Introduction: Pressure sores are the most common complication post spinal cord injury. Pressure sores of the sacral area commonly occur and often lead to patients being placed on bed rest. Bed rest periods delay rehabilitation, and may lead to other complications associated with immobility. Physiotherapy is crucial for these patients to decrease complications and increase function. This study set out to establish the treatment interventions physiotherapists provide to patients with sacral pressure sores and the factors that they take into consideration when deciding whether the patient should receive physiotherapy in bed (in the ward) or in the gym environment. Methods: This was a cross sectional survey administered to physiotherapists working in neurological rehabilitation units around South Africa that treat patients with spinal cord injuries. A self-administered questionnaire was used for data collection. The questionnaires were sent to all eligible physiotherapists via email. All the data was captured onto an excel spread sheet. Data collected were presented as frequencies and percentages with the aid of tables, pie charts and bar graphs as was appropriate. Results: Thirty-nine physiotherapists responded which showed a response rate of 76%.The majority of the respondents were female (98%). There were 11 rehabilitation facilities represented in the study with the majority of the respondents being from the private sector (69%) and 31% from the public sector. The most common practice for patients with sacral pressure sores is to be placed onto bed rest (98%). Nineteen physiotherapists stated that they did not have set protocols for the treatment of patients with sacral pressure sores. The most common physiotherapy interventions (70%) when the patient is on bed rest are upper limb strengthening, lower limb passive movements, positioning into prone and side lying as well as upper limb passive movements and passive stretching. The same were done when the patient was brought to the gym except that bed mobility training then also formed part of common intervention as well as the use of the tilt table for passive standing. The treatment environment was dependant mostly on doctors’ orders and the size, grade and duration of the pressure sores. The choice of treatment techniques was guided mostly by past clinical experience or the successful experience of colleagues. Conclusion: There is a need for the development of standardised protocols when treating spinal cord injured patients with sacral pressure sores to possibly ensure maximal healing and rehabilitation. Key words: Physiotherapy management of paraplegic patients, sacral pressure sores, bed rest

Thesis (doctoral)--München, 1934.

Thesis (M.S.)--University of Michigan, 1990.

Thesis (M.S.)--University of Michigan, 1990.

Thesis (doctoral)--München, 1934.

A strategy was proposed to the rule for paralyzed patients. One goal of the design is to reduce or avoid the occurrence of decubitus ulcer. The other goal is to reduce the decline of muscle strength of patient. The contents of the study include collection and system analysis. The issue is know how the burdens of muscles are affected by the locations and postures that sickbed supporting the body. To attack this issue, a simplified body model, which is consisted of 11 rigid bodies, is proposed. An analysis method, which adopts the optimization approach, is suggested to calculate the ¡§ relaxed burdens of muscles ¡¨. Apply the mathematical model of the optimization to acquire an analysis method of the relaxed burdens of muscles, modeling the concern of the support loading and burdens of muscles. According to the analysis answer of the mathematical model verified that a patient lay on the bed by the horizontal postures and variation postures, the best support locations resulted in the relaxed burdens of muscles and strengthen muscles. So, the rule of the logical thinking to reduce or avoid the occurrence of decubitus ulcer and the decline of muscle strength.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.

