The effects of intermittent electrical stimulation on the prevention of deep tissue injury: varying loads and stimulation paradigms

A pressure ulcer is a medical complication that arises in persons with decreased mobility and/or sensation. Deep pressure ulcers starting at the bone-muscle interface are the most dangerous, as they can cause extensive damage before showing any signs at the skin surface. We previously proposed a novel intervention called intermittent electrical stimulation (IES) for the prevention of deep tissue injury (DTI). In this study, we tested the effects of four paradigms of IES and one conventional pressure relief paradigm in preventing the formation of deep pressure ulcers in rats. Loading equivalent to 18, 28, or 38% of the body weight (BW) of each rat was applied to the triceps surae muscle in one hind limb. Treatment groups received IES every 10 min for either (i) 5 or 10 s with moderate or maximal contraction, or (ii) complete pressure removal every 10 min for 10 s (conventional pressure relief). The results showed that conventional pressure relief, emulating a wheelchair push-up every 10 min, was inadequate for the prevention of DTI. In contrast, all IES paradigms were equally effective in significantly reducing the extent of deep muscle damage caused by 28 or 38% BW pressure application. These findings suggest that, in conjunction with existing techniques, IES may be an effective intervention for the prophylactic prevention of DTI.