Use of weight-bearing MRI for evaluating wheelchair cushions based on internal soft-tissue deformations under ischial tuberosities

Nogah Shabshin, Gil Zoizner, Amir Herman, Vlad Ougortsin, Amit Gefen

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

Deep tissue injury (DTI) is a severe type of pressure ulcer, in which damage initiates under intact skin, in soft tissues that are mechanically deformed by load-bearing bony prominences. Sitting-acquired DTI typically occurs in the gluteus muscles that could sustain deformations by the weight-bearing ischial tuberosities (ITs). No clinical method currently exists for measuring internal tissue deformations; so design and selection of wheelchair cushions are based mostly on measuring sitting pressures. Our objective was to evaluate the influence of different commercial cushions on internal soft-tissue deformations under the ITs, using weight-bearing magnetic resonance imaging (MRI). We specifically compared muscle, superficial fat, and effective (muscle and fat together) tissue deformations while subjects (n = 10) sat on four cushions (two viscoelastic and two foam) and directly on a rigid support. Deformations were maximal in muscle tissue (mean ∼70%), twice more the amount than in fat (∼30%). Effective soft-tissue deformations were ∼50% to ∼60%. Although cushions mildly reduced muscle deformations in the order of 10%, theoretically, our interpretation suggests that this deformation level adds safe sitting time. This study demonstrated that weight-bearing MRI is applicable for evaluating wheelchair cushions and, in the future, may be a tool to systematically support cushion design and selection.

Original languageEnglish
Pages (from-to)31-42
Number of pages12
JournalJournal of Rehabilitation Research and Development
Volume47
Issue number1
DOIs
StatePublished - 26 Mar 2010
Externally publishedYes

Keywords

  • Bedsores
  • Decubitus
  • Deep tissue injury
  • Foam
  • Open MRI
  • Pressure sores
  • Pressure ulcer
  • Rehabilitation
  • Sitting pressures
  • Viscoelastic

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