Tissue changes in patients following spinal cord injury and implications for wheelchair cushions and tissue loading: A literature review

Ostomy Wound Management

Volumn 60, Issue 2, 2014, Pages 34-45

  Gefen, Amit ^a  

^a TEL AVIV UNIVERSITY   (Israel)

Author keywords

Durable medical equipment; Pressure ulcer; Review; Spinal cord injuries; Tissues

Indexed keywords

BIOENGINEERING; BIOMECHANICS; HUMAN; PATHOLOGY; SPINAL CORD INJURY; WHEELCHAIR;

BIOMECHANICAL PHENOMENA; HUMAN ENGINEERING; HUMANS; SPINAL CORD INJURIES; WHEELCHAIRS;

EID: 84894169746     PISSN: 08895899     EISSN: 19432720     Source Type: Journal    
DOI: None     Document Type: Review

References (68)

1. EPUAP/NPUAP International Guidelines 2009. Available at: www.epuap.org or www.npuap.org. Accessed January 22, 2014.
2. Gefen A. The biomechanics of sitting-acquired pressure ulcers in patients with spinal cord injury or lesions. Int Wound J. 2007;4(3):222-231.
3. Brienza D, Kelsey S, Karg P, Allegretti A, Olson M, Schmeler M, et al. A randomized clinical trial on preventing pressure ulcers with wheelchair seat cushions. J Am Geriatr Soc. 2010;58(12):2308-2314.
4. Brienza DM, Karg PE, Geyer MJ, Kelsey S, Trefler E. The relationship between pressure ulcer incidence and buttock-seat cushion interface pressure in at-risk elderly wheelchair users. Arch Phys Med Rehabil. 2001;82(4):529-533. (Pubitemid 32289720)
5. Geyer MJ, Brienza DM, Karg P, Trefler E, Kelsey S. A randomized control trial to evaluate pressure-reducing seat cushions for elderly wheelchair users. Adv Skin Wound Care 2001;14(3):120-132.
6. Beeckman D, Vanderwee K. Skin protection wheelchair cushions for older nursing home residents reduce 6-month incidence of ischial tuberosity pressure ulcers compared with segmented foam cushions. Evid Based Nurs. 2011;14(3):79-80.
7. Linder-Ganz E, Gefen A. Stress analyses coupled with damage laws to determine biomechanical risk factors for deep tissue injury during sitting. J Biomech Eng. 2009;131(1):011003.
8. Shabshin N, Zoizner G, Herman A, Ougortsin V, Gefen A. Use of weight-bearing MRI for evaluating wheelchair cushions based on internal soft-tissue deformations under ischial tuberosities. J Rehabil Res Dev. 2010;47(1):31-42.
9. Loerakker S, Manders E, Strijkers GJ, Nicolay K, Baaijens FP, Bader DL, et al. Oomens CW. The effects of deformation, ischemia, and reperfusion on the development of muscle damage during prolonged loading. J Appl Physiol. 2011;111(4):1168-1177.
10. Oomens CW, Zenhorst W, Broek M, Hemmes B, Poeze M, Brink PR, Bader DL, et al. A numerical study to analyse the risk for pressure ulcer development on a spine board. Clin Biomech (Bristol, Avon). 2013;28(7):736-742.
11. Shabshin N, Ougortsin V, Zoizner G, Gefen A. Evaluation of the effect of trunk tilt on compressive soft tissue deformations under the ischial tuberosities using weight-bearing MRI. Clin Biomech (Bristol, Avon). 2010;25(5):402-408.
12. Linder-Ganz E, Shabshin N, Itzchak Y, Yizhar Z, Siev-Ner I, Gefen A. Strains and stresses in sub-dermal tissues of the buttocks are greater in paraplegics than in healthy during sitting. J Biomech. 2008;41(3):567-580. (Pubitemid 351179714)
13. Linder-Ganz E, Engelberg S, Scheinowitz M, Gefen A. Pressuretime cell death threshold for albino rat skeletal muscles as related to pressure sore biomechanics. J Biomech. 2006;39(14):2725-2732. (Pubitemid 44465915)
14. Gefen A, van Nierop B, Bader DL, Oomens CW. Strain-time celldeath threshold for skeletal muscle in a tissue-engineered model system for deep tissue injury. J Biomech. 2008;41(9):2003-2012.
15. Metring NL, Gaspar MI, Mateus-Vasconcelos EC, Gomes MM, de Abreu DC. Influence of different types of seat cushions on the static sitting posture in individuals with spinal cord injury. Spinal Cord. 2012;50(8):627-631.
16. de Abreu DC, Takara K, Metring NL, Reis JG, Cliquet A Jr. Interference of different types of seats on postural control system during a forward-reaching task in individuals with paraplegia. Int J Rehabil Res. 2012;35(3):208-213.
17. Aissaoui R, Boucher C, Bourbonnais D, Lacoste M, Dansereau J. Effect of seat cushion on dynamic stability in sitting during a reaching task in wheelchair users with paraplegia. Arch Phys Med Rehabil. 2001;82(2):274-281. (Pubitemid 32147904)
18. Sprigle S, Wootten M, Sawacha Z, Thielman G. Relationships among cushion type, backrest height, seated posture, and reach of wheelchair users with spinal cord injury. J Spinal Cord Med. 2003;26(3):236-243. (Pubitemid 37082483)
19. Levy A, Kopplin K, Gefen A. Simulations of skin and subcutaneous tissue loading in the buttocks while regaining weight-bearing after a push-up in wheelchair users. J Mech Behav Biomed Mater. 2013;28:436-447.
20. Adams MM, Hicks AL. Spasticity after spinal cord injury. Spinal Cord. 2005;43(10):577-586. (Pubitemid 41486865)
21. Sopher R, Nixon J, Gorecki C, Gefen A. Effects of intramuscular fat infiltration, scarring, and spasticity on the risk for sitting-acquired deep tissue injury in spinal cord injury patients. J Biomech Eng. 2011;133(2):021011.
22. Lamid S, El Ghatit AZ. Smoking, spasticity and pressure sores in spinal cord injured patients. Am J Phys Med. 1983;62(6):300-306. (Pubitemid 14201145)
23. Gorgey AS, Dudley GA. Spasticity may defend skeletal muscle size and composition after incomplete spinal cord injury. Spinal Cord. 2008;46(2):96-102. (Pubitemid 351220582)
24. Gracies JM. Pathophysiology of spastic paresis. II: Emergence of muscle overactivity. Muscle Nerve. 2005;31(5):552-571.
25. Crane DA, Little JW, Burns SP. Weight gain following spinal cord injury: a pilot study. J Spinal Cord Med. 2011;34(2):227-232.
26. Cox SA, Weiss SM, Posuniak EA, Worthington P, Prioleau M, Heffley G. Energy expenditure after spinal cord injury: an evaluation of stable rehabilitating patients. J Trauma 1985;25(5):419-423. (Pubitemid 15009550)
27. Chen Y, Henson S, Jackson AB, Richards JS. Obesity intervention in persons with spinal cord injury. Spinal Cord. 2006;44(2):82-91. (Pubitemid 43190351)
28. Elsner JJ, Gefen A. Is obesity a risk factor for deep tissue injury in patients with spinal cord injury? J Biomech. 2008;41(16):3322-3331.
29. Sopher R, Nixon J, Gorecki C, Gefen A. Exposure to internal muscle tissue loads under the ischial tuberosities during sitting is elevated at abnormally high or low body mass indices. J Biomech. 2010;43(2):280-286.
30. Dudley-Javoroski S, Shields RK. Muscle and bone plasticity after spinal cord injury: review of adaptations to disuse and to electrical muscle stimulation. J Rehabil Res Dev. 2008;45(2):283-296.
31. Garland DE, Adkins RH, Stewart CA. Five-year longitudinal bone evaluations in individuals with chronic complete spinal cord injury. J Spinal Cord Med. 2008;31(5):543-550.
32. Be'ery-Lipperman M, Gefen A. Contribution of muscular weakness to osteoporosis: Computational and animal models. Clin Biomech (Bristol, Avon). 2005;20:984-997. (Pubitemid 41376517)
