Effects of conventional and alternating cushion weight-shifting in persons with spinal cord injury

J Rehabil Res Dev, 2014 · DOI: 10.1682/JRRD.2014.01.0009 · Published: January 1, 2014

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study aimed to determine if alternating-pressure air cushions (APACs) provide better pressure relief than independent pressure relief (IPR) for people with spinal cord injury (SCI). The study measured ischial interface pressure, tissue oxygen tension, and blood flow. The results showed that both IPR and APAC use decreased interface pressure. However, APAC use led to more sustained positive effects on tissue health compared to the transient improvements seen with IPR. The study suggests that APACs could be a valuable tool for pressure relief and tissue health maintenance in individuals with SCI who use wheelchairs.

Study Duration

18 months

Participants

13 adult full-time wheelchair users with spinal cord injury (SCI)

Evidence Level

Not specified

Key Findings

1
IPR decreased mean ischial IP and increased mean TcPO2, but these variables rapidly returned to preintervention levels.
2
APAC-induced weight-shifting decreased mean ischial IP, and mean TcPO2 increased and was higher than for IPR.
3
Quiet sitting following APAC-induced weight-shifting produced a higher neurogenic component of blood flow than following IPR.

Research Summary

This study compared the effects of independent pressure relief (IPR) and alternating-pressure air cushion (APAC) use on tissue health in individuals with spinal cord injury (SCI). The study found that while IPR provides transient improvements in tissue health, APACs offer more sustained positive effects by dynamically and continuously altering interface pressure distribution. The findings suggest that APACs could be a beneficial intervention for promoting tissue health and preventing pressure ulcers in wheelchair users with SCI.

Practical Implications

Clinical Practice

Clinicians should consider APACs as a viable option for pressure relief in SCI patients.

Personalized Interventions

Detailed tissue health profiles may facilitate development of personalized pressure ulcer prevention regimes, including optimization of APAC inflation and deflation cycles.

Future Research

Further research should focus on identifying individuals who would benefit most from APAC use and optimizing cushion parameters for individual needs.

Study Limitations

1
The study included a statistically valid but relatively small cohort of individuals with SCI.
2
The study compared repeated use of a single commercially available APAC with IPR, which may affect generalization to other APACs or other cell layouts.
3
The current controlled study design employed APAC activation with a standardized cycle based on clinical recommendations.

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