Archives of Physical Medicine and Rehabilitation
Volume 91, Issue 5 , Pages 669-678, May 2010

Electrical Stimulation Therapy Increases Rate of Healing of Pressure Ulcers in Community-Dwelling People With Spinal Cord Injury

  • Pamela E. Houghton, PT, PhD

      Affiliations

    • Rehabilitation and Geriatric Care Center, Lawson Health Research Institute, London, Ontario, Canada
    • Corresponding Author InformationCorrespondence to Pamela E. Houghton, PT, PhD, School of Physical Therapy, Rm 1588, Elborn College, University of Western Ontario, London, Ontario, Canada N6G 2A9
    • ,
  • Karen E. Campbell, RN, PhD

      Affiliations

    • School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
    • Rehabilitation and Geriatric Care Center, Lawson Health Research Institute, London, Ontario, Canada
    • ,
  • Christine H. Fraser, RD, HBSc

      Affiliations

    • Parkwood Hospital, St Joseph's Health Care London, London, Ontario, Canada
    • ,
  • Connie Harris, RN, ET, MSc

      Affiliations

    • Care Partners Inc, Waterloo, Ontario, Canada
    • ,
  • David H. Keast, MD, MSc

      Affiliations

    • Parkwood Hospital, St Joseph's Health Care London, London, Ontario, Canada
    • Rehabilitation and Geriatric Care Center, Lawson Health Research Institute, London, Ontario, Canada
    • ,
  • Patrick J. Potter, MD

      Affiliations

    • Parkwood Hospital, St Joseph's Health Care London, London, Ontario, Canada
    • ,
  • Keith C. Hayes, PhD

      Affiliations

    • Parkwood Hospital, St Joseph's Health Care London, London, Ontario, Canada
    • Rehabilitation and Geriatric Care Center, Lawson Health Research Institute, London, Ontario, Canada
    • ,
  • M. Gail Woodbury, PhD

      Affiliations

    • School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada

Abstract 

Houghton PE, Campbell KE, Fraser CH, Harris C, Keast DH, Potter PJ, Hayes KC, Woodbury MG. Electrical stimulation therapy increases rate of healing of pressure ulcers in community-dwelling people with spinal cord injury.

Objective

To investigate whether electric stimulation therapy (EST) administered as part of a community-based, interdisciplinary wound care program accelerates healing of pressure ulcers in people with spinal cord injury (SCI).

Design

Single-blind, parallel-group, randomized, controlled, clinical trial.

Setting

Community-based home care setting, Ontario, Canada.

Participants

Adults (N=34; mean age ± SD, 51±14y) with SCI and stage II to IV pressure ulcers.

Interventions

Subjects were stratified based on wound severity and duration and randomly assigned to receive either a customized, community-based standard wound care (SWC) program that included pressure management or the wound care program plus high-voltage pulsed current applied to the wound bed (EST+SWC).

Main Outcome Measures

Wound healing measured by reduction in wound size and improvement in wound appearance at 3 months of treatment with EST+SWC or SWC.

Results

The percentage decrease in wound surface area (WSA) at the end of the intervention period was significantly greater in the EST+SWC group (mean ± SD, 70±25%) than in the SWC group (36±61%; P=.048). The proportion of stage III, IV, or X pressure ulcers improving by at least 50% WSA was significantly greater in the EST+SWC group than in the SWC group (P=.02). Wound appearance assessed using the photographic wound assessment tool was improved in wounds treated with EST+SWC but not SWC alone.

Conclusions

These results demonstrate that EST can stimulate healing of pressure ulcers of people with SCI. EST can be incorporated successfully into an interdisciplinary wound care program in the community.

Key Words: Electric stimulation, Pressure ulcer, Rehabilitation, Spinal cord injuries

List of Abbreviations: CCAC, community care access center, EST, electrical stimulation therapy, PSST, pressure sore status tool, PWAT, photographic wound assessment tool, SCI, spinal cord injury, SWC, standard wound care, WSA, wound surface area, % ↓ WSA, percentage wound surface area reduction from baseline

 

 Supported by the Ontario Neurotrauma Foundation (grant no. 2004-SCI-SC-01), which required matching in kind support from industrial partners. Equipment and supplies industrial partners are Prizm Medical Inc, The Roho Group, Argentum Medical Inc, and Dermasciences Canada Inc.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Reprints are not available from the author.

PII: S0003-9993(10)00074-2

doi:10.1016/j.apmr.2009.12.026

Archives of Physical Medicine and Rehabilitation
Volume 91, Issue 5 , Pages 669-678, May 2010

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