Periodically Relieving Ischial Sitting Load to Decrease the Risk of Pressure Ulcers
Abstract
Makhsous M, Rowles DM, Rymer WZ, Bankard J, Nam EK, Chen D, Lin F. Periodically relieving ischial sitting load to decrease the risk of pressure ulcers.
Objective
To investigate the relieving effect on interface pressure of an alternate sitting protocol involving a sitting posture that reduces ischial support.
Design
Repeated measures in 2 protocols on 3 groups of subjects.
Setting
Laboratory.
Participants
Twenty able-bodied persons, 20 persons with paraplegia, and 20 persons with tetraplegia.
Interventions
Two 1-hour protocols were used: alternate and normal plus pushup. In the alternate protocol, sitting posture was alternated every 10 minutes between normal (sitting upright with ischial support) and with partially removed ischial support (WO-BPS) postures; in the normal plus pushup protocol, sitting was in normal posture with pushups (lifting the subject off the seat) performed every 20 minutes.
Main Outcome Measure
Interface pressure on seat and backrest.
Results
In WO-BPS posture, the concentrated interface pressure observed around the ischia in normal posture was significantly repositioned to the thighs. By cyclically repositioning the interface pressure, the alternate protocol was superior to the normal plus pushup protocol in terms of a significantly lower average interface pressure over the buttocks.
Conclusions
A sitting protocol periodically reducing the ischial support helps lower the sitting load on the buttocks, especially the area close to ischial tuberosities.
aDepartment of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL
bDepartment of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL
cDepartment of Orthopaedic Surgery, Northwestern University, Chicago, IL
dSensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL
eSpinal Cord Injury Program, Rehabilitation Institute of Chicago, Chicago, IL
fDepartment of Orthopaedic Surgery, Chicago Orthopaedics and Sports Medicine, Chicago, IL.
Reprint requests to Mohsen Makhsous, PhD, Dept Physical Therapy & Human Movement Sciences, Northwestern University, 645 N Michigan Ave, Ste 1100, Chicago, IL 60611
Supported by the National Institutes of Health (grant nos. R24 Rehab Network, R21 HD046844-01A1), Falk Medical Research Trust, and the Paralyzed Veterans Association (grant no. 2321-01).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT