 3 mo for 18 mo. IPR weight-shifting decreased mean ischial IP (p < 0.05) and increased mean TcPO2 (p < 0.05). All variables rapidly returned to preintervention levels following weight-shifting except for the cardiac component of blood flow. APAC-induced weight-shifting decreased mean ischial IP (p < 0.05). Mean TcPO2 increased and was higher than for IPR. STFT analysis indicated that quiet sitting following APAC-induced weight-shifting produced a higher neurogenic component of blood flow than following IPR (p = 0.02). Thus, IPR positively affects multiple aspects of tissue health but produces transient improvements and must be repeated regularly. APAC activation dynamically and continuously alters IP distribution with more sustained positive tissue health effects.
对13名成年脊髓损伤（SCI）全职轮椅使用者进行了一项重复测量研究，以确定与自主减压（IPR）相比，使用交替压力气垫（APAC）是否能为SCI患者提供可靠、有效的减压效果。评估了双侧平均坐骨界面压力（IP）、经皮氧分压（TcPO2）和单侧激光多普勒血流。使用基于短时傅里叶变换（STFT）的频谱分析确定血流成分贡献。在招募时进行IPR评估。研究参与者随后每3个月使用APAC 2周，共18个月。IPR体重转移降低了平均坐骨IP（p<0.05），并提高了平均TcPO2（p<0.05）。除血流的心脏成分外，体重转移后所有变量迅速恢复到干预前水平。APAC诱导的体重转移降低了平均坐骨IP（p<0.05）。平均TcPO2升高且高于IPR。STFT分析表明，APAC诱导的体重转移后安静坐姿产生的血流神经源性成分高于IPR后（p = 0.02）。因此，IPR对组织健康的多个方面有积极影响，但产生的改善是短暂的，必须定期重复。APAC激活动态且持续地改变IP分布，对组织健康有更持续的积极影响。
