Continuous pressure monitoring of inpatient spinal cord injured patients: implications for pressure ulcer development
Continuous pressure monitoring of inpatient spinal cord injured patients: implications for pressure ulcer development
Study design: Cohort observational study. Objectives: To examine the movement profiles of individuals with spinal cord injury (SCI) during their inpatient rehabilitative phase using continuous pressure monitoring (CPM), evaluating the trends in those with skin damage. Setting: SCI specialist rehabilitation centre in the United Kingdom. Methods: Individuals with SCI (n = 12) were assessed using CPM in the bed and chair over a 24–72 h. Pressure data was used as a surrogate for movement using both nursing interpretation and an intelligent algorithm. Clinical features were obtained including participants age, injury level, ASIA score, co-morbidities and prescribed support surfaces. Trends between movement profiles (frequency and intervals), SCI demographics and observed skin damage were assessed using cross-tabulation and histograms. Results: The data revealed significant correlations (p < 0.05) between the nursing observation and algorithm for predicting movement, although the algorithm was more sensitive. Individuals with high level injuries (C1-T6) were observed to have a lower frequency of movement and larger intervals between movements when compared to low level injuries (T7-L5) during both lying and sitting periods. The individuals observed to have skin damage were predominantly those who had both a low frequency of movement and extended gaps between movements. Conclusions: Movements for pressure relief in both the bed and chair environments were dependent on the level of injury in individuals with SCI during their inpatient rehabilitation. Distinct movement patterns corresponded with those who acquired skin damage, revealing the potential clinical applications for technologies to monitor PU risk and inform personalised care.
Fryer, Sarah Louise
b3bb565e-d38b-401b-baf4-18fac8ee765b
Caggiari, Silvia
58f49054-6ca6-429b-b499-49b93357e5ba
Major, Denise
b367b37c-3a05-4d1e-a80b-bbe23ff13848
Bader, Dan L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
17 August 2022
Fryer, Sarah Louise
b3bb565e-d38b-401b-baf4-18fac8ee765b
Caggiari, Silvia
58f49054-6ca6-429b-b499-49b93357e5ba
Major, Denise
b367b37c-3a05-4d1e-a80b-bbe23ff13848
Bader, Dan L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Fryer, Sarah Louise, Caggiari, Silvia, Major, Denise, Bader, Dan L. and Worsley, Peter
(2022)
Continuous pressure monitoring of inpatient spinal cord injured patients: implications for pressure ulcer development.
Spinal Cord.
(doi:10.1038/s41393-022-00841-7).
Abstract
Study design: Cohort observational study. Objectives: To examine the movement profiles of individuals with spinal cord injury (SCI) during their inpatient rehabilitative phase using continuous pressure monitoring (CPM), evaluating the trends in those with skin damage. Setting: SCI specialist rehabilitation centre in the United Kingdom. Methods: Individuals with SCI (n = 12) were assessed using CPM in the bed and chair over a 24–72 h. Pressure data was used as a surrogate for movement using both nursing interpretation and an intelligent algorithm. Clinical features were obtained including participants age, injury level, ASIA score, co-morbidities and prescribed support surfaces. Trends between movement profiles (frequency and intervals), SCI demographics and observed skin damage were assessed using cross-tabulation and histograms. Results: The data revealed significant correlations (p < 0.05) between the nursing observation and algorithm for predicting movement, although the algorithm was more sensitive. Individuals with high level injuries (C1-T6) were observed to have a lower frequency of movement and larger intervals between movements when compared to low level injuries (T7-L5) during both lying and sitting periods. The individuals observed to have skin damage were predominantly those who had both a low frequency of movement and extended gaps between movements. Conclusions: Movements for pressure relief in both the bed and chair environments were dependent on the level of injury in individuals with SCI during their inpatient rehabilitation. Distinct movement patterns corresponded with those who acquired skin damage, revealing the potential clinical applications for technologies to monitor PU risk and inform personalised care.
Text
Continuous Pressure Monitoring of Inpatient Spinal Cord Injured Patients
- Accepted Manuscript
Text
s41393-022-00841-7
- Version of Record
More information
Accepted/In Press date: 26 July 2022
e-pub ahead of print date: 17 August 2022
Published date: 17 August 2022
Additional Information:
Funding Information:
Clinical data were acquired by the clinician (SF) as part of her clinical academic Ph.D. project, supported by Duke of Cornwall Spinal Treatment Centre, Salisbury NHS Foundation Trust. The postgraduate researcher (SC) was supported by a UK Engineering and Physical Sciences Research Council CASE award, in association with Sumed International, who also provided the pressure mapping systems (ForeSite PT and SS). The work was also supported by the EPSRC-NIHR ‘Medical Device and Vulnerable Skin’ Network and NetworkPLUS (Refs. EP/M000303/1 and EP/N02723X/1).
Publisher Copyright:
© 2022, The Author(s).
Identifiers
Local EPrints ID: 469111
URI: http://eprints.soton.ac.uk/id/eprint/469111
ISSN: 1362-4393
PURE UUID: 643be1f5-0074-48df-8e88-93e2534e11cd
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Date deposited: 06 Sep 2022 18:49
Last modified: 17 Mar 2024 04:06
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Author:
Sarah Louise Fryer
Author:
Denise Major
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