Abstract
Objective
To investigate intersections between pressure injury (PrI) history, muscle composition,
and tissue health responses under physiologically relevant loading conditions for
individuals with spinal cord injury (SCI).
Design
Repeated measures study design with annual follow-up for up to 3 years.
Setting
Tertiary care center.
Participants
Persons with SCI (N=38). Exclusion criteria included having an open pelvic region
PrI at the time of recruitment, presence of systemic disease, and/or known sensitivity
to contrast.
Interventions
Not applicable.
Main Outcome Measures
Gluteal muscle composition, ischial interface pressures, tissue oxygenation.
Results
Ischial region mean interface pressures are the same for individuals with or without
a PrI history. Tissue oxygenation is lower during sitting for persons with a PrI history.
Individuals with >15% gluteal intramuscular fat were statistically highly significantly
(P<.001) more likely to have a history of severe or recurrent PrI. Intramuscular adipose
tissue (IMAT) levels within the gluteal muscle may remain low over time or muscle
tissue in the gluteal muscle region may be almost entirely replaced by IMAT. In the
current study cohort, it was found that muscle composition also continues to change
over time even for individuals with long-standing SCI.
Conclusions
Soft-tissue compositional changes, specifically IMAT, provides a reliable indicator
of PrI history and may provide a key to personalized PrI risk status for persons with
SCI. The current findings confirm that interface pressure mapping alone is a limited
indicator for PrI development.
Keywords
List of abbreviations:
2D (2 dimensional), 3D (3 dimensional), CT (computed tomography), DTPrI (deep tissue pressure injury), IMAT (intramuscular adipose tissue), IP (interface pressure), IV (intravenous), PrI (pressure injury), ROI (region of interest), SCI (spinal cord injury), TcPO2 (transcutaneous oxygen pressure)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 07, 2018
Footnotes
Supported by the CDMRP Spinal Cord Injury Research Program (grant no. W81XWH-14-1-0618) and the Craig H. Neilsen Foundation (grant no. 315537).
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