A tomada de decisão do enfermeiro na sua prática diária necessita ser fundamentada em conhecimento científico. A prática baseada em evidências é uma abordagem que preconiza a utilização de resultados de pesquisas na prática clínica, sendo a revisão integrativa um de seus recursos. A presente investigação é uma revisão integrativa que teve como objetivo buscar e avaliar as evidências disponíveis sobre as intervenções eficazes de enfermagem para a prevenção de lesões de pele no paciente cirúrgico, no período transoperatório, ou em decorrência deste. Para a seleção dos artigos utilizamos duas bases de dados, Cinalh e Medline, e a amostra desta revisão constituiu-se em 14 artigos, referentes principalmente ao uso de superfícies de suporte. Após análise dos artigos incluídos na revisão , os resultados dos estudos apontaram que os dispositivos considerados mais eficazes na prevenção de lesões de pele foram o colchão de ar micropulsante, cobertura de colchão de polímero de visco elástico seco e almofadas de gel sucessivamente. / Nursing decision making in daily practice needs to be based on scientific knowledge. Evidence-based practice establishes the use of research results in clinical practice, with integrative literature review as one of its resources. This integrative review aimed to find and evaluate the available evidence on efficient nursing care interventions for the prevention of skin injuries in surgical patients, during or as a result of the perioperative period. To select the articles, we use two databases, Cinalh and Medline, resulting in a sample of 14 articles, which mainly dealt with the use of support surfaces. The results of this analysis indicated that the devices considered most efficient in the prevention of skin injuries were, in decreasing order, the multi-cell pulsating dynamic mattress system, a dry visco-elastic polymer pad and gel cushions.

The three goals of this research were to investigate how normal subjects move while seated, how paraplegic patients move while seated, and whether seated movements can be modeled using a hemi-ellipsoid shape. Pressure readings were recorded at 11 Hz using a 36 by 36 sensor pressure map by XSENSOR. Subjects were instructed to move or perform pressure relief as they normally would while seated. Analysis was performed using Microsoft Excel with Solver and Matrix.xla add-ins and automated with VBA code. Major movements and time intervals between movements were calculated by locating the area of maximum pressure on each hemi-buttock for 20 normal and 6 paraplegic subjects. Statistical analysis revealed movements followed a normal distribution while time intervals followed a lognormal distribution. For both the normal (p=0.041) and paraplegic groups (p=0.007) the number of movements significantly increased from the first hour of recording to the second hour. The time interval between major movements decreased but not significantly for neither the normal subjects nor the paraplegics. No significant differences were identified between the normal and paraplegic groups over the first hour or second hour for number of movements or time intervals. Time series analysis with plotting, trend lines, ARIMA, and periodograms did not reveal patterns in the data. Preference for a side was shown. Next, all areas of identified major movements for one subject and one frame for each of the paraplegic patients were modeled as a hemi-ellispoid shape using minimization with Solver. Eigenvalues were calculated in order to obtain the lengths of the x, y, and z axis of the hemi-ellipsoid with an average error of 39.87% for the normal subject and an error range of 5.10% to 2701.81% for the paraplegic patients.

A tomada de decisão do enfermeiro na sua prática diária necessita ser fundamentada em conhecimento científico. A prática baseada em evidências é uma abordagem que preconiza a utilização de resultados de pesquisas na prática clínica, sendo a revisão integrativa um de seus recursos. A presente investigação é uma revisão integrativa que teve como objetivo buscar e avaliar as evidências disponíveis sobre as intervenções eficazes de enfermagem para a prevenção de lesões de pele no paciente cirúrgico, no período transoperatório, ou em decorrência deste. Para a seleção dos artigos utilizamos duas bases de dados, Cinalh e Medline, e a amostra desta revisão constituiu-se em 14 artigos, referentes principalmente ao uso de superfícies de suporte. Após análise dos artigos incluídos na revisão , os resultados dos estudos apontaram que os dispositivos considerados mais eficazes na prevenção de lesões de pele foram o colchão de ar micropulsante, cobertura de colchão de polímero de visco elástico seco e almofadas de gel sucessivamente. / Nursing decision making in daily practice needs to be based on scientific knowledge. Evidence-based practice establishes the use of research results in clinical practice, with integrative literature review as one of its resources. This integrative review aimed to find and evaluate the available evidence on efficient nursing care interventions for the prevention of skin injuries in surgical patients, during or as a result of the perioperative period. To select the articles, we use two databases, Cinalh and Medline, resulting in a sample of 14 articles, which mainly dealt with the use of support surfaces. The results of this analysis indicated that the devices considered most efficient in the prevention of skin injuries were, in decreasing order, the multi-cell pulsating dynamic mattress system, a dry visco-elastic polymer pad and gel cushions.