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Adaptation of a MR imaging protocol into a real-time clinical biometric ultrasound protocol for persons with spinal cord injury at risk for deep tissue injury: A reliability study

Adaptation of a MR imaging protocol into a real-time clinical biometric ultrasound protocol for persons with spinal cord injury at risk for deep tissue injury: A reliability study
Adaptation of a MR imaging protocol into a real-time clinical biometric ultrasound protocol for persons with spinal cord injury at risk for deep tissue injury: A reliability study
Background: High strain in soft tissues that overly bony prominences are considered a risk factor for pressure ulcers (PUs) following spinal cord impairment (SCI) and have been computed using Finite Element methods (FEM). The aim of this study was to translate a MRI protocol into ultrasound (US) and determine between-operator reliability of expert sonographers measuring diameter of the inferior curvature of the ischial tuberosity (IT) and the thickness of the overlying soft tissue layers on able-bodied (AB) and SCI using real-time ultrasound.

Material and methods: Part 1: Fourteen AB participants with a mean age of 36.7 ± 12.09 years with 7 males and 7 females had their 3 soft tissue layers in loaded and unloaded sitting measured independently by 2 sonographers: tendon/muscle, skin/fat and total soft tissue and the diameter of the IT in its short and long axis. Part 2: Nineteen participants with SCI were screened, three were excluded due to abnormal skin signs, and eight participants (42%) were excluded for abnormal US signs with normal skin. Eight SCI participants with a mean age of 31.6 ± 13.6 years and all male with 4 paraplegics and 4 tetraplegics were measured by the same sonographers for skin, fat, tendon, muscle and total. Skin/fat and tendon/muscle were computed.

Results: AB between-operator reliability was good (ICC ¼ 0.81e0.90) for 3 soft tissues layers in unloaded and loaded sitting and poor for both IT short and long axis (ICC ¼ 0.028 and 0.01). SCI between operator reliability was good in unloaded and loaded for total, muscle, fat, skin/fat, tendon/muscle (ICC ¼ 0.75e0.97) and poor for tendon (ICC ¼ 0.26 unloaded and ICC¼0.71 loaded) and skin (ICC ¼ 0.37 unloaded and ICC ¼ 0.10).
0965-206X
Swaine, Jillian M.
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Moe, Andrew
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Breidahl, William
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Bader, Daniel L.
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Oomens, Cees W. J.
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Lester, Leanne
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O'Loughlin, Edmond
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Santamaria, Nick
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Stacey, Michael C.
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Swaine, Jillian M.
b8797f4e-ac21-43be-bcb7-ae479bb19d55
Moe, Andrew
8553c1c5-04f8-4bdc-84af-ee0408aca0fd
Breidahl, William
6dad692b-7b06-4427-9b5f-f23c58a6dc39
Bader, Daniel L.
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Oomens, Cees W. J.
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Lester, Leanne
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O'Loughlin, Edmond
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Santamaria, Nick
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Stacey, Michael C.
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Swaine, Jillian M., Moe, Andrew, Breidahl, William, Bader, Daniel L., Oomens, Cees W. J., Lester, Leanne, O'Loughlin, Edmond, Santamaria, Nick and Stacey, Michael C. (2017) Adaptation of a MR imaging protocol into a real-time clinical biometric ultrasound protocol for persons with spinal cord injury at risk for deep tissue injury: A reliability study. Journal of Tissue Viability, 27 (1). (doi:10.1016/j.jtv.2017.07.004).

Record type: Article

Abstract

Background: High strain in soft tissues that overly bony prominences are considered a risk factor for pressure ulcers (PUs) following spinal cord impairment (SCI) and have been computed using Finite Element methods (FEM). The aim of this study was to translate a MRI protocol into ultrasound (US) and determine between-operator reliability of expert sonographers measuring diameter of the inferior curvature of the ischial tuberosity (IT) and the thickness of the overlying soft tissue layers on able-bodied (AB) and SCI using real-time ultrasound.

Material and methods: Part 1: Fourteen AB participants with a mean age of 36.7 ± 12.09 years with 7 males and 7 females had their 3 soft tissue layers in loaded and unloaded sitting measured independently by 2 sonographers: tendon/muscle, skin/fat and total soft tissue and the diameter of the IT in its short and long axis. Part 2: Nineteen participants with SCI were screened, three were excluded due to abnormal skin signs, and eight participants (42%) were excluded for abnormal US signs with normal skin. Eight SCI participants with a mean age of 31.6 ± 13.6 years and all male with 4 paraplegics and 4 tetraplegics were measured by the same sonographers for skin, fat, tendon, muscle and total. Skin/fat and tendon/muscle were computed.

Results: AB between-operator reliability was good (ICC ¼ 0.81e0.90) for 3 soft tissues layers in unloaded and loaded sitting and poor for both IT short and long axis (ICC ¼ 0.028 and 0.01). SCI between operator reliability was good in unloaded and loaded for total, muscle, fat, skin/fat, tendon/muscle (ICC ¼ 0.75e0.97) and poor for tendon (ICC ¼ 0.26 unloaded and ICC¼0.71 loaded) and skin (ICC ¼ 0.37 unloaded and ICC ¼ 0.10).

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Adaptation of a MR imaging protocol into a real-time clinical biometric ultrasound protocol for persons with spinal cord injury at risk for deep tissue injury: A reliability study - Version of Record
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Accepted/In Press date: 28 July 2017
e-pub ahead of print date: 1 August 2017

Identifiers

Local EPrints ID: 415775
URI: http://eprints.soton.ac.uk/id/eprint/415775
ISSN: 0965-206X
PURE UUID: 70b00538-ff6e-4602-83cf-3a0051762cf9
ORCID for Daniel L. Bader: ORCID iD orcid.org/0000-0002-1208-3507

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Date deposited: 23 Nov 2017 17:30
Last modified: 26 Nov 2021 02:57

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Contributors

Author: Jillian M. Swaine
Author: Andrew Moe
Author: William Breidahl
Author: Daniel L. Bader ORCID iD
Author: Cees W. J. Oomens
Author: Leanne Lester
Author: Edmond O'Loughlin
Author: Nick Santamaria
Author: Michael C. Stacey

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