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A Randomized Clinical Trial of Wheeled Mobility for Pressure Injury Prevention and Better Function.

Abstract：

OBJECTIVES:To evaluate the effectiveness of wheelchair assessment and configuration on pressure injury incidence, mobility, and functioning in a wheelchair. DESIGN:Randomized controlled trial with participants individually randomized into intervention and control groups. SETTING:Nursing home. PARTICIPANTS:Nursing home residents aged 60 and older who used wheelchairs and were at risk for pressure injuries (N=258). INTERVENTION:Treatment and evaluation, individually configured wheelchair and skin protection cushion; control and evaluation, facility-provided wheelchair and skin protection cushion. MEASUREMENTS:Pressure injury incidence, Nursing Home Life Space Diameter score, Functioning Every Day in a Wheelchair-Capacity (FEW-C) score, and Wheelchair Skills Test (WST) score. RESULTS:No differences in pressure injuries (p=.77) were found. Pelvic rotation (odds ratio (OR)=0.15, 95% confidence interval (CI)=0.03-0.70, p=.02) and Day 14 WST skill score (OR=0.74, 95% CI=0.60-0.91, p=.004) were significant predictors of pressure injuries. Significant differences were observed between groups in change in FEW-C independence scores between before randomization and endpoint (p=.03) and before randomization and 14 days (p=.04). CONCLUSION:Participants with individually configured wheelchairs improved more in the safe and effective use of their wheelchairs than residents with facility-provided wheelchairs. The outcomes indicated that nursing home residents functioned safely at a higher level in their wheelchairs if their devices were individually configured using a comprehensive wheelchair and seating assessment process. There was no difference in the incidence of pressure injuries between the two groups. TRIAL REGISTRATION:NCT01275313.

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Brienza DM,Karg PE,Bertolet M,Schmeler M,Poojary-Mazzotta P,Vlachos H,Wilkinson D

doi

10.1111/jgs.15495

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

1752-1759

issue

9

eissn

0002-8614

issn

1532-5415

journal_volume

66

pub_type

杂志文章,随机对照试验

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