Sacral interface pressure can be alleviated by repositioning with a small-angle change using an automated bed in patients with spinal cord injury |
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| Institution: | 1. Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, Seoul, South Korea;2. Department of Rehabilitative and Assistive Technology, National Rehabilitation Center, Seoul, South Korea;3. Department of Nursing, National Rehabilitation Center, Seoul, South Korea;1. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;2. Japan Society for the Promotion of Science, Tokyo, Japan;3. Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;4. Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;5. AI Hospital/Macro Signal Dynamics Research and Development Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan;6. Research Center for Implementation Nursing Science Initiative, School of Health Sciences, Fujita Health University, Aichi, Japan;7. Department of Nursing, Sengi Hospital, Ishikawa, Japan;8. School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;1. School of Nursing and Midwifery, Monash University, Level 3, Building 13D, Clayton Campus, 35 Rainforest Walk, Clayton, VIC, 3800, Australia;2. Department of Physiotherapy, Monash University, Building B, Peninsula Campus, 47-49 Moorooduc Highway, Frankston, VIC, 3199, Australia;1. Independent Researcher, Tabriz, Iran;2. Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, 15403, Ferrol, Spain;3. School of Nursing, Physiotherapy and Podiatry. Universidad Complutense de Madrid, Spain;4. Department Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Peñalosa 3, Ampliación de Campus de Teatinos, 29071, Málaga, Spain;5. Instituto de Investigación Biomédica de Málaga (IBIMA), Spain;6. Department of Sociology, Social Work and Public Health, Universidad de Huelva, Huelva, Spain;7. Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, 092301, Ecuador;8. Faculty of Health Sciences, Universidad Rey Juan Carlos, Spain;9. Department of Nursing, Faculty of Nursing and Podiatry, Frailty Research Organized Group, University of Valencia, Valencia, Spain;1. Nursing Division, Singapore General Hospital, Singapore;2. Skin Research Institute of Singapore, Singapore;1. Thoracic Surgery, Health Research and Application Center, Trakya University, Edirne, Turkey;2. Department of Surgical Nursing, Faculty of Health Sciences, Trakya University, Edirne, Turkey |
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| Abstract: | Aim of the studyThis study aimed to compare interface pressure and total contact area of the sacral region in different positions, including small-angle changes, in patients with spinal cord injury (SCI). Furthermore, we analyzed the clinical factors influencing pressure to identify the pressure injury (PI) high-risk group.Materials and methodsAn intervention was conducted for patients with paraplegia (n = 30) with SCI. In the first and second trials, interface pressure and total contact area of the sacral region were recorded from large- and small-angled positions using the automatic repositioning bed, which can change the angle of the back, lateral tilt, and knee.ResultsPositions with back raised ≥45° showed significantly higher pressure on the sacrum than most other positions. The pressure and contact area differences were statistically insignificant for combinations of small-angled changes <30°.Additionally, the duration of injury (β = 0.51, p = 0.010) and neurological level of injury (NLI) (β = −0.47, p = 0.020) were significant independent predictors of average pressure. Similarly, the duration of injury (β = 0.64, p = 0.001), the Korean version of the spinal cord independence measure-III (β = −0.52, p = 0.017), and body mass index (BMI; β = −0.34, p = 0.041) were significant independent predictors of peak pressure.ConclusionsFor repositioning, combinations of small-angle changes <30° effectively reduce pressure on the sacral region in patients with SCI. Lower BMI, longer duration of injury, lower functioning score, and NLI ≥ T7 are predictors of high sacral pressures, which increase the risk for PI. Therefore, patients with these predictors require strict management. |
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| Keywords: | Pressure injury Paraplegia Spinal cord injury Repositioning Interface pressure Position angle |
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