33. Rittweger J, Gerrits K, Altenburg T, Reeves N, Maganaris CN, de Haan A. Bone adaptation to altered loading after spinal cord injury: a study of bone and muscle strength. J Musculoskelet Neuronal Interact. 2006;6(3):269-276. (Pubitemid 44650786)
34. Giangregorio LM, Craven BC, Webber CE. Musculoskeletal changes in women with spinal cord injury: a twin study. J Clin Densitom. 2005;8(3):347-351. (Pubitemid 41112853)
35. de Bruin ED, Dietz V, Dambacher MA, Stüssi E. Longitudinal changes in bone in men with spinal cord injury. Clin Rehabil. 2000;14(2):145-152. (Pubitemid 30162629)
36. Maggioni M, Bertoli S, Margonato V, Merati G, Veicsteinas A, Testolin G. Body composition assessment in spinal cord injury subjects. Acta Diabetol. 2003;40(suppl 1):S183-S186. (Pubitemid 37322750)
37. Carda S, Cisari C, Invernizzi M. Sarcopenia or muscle modifications in neurologic diseases: a lexical or pathophysiological difference? Eur J Phys Rehabil Med. 2013;49(1):119-130.
38. Gorgey AS, Dudley GA. Skeletal muscle atrophy and increased intramuscular fat after incomplete spinal cord injury. Spinal Cord. 2007;45(4):304-309. (Pubitemid 46572861)
39. Shah PK, Stevens JE, Gregory CM, Pathare NC, Jayaraman A, Bickel SC, et al. Lower-extremity muscle cross-sectional area after incomplete spinal cord injury. Arch Phys Med Rehabil. 2006;87(6):772-778. (Pubitemid 43767715)
40. Castro MJ, Apple DF Jr, Hillegass EA, Dudley GA. Influence of complete spinal cord injury on skeletal muscle cross-sectional area within the first 6 months of injury. Eur J Appl Physiol Occup Physiol. 1999;80(4):373-378. (Pubitemid 29405672)
41. Wu GA, Bogie KM. Not just quantity: Gluteus maximus muscle characteristics in able-bodied and SCI individuals-implications for tissue viability. J Tissue Viability. 2013;22(3):74-82.
42. Roubenoff R. The pathophysiology of wasting in the elderly. J Nutr. 1999;129(1 suppl):256S-259S. (Pubitemid 29035986)
43. Kovanlikaya A, Mittelman SD, Ward A, Geffner ME, Dorey F, Gilsanz V. Obesity and fat quantification in lean tissues using three-point Dixon MR imaging. Pediatr Radiol. 2005;35(6):601-607. (Pubitemid 40724032)
44. Shaw CS, Clark J, Wagenmakers AJ. The effect of exercise and nutrition on intramuscular fat metabolism and insulin sensitivity. Annu Rev Nutr. 2010;30(Aug):13-34.
45. Kern H, Boncompagni S, Rossini K, Mayr W, Fanò G, Zanin ME, et al. Long-term denervation in humans causes degeneration of both contractile and excitation-contraction coupling apparatus, which is reversible by functional electrical stimulation (FES): a role for myofiber regeneration? J Neuropathol Exp Neurol. 2004;63(9):919-931. (Pubitemid 39202495)
46. Palevski A, Glaich I, Portnoy S, Linder-Ganz E, Gefen A. Stress relaxation of porcine gluteus muscle subjected to sudden transverse deformation as related to pressure sore modeling. J Biomech Eng. 2006;128(5)[AU: Number?]:782-787. (Pubitemid 44622809)
47. Gefen A, Haberman E. Viscoelastic properties of ovine adipose tissue covering the gluteus muscles. J Biomech Eng. 2007;129(6):924-930. (Pubitemid 351153482)
48. Loerakker S, Solis LR, Bader DL, Baaijens FP, Mushahwar VK, Oomens CW. How does muscle stiffness affect the internal deformations within the soft tissue layers of the buttocks under constant loading? Comput Methods Biomech Biomed Engin. 2013;16(5):520-529.
49. Yalcin E, Akyuz M, Onder B, Unalan H, Degirmenci I. Skin thickness on bony prominences measured by ultrasonography in patients with spinal cord injury. J Spinal Cord Med. 2013;36(3):225-230.
