Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 7 , Pages 862-870, July 2007

Periodically Relieving Ischial Sitting Load to Decrease the Risk of Pressure Ulcers

  • Mohsen Makhsous, PhD

      Affiliations

    • Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL
    • Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL
    • Department of Orthopaedic Surgery, Northwestern University, Chicago, IL
    • Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL
    • Corresponding Author InformationReprint requests to Mohsen Makhsous, PhD, Dept Physical Therapy & Human Movement Sciences, Northwestern University, 645 N Michigan Ave, Ste 1100, Chicago, IL 60611
    • ,
  • Diane M. Rowles, MS, ACNP, BC

      Affiliations

    • Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL
    • Spinal Cord Injury Program, Rehabilitation Institute of Chicago, Chicago, IL
    • ,
  • William Z. Rymer, MD, PhD

      Affiliations

    • Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL
    • Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL
    • ,
  • James Bankard, BS

      Affiliations

    • Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL
    • ,
  • Ellis K. Nam, MD

      Affiliations

    • Department of Orthopaedic Surgery, Chicago Orthopaedics and Sports Medicine, Chicago, IL.
    • ,
  • David Chen, MD

      Affiliations

    • Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL
    • Spinal Cord Injury Program, Rehabilitation Institute of Chicago, Chicago, IL
    • ,
  • Fang Lin, DSc

      Affiliations

    • Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL
    • Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL
    • Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL

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.

Key Words: Pressure ulcer, Rehabilitation, Spinal cord injuries, Wheelchairs

 

 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.

PII: S0003-9993(07)00226-2

doi:10.1016/j.apmr.2007.03.017

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 7 , Pages 862-870, July 2007

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