ISS 2017 Program
 

 


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PS6.2: An MRI Investigation Evaluating Tissue Response to Seat Cushions

Tissue response plays a role in the development of pressure injuries. Skin protection cushion efficacy has been demonstrated. Choosing between the many varieties of cushions to best meet a specific patient’s needs remains a challenge. While pressure mapping can measure superficial loading, pressure induced injuries show evidence of deep tissue injury. The impact on deeper tissues should be considered when evaluating and selecting a cushion. A recent study challenged the assumptions about the anatomy of people with SCI, suggesting that research in this field cannot be advanced without carefully examining the 3D seated anatomy. The study showed that tissue displacement can be important when looking at risk, and more research is needed. This study is the first 3D analysis-based comparison of ischial tissue response for a variety of wheelchair cushions. MRI examinations were conducted and 3D models created for 6 individuals (4 with SCI). Tissue composition under the ITs was very consistent amongst all of the participants with SCI; all 4 sat on mostly fat, with a maximum of 7% muscle. The anatomical feature that was seen in all of the participants with SCI was muscle displaced laterally when loaded. Since all of the participants with SCI had similar loaded tissue composition, the amount of tissue under the ITs can be used to visually assess loaded tissue conditions. No one cushion consistently had better results, stressing the importance of personalized cushion selection.

 

Learning Objectives:

Upon completion of this session, attendees will be able to;

 

Faculty:

David M Brienza, PhD
University of Pittsburgh
Pittsburgh, Pennsylvania
United States

David Brienza, PhD, is a Professor of Rehabilitation Science and Technology at Pitt and Associate Dean for Research in SHRS. He has served as the Director of the RERC on Wheeled Mobility, Director of the RERC on Telerehabilitation and Director of the RERC on Spinal Cord Injury. His work ranges from technology development in the seating and mobility, to investigations on physiological responses to mechanical and heat loading, to clinical effectiveness research with large-scale RCTs.

Patricia Karg, MSE
University of Pittsburgh
Pittsburgh, Pennsylvania
United States

 

References:

    1. Linder-Ganz, E., et al., Pressure & time cell death threshold for albino rat skeletal muscles as related to pressure sore biomechanics. Journal of biomechanics, 2006. 39(14): p. 2725-2732.
    2. Brienza, D., et al., A randomized clinical trial on preventing pressure ulcers with wheelchair seat cushions. Journal of the American Geriatrics Society, 2010. 58(12): p. 2308-2314.
    3. Sonenblum, S.E., et al., 3D anatomy and deformation of the seated buttocks. Journal of tissue viability, 2015

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Updated | 11.22.2016      Facebook logo  Twitter
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