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Titre : | Using Reactive Hyperemia to Assess the Efficacy of Local Cooling on Reducing Sacral Skin Ischemia Under Surface Pressure in People With Spinal Cord Injury: A Preliminary Report (2013) |
Auteurs : | Yih-Kuen Jan ; Liao Fuyuan ; Laura Rice ; et al. |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2013/10, 2013) |
Article en page(s) : | pp. 1982-1989 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Escarre ; Rééducation et réadaptation ; Traumatismes de la moelle épinière |
Mots-clés: | Laser-Doppler Flowmetry ; Fluxmétrie laser Dopple ; Microcirculation ; Pressure Ulce ; Skin Temperature ; Température cutanée ; Spinal Cord Injuries ; Wavelet Analysis ; Analyse en ondelettes |
Résumé : |
Objectives To investigate the efficacy of local cooling on reducing sacral skin ischemia in a weight-bearing position, and to identify the underlying physiological mechanisms using wavelet-based spectrum analysis of reactive hyperemia in people with spinal cord injury (SCI). Design Repeated-measures and before-after trial design. Setting University research laboratory. Participants Wheelchair users with SCI with injury level between C4 and T5 (n=10) and able-bodied controls (n=10). Interventions Three protocols consisting of pressure without temperature changes, pressure with local cooling (Δt=−10°C), and pressure with local heating (Δt=+10°C) were tested. Each protocol consisted of a 10-minute baseline period, a 20-minute loading period at 60mmHg, and a 20-minute recovery period (reactive hyperemia). A 30-minute washout period was allowed between protocols. Main Outcome Measures A compound sensor head consisting of laser Doppler and heating and cooling probes was used to measure sacral skin blood flow and control skin temperature. Reactive hyperemic response to pressure and temperature stimuli was characterized in the time and frequency (metabolic [.0095.02Hz], neurogenic [.02.05Hz], and myogenic [.05.15Hz] components) domains. Results Pressure with local cooling resulted in a smaller reactive hyperemic response in both people with SCI and able-bodied controls as compared with pressure with local heating (P<.017 and pressure without temperature changes the smaller hyperemia was attributed to reduced metabolic neurogenic activities. people with sci showed an attenuated response in reactive> Conclusions This study supports the concept of using local cooling to reduce skin ischemia under surface pressure in people with SCI. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/archives-of-physical-medicine-and-rehabilitation |