David P Lemmer1, Nannette Alvarado1, Kristi Henzel2, Mary Ann Richmond1, John McDaniel3, Jennifer Graebert1, Katelyn Schwartz1, Jiayang Sun4, Kath M Bogie5. 1. Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH. 2. Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH; Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, OH. 3. Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH; Exercise Physiology Program, Kent State University, Kent, OH. 4. Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH. 5. Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH; Department of Orthopaedics, Case Western Reserve University, Cleveland, OH. Electronic address: kmb3@case.edu.
Abstract
OBJECTIVE: To investigate intersections between pressure injury (PrI) history, muscle composition, and tissue health responses under physiologically relevant loading conditions for individuals with spinal cord injury (SCI). DESIGN: Repeated measures study design with annual follow-up for up to 3 years. SETTING: Tertiary care center. PARTICIPANTS: Persons with SCI (N=38). Exclusion criteria included having an open pelvic region PrI at the time of recruitment, presence of systemic disease, and/or known sensitivity to contrast. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Gluteal muscle composition, ischial interface pressures, tissue oxygenation. RESULTS: Ischial region mean interface pressures are the same for individuals with or without a PrI history. Tissue oxygenation is lower during sitting for persons with a PrI history. Individuals with >15% gluteal intramuscular fat were statistically highly significantly (P<.001) more likely to have a history of severe or recurrent PrI. Intramuscular adipose tissue (IMAT) levels within the gluteal muscle may remain low over time or muscle tissue in the gluteal muscle region may be almost entirely replaced by IMAT. In the current study cohort, it was found that muscle composition also continues to change over time even for individuals with long-standing SCI. CONCLUSIONS: Soft-tissue compositional changes, specifically IMAT, provides a reliable indicator of PrI history and may provide a key to personalized PrI risk status for persons with SCI. The current findings confirm that interface pressure mapping alone is a limited indicator for PrI development. Published by Elsevier Inc.
OBJECTIVE: To investigate intersections between pressure injury (PrI) history, muscle composition, and tissue health responses under physiologically relevant loading conditions for individuals with spinal cord injury (SCI). DESIGN: Repeated measures study design with annual follow-up for up to 3 years. SETTING: Tertiary care center. PARTICIPANTS: Persons with SCI (N=38). Exclusion criteria included having an open pelvic region PrI at the time of recruitment, presence of systemic disease, and/or known sensitivity to contrast. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Gluteal muscle composition, ischial interface pressures, tissue oxygenation. RESULTS: Ischial region mean interface pressures are the same for individuals with or without a PrI history. Tissue oxygenation is lower during sitting for persons with a PrI history. Individuals with >15% gluteal intramuscular fat were statistically highly significantly (P<.001) more likely to have a history of severe or recurrent PrI. Intramuscular adipose tissue (IMAT) levels within the gluteal muscle may remain low over time or muscle tissue in the gluteal muscle region may be almost entirely replaced by IMAT. In the current study cohort, it was found that muscle composition also continues to change over time even for individuals with long-standing SCI. CONCLUSIONS: Soft-tissue compositional changes, specifically IMAT, provides a reliable indicator of PrI history and may provide a key to personalized PrI risk status for persons with SCI. The current findings confirm that interface pressure mapping alone is a limited indicator for PrI development. Published by Elsevier Inc.
Authors: Sharon Gabison; Sunita Mathur; Ethne L Nussbaum; Milos R Popovic; Mary C Verrier Journal: J Spinal Cord Med Date: 2019-10 Impact factor: 1.985
Authors: Giovanna Albertin; Barbara Ravara; Helmut Kern; Christian Hofer; Stefan Loefler; Wolfgang Jurecka; Diego Guidolin; Anna Rambaldo; Andrea Porzionato; Raffaele De Caro; Sandra Zampieri; Amber Pond; Mauro Alaibac; Ugo Carraro Journal: Medicine (Baltimore) Date: 2019-12 Impact factor: 1.889
Authors: Katie Schwartz; M Kristi Henzel; Mary Ann Richmond; Jennifer K Zindle; Jacinta M Seton; David P Lemmer; Nannette Alvarado; Kath M Bogie Journal: J Spinal Cord Med Date: 2019-09-06 Impact factor: 1.985