Brienza David, Vallely Jaxon, Karg Patricia, Akins Jonathan, Gefen Amit
University of Pittsburgh, Dept. of Rehabilitation Science and Technology, Pittsburgh, PA, United States; University of Pittsburgh, Dept. of Bioengineering, Pittsburgh, PA, United States; University of Pittsburgh, McGowan Institute of Regenerative Medicine, Pittsburgh, PA, United States.
University of Pittsburgh, Dept. of Rehabilitation Science and Technology, Pittsburgh, PA, United States.
J Tissue Viability. 2018 Feb;27(1):42-53. doi: 10.1016/j.jtv.2017.04.001. Epub 2017 Apr 11.
Tissue deformation is recognized as an important risk factor for pressure injuries. This study investigated the effects of anatomy and wheelchair cushion type on tissue deformation.
Direct 3-dimensional tissue deformation response was measured for six participants sitting on six different wheelchair cushions using MR imaging. Two participants had a traumatic spinal cord injury (SCI) within one year of the assessment, two sustained traumatic SCI at least 13 years prior, and two were without SCI. Tissue deformation was quantified using the difference in volume of tissue beneath the ischial tuberosity (IT) between unloaded and loaded (sitting) conditions.
The participants with SCI tended to have less muscle tissue volume beneath their ITs while sitting compared to participants without SCI. Reductions in muscle and fat volumes in the loaded conditions varied depending on both cushion and participant. Higher interface pressures tended to be associated with lower unloaded tissue thicknesses.
The study showed no single cushion type tested produced the lowest amount of tissue deformation across all participants. Individual anatomy and cushion type affect deformation response of tissue and related pressure injury risk.
组织变形被认为是压疮的一个重要风险因素。本研究调查了解剖结构和轮椅坐垫类型对组织变形的影响。
使用磁共振成像测量了六名参与者坐在六种不同轮椅坐垫上时的直接三维组织变形反应。两名参与者在评估后一年内发生创伤性脊髓损伤(SCI),两名至少在13年前发生过创伤性SCI,另外两名没有SCI。通过测量坐骨结节(IT)下方组织在无负荷(未坐)和有负荷(坐着)状态下的体积差异来量化组织变形。
与没有SCI的参与者相比,患有SCI的参与者在坐着时其IT下方的肌肉组织体积往往较小。在有负荷状态下,肌肉和脂肪体积的减少因坐垫和参与者的不同而有所差异。较高的界面压力往往与较低的无负荷组织厚度相关。
该研究表明,所测试的任何一种坐垫类型都不会在所有参与者中产生最低程度的组织变形。个体解剖结构和坐垫类型会影响组织的变形反应以及相关的压疮风险。