50. Park JW, Seo CH, Han SH, Lee YG. Sympathetic influence on biomechanical skin properties after spinal cord injury. Spinal Cord. 2011;49(2):236-243.
51. Rodriguez GP, Garber SL. Prospective study of pressure ulcer risk in spinal cord injury patients. Paraplegia. 1994;32(3):150-158. (Pubitemid 24071006)
52. Zhu C, Galea M, Livote E, Signor D, Wecht JM. A retrospective chart review of heart rate and blood pressure abnormalities in veterans with spinal cord injury. J Spinal Cord Med. 2013;36(5):463-475.
53. West CR, Mills P, Krassioukov AV. Influence of the neurological level of spinal cord injury on cardiovascular outcomes in humans: a meta-analysis. Spinal Cord. 2012;50(7):484-492.
54. Scelsi R. Skeletal muscle pathology after spinal cord injury, our 20 year experience, and results on skeletal muscle changes in paraplegics, related to functional rehabilitation. Basic Appl Myol. 2001;11(2):75-85.
55. Ruschkewitz Y, Gefen A. Cellular-scale transport in deformed skeletal muscle following spinal cord injury. Comput Methods Biomech Biomed Engin. 2011;14(5):411-424.
56. Thorfinn J, Sjöberg F, Sjöstrand L, Lidman D. Perfusion of the skin of the buttocks in paraplegic and tetraplegic patients, and in healthy subjects after a short and long load. Scand J Plast Reconstr Surg Hand Surg. 2006;40(3):153-160.
57. Shoham N, Gefen A. Deformations, mechanical strains and stresses across the different hierarchical scales in weight-bearing soft tissues. J Tissue Viability. 2012;21(2):39-46.
58. da Silva FP, Beretta EM, Prestes RC, Kindlein Junior W. Design and milling manufacture of polyurethane custom contoured cushions for wheelchair users. Australas Med J. 2011;4(9):500-506.
59. Tasker LH, Shapcott NG, Watkins AJ, Holland PM. The effect of seat shape on the risk of pressure ulcers using discomfort and interface pressure measurements. Prosthet Orthot Int. 2014;38(1):46-53.
60. Sprigle S. Visual inspections of wheelchair cushions after everyday use. Assist Technol. 2013;25(3):176-180.
61. Akins JS, Karg PE, Brienza DM. Interface shear and pressure characteristics of wheelchair seat cushions. J Rehabil Res Dev. 2011;48(3):225-234.
62. Sprigle S, Chung B, Meyer T. Assessment of the ISO impact damping test for wheelchair cushions. Assist Technol. 2010;22(4):236-244.
63. Hobson DA. Comparative effects of posture on pressure and shear at the body-seat interface. J Rehabil Res Dev. 1992;29(4):21-31. (Pubitemid 23052602)
64. Bader DL. Editorial. J Tissue Viabil. 2013;22(2):2-24.
65. Gefen A. State-of-the-art bioengineering technologies for evaluating support surfaces. Proceedings of the 16th European Pressure Ulcer Advisory Panel (EPUAP) Annual Conference, Vienna, Austria. August 28-30 2013.
66. Shaked E, Gefen A. Modeling the effects of moisture-related skinsupport friction on the risk for superficial pressure ulcers during patient repositioning in bed. Front Bioeng Biotechnol. 2013;1(9):1-7.
67. Levy A, Kopplin K, Gefen A. An air-cell-based cushion for pressure ulcer protection remarkably reduces tissue stresses in the seated buttocks with respect to foams: Finite element studies. J Tissue Viability. 2013; in press (available online). doi: 10.1016/j. jtv.2013.12.005.
68. Eslami V, Saadat S, Habibi Arejan R, Vaccaro AR, Ghodsi SM, Rahimi-Movaghar V. Factors associated with the development of pressure ulcers after spinal cord injury. Spinal Cord. 2012;50(12):899-903.