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  4. Trunk Function and Ischial Pressure Offloading in Individuals with Spinal Cord Injury

Trunk Function and Ischial Pressure Offloading in Individuals with Spinal Cord Injury

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1080/10790268.2017.1328345 · Published: January 1, 2017

Spinal Cord InjuryRehabilitationDermatology

Simple Explanation

This study explores the connection between trunk function and how well individuals with spinal cord injuries (SCI) can relieve pressure on their ischial tuberosities (the bony part of the buttocks that bears weight when sitting). The research involved assessing trunk strength, reaching ability, and the time spent offloading pressure from the ischial tuberosities using a pressure mat. The findings highlight the importance of identifying factors that contribute to offloading behavior in individuals with SCI, particularly those with insufficient trunk strength.

Study Duration
Not specified
Participants
Fifteen non-ambulatory participants with complete or incomplete traumatic and non-traumatic SCI, American Spinal Injury Association Impairment Scale (AIS), Classification A-D.
Evidence Level
Prospective cross-sectional evaluation

Key Findings

  • 1
    Participants with greater trunk strength, defined as 'Reachers,' demonstrated significantly higher trunk strength compared to 'Non-Reachers' (P < 0.05).
  • 2
    Offloading times over the right ischial tuberosity were significantly lower in Non-Reachers compared to Reachers (P < 0.05).
  • 3
    No significant correlation was found between trunk strength and pressure offloading times in either group.

Research Summary

The study investigated the relationship between trunk function and ischial pressure offloading in individuals with SCI, using trunk strength and reaching ability as indices of trunk function. The results indicated that individuals with better trunk strength and reaching ability (Reachers) spent more time offloading pressure, particularly on the right ischial tuberosity, compared to those with weaker trunk function (Non-Reachers). Despite the differences in offloading times between the two groups, no direct correlation was found between trunk strength and pressure offloading duration.

Practical Implications

Targeted Rehabilitation

Assess reaching abilities and trunk muscle activation patterns before designing rehabilitation strategies.

Customized Training

Establish baselines for patient-specific customized training for pressure offloading.

Further Research

Explore other factors contributing to pressure ulcer development during rehabilitation.

Study Limitations

  • 1
    Small sample size limited stratification by injury level and etiology.
  • 2
    Pre-injury reaching profile was not assessed.
  • 3
    Trajectories of trunk or arm movement were not examined during offloading.

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