Jillian M Swaine1, Andrew Moe2, William Breidahl3, Daniel L Bader4, Cees W J Oomens5, Leanne Lester6, Edmond O'Loughlin2, Nick Santamaria7, Michael C Stacey8. 1. Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia; Institute for Health Research, The University of Notre Dame Australia, 19 Mouat Street (PO Box 1225), Fremantle, Western Australia, 6959, Australia; Fiona Stanley Hospital, State Rehabilitation Service, Spinal Service, South Metropolitan Health Service Fiona Stanley Fremantle Hospitals Group, Locked Bag 100, Palmyra DC, Western Australia, 6961, Australia. Electronic address: jillian.swaine@uwa.edu.au. 2. Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia; Fiona Stanley Hospital, South Metropolitan Health Service Fiona Stanley Fremantle Hospitals Group, Locked Bag 100, Palmyra DC, Western Australia, 6961, Australia. 3. Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia; Perth Radiological Clinic, PO Box 99, Mirrabooka, Western Australia, 6941, Australia. 4. Faculty of Health Sciences, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK; Biomedical Engineering Department, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands. 5. Biomedical Engineering Department, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands. 6. Health Evaluation Promotion Unit, School of Human Sciences, The University of Western Australia M408, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia. 7. Melbourne School of Health Sciences, University of Melbourne, Parkville, Victoria, 2010, Australia. 8. Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia; Department of Surgery, McMaster University, 1280 Main St W, Hamilton, Ontario, L8S 4L8, Canada.
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 = 0.81-0.90) for 3 soft tissues layers in unloaded and loaded sitting and poor for both IT short and long axis (ICC = -0.028 and -0.01). SCI between-operator reliability was good in unloaded and loaded for total, muscle, fat, skin/fat, tendon/muscle (ICC = 0.75-0.97) and poor for tendon (ICC = 0.26 unloaded and ICC = -0.71 loaded) and skin (ICC = 0.37 unloaded and ICC = 0.10). CONCLUSION: A MRI protocol was successfully adapted for a reliable 3 soft tissue layer model and could be used in a 2-D FEM model designed to estimate soft tissue strain as a novel risk factor for the development of a PU.
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 = 0.81-0.90) for 3 soft tissues layers in unloaded and loaded sitting and poor for both IT short and long axis (ICC = -0.028 and -0.01). SCI between-operator reliability was good in unloaded and loaded for total, muscle, fat, skin/fat, tendon/muscle (ICC = 0.75-0.97) and poor for tendon (ICC = 0.26 unloaded and ICC = -0.71 loaded) and skin (ICC = 0.37 unloaded and ICC = 0.10). CONCLUSION: A MRI protocol was successfully adapted for a reliable 3 soft tissue layer model and could be used in a 2-D FEM model designed to estimate soft tissue strain as a novel risk factor for the development of a PU.
Authors: Jillian M Swaine; William Breidahl; D L Bader; C W J Oomens; Edmond O'Loughlin; Nick Santamaria; Michael C Stacey Journal: Top Spinal Cord Inj Rehabil Date: 2018-02-12
Authors: Jan W van der Scheer; Julia O Totosy de Zepetnek; Cheri Blauwet; Katherine Brooke-Wavell; Terri Graham-Paulson; Amber N Leonard; Nick Webborn; Victoria L Goosey-Tolfrey Journal: PLoS One Date: 2021-05-07 Impact factor: 3.240