Alisa Ahmetović1, Vivian K Mushahwar2, Ryan Sommer3, Dana Schnepf4, Lisa Kawasaki1, Robyn Warwaruk-Rogers5, Tim Barlott6, Su Ling Chong1, Glen Isaacson7, Seoyoung Kim1, Martin Ferguson-Pell8, Richard B Stein9, Chester Ho5, Sean Dukelow5, K Ming Chan2. 1. Centre for Neuroscience, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta, Canada . 2. Centre for Neuroscience, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta, Canada . ; Division of Physical Medicine and Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta, Canada . 3. Glenrose Rehabilitation Hospital , Edmonton, Alberta, Canada . 4. Allen Gray Continuing Care Centre , Edmonton, Alberta, Canada . 5. Foothills Medical Centre , Calgary, Alberta, Canada . ; Department of Clinical Neurosciences, Faculty of Medicine, Hotchkiss Brain Institute, University of Calgary , Calgary, Alberta, Canada . 6. Integrated Home Living, Alberta Health Services , Edmonton, Alberta, Canada . 7. Division of Physical Medicine and Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta, Canada . 8. Faculty of Rehabilitation Medicine, University of Alberta , Edmonton, Alberta, Canada . 9. Centre for Neuroscience, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta, Canada . ; Department of Physiology, University of Alberta , Edmonton, Alberta, Canada .
Abstract
Objective: To investigate the safety, feasibility, and acceptability of a novel treatment, intermittent electrical stimulation (IES), for preventing deep tissue injury (DTI) in different healthcare settings. Approach: Testing was conducted in an acute rehabilitation unit of a general hospital, a tertiary rehabilitation hospital, a long-term care facility, and homecare (HC). IES was delivered through surface electrodes placed either directly on the gluteal muscles or through mesh panels inside a specialized garment. Study participants at risk for DTI used the system for an average of 4 weeks. Outcome measures included skin reaction to long-term stimulation, demands on the caregiver, stability of induced muscle contraction, and acceptability as part of the users' daily routine. Results: A total of 48 study participants used the IES system. The system proved to be safe and feasible in all four clinical settings. No pressure ulcers were observed in any of the participants. There was no difference between the clinical settings in patient positioning, ease of finding optimal stimulation site, and patient acceptance. Although donning and doffing time was longer in the long-term care and HC settings than the acute rehabilitation unit and tertiary rehabilitation facility, time required to apply the IES system was <18 min (including data collection). The patients and caregivers did not find the application disruptive and indicated that the stimulation was acceptable as part of their daily routine in over 97% of the time. Innovation and Conclusion: We demonstrated the safety, feasibility, and acceptability of a novel method of IES to prevent DTI in a continuum of healthcare settings.
Objective: To investigate the safety, feasibility, and acceptability of a novel treatment, intermittent electrical stimulation (IES), for preventing deep tissue injury (DTI) in different healthcare settings. Approach: Testing was conducted in an acute rehabilitation unit of a general hospital, a tertiary rehabilitation hospital, a long-term care facility, and homecare (HC). IES was delivered through surface electrodes placed either directly on the gluteal muscles or through mesh panels inside a specialized garment. Study participants at risk for DTI used the system for an average of 4 weeks. Outcome measures included skin reaction to long-term stimulation, demands on the caregiver, stability of induced muscle contraction, and acceptability as part of the users' daily routine. Results: A total of 48 study participants used the IES system. The system proved to be safe and feasible in all four clinical settings. No pressure ulcers were observed in any of the participants. There was no difference between the clinical settings in patient positioning, ease of finding optimal stimulation site, and patient acceptance. Although donning and doffing time was longer in the long-term care and HC settings than the acute rehabilitation unit and tertiary rehabilitation facility, time required to apply the IES system was <18 min (including data collection). The patients and caregivers did not find the application disruptive and indicated that the stimulation was acceptable as part of their daily routine in over 97% of the time. Innovation and Conclusion: We demonstrated the safety, feasibility, and acceptability of a novel method of IES to prevent DTI in a continuum of healthcare settings.
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