Continuous pressure monitoring of inpatient spinal cord injured patients: implications for pressure ulcer development

Abstract

Study design: Cohort observational study. Objectives: To examine the movement profiles of individuals with spinal cord injury (SCI) during their inpatient rehabilitative phase using continuous pressure monitoring (CPM), evaluating the trends in those with skin damage. Setting: SCI specialist rehabilitation centre in the United Kingdom. Methods: Individuals with SCI (n = 12) were assessed using CPM in the bed and chair over a 24–72 h. Pressure data was used as a surrogate for movement using both nursing interpretation and an intelligent algorithm. Clinical features were obtained including participants age, injury level, ASIA score, co-morbidities and prescribed support surfaces. Trends between movement profiles (frequency and intervals), SCI demographics and observed skin damage were assessed using cross-tabulation and histograms. Results: The data revealed significant correlations (p < 0.05) between the nursing observation and algorithm for predicting movement, although the algorithm was more sensitive. Individuals with high level injuries (C1-T6) were observed to have a lower frequency of movement and larger intervals between movements when compared to low level injuries (T7-L5) during both lying and sitting periods. The individuals observed to have skin damage were predominantly those who had both a low frequency of movement and extended gaps between movements. Conclusions: Movements for pressure relief in both the bed and chair environments were dependent on the level of injury in individuals with SCI during their inpatient rehabilitation. Distinct movement patterns corresponded with those who acquired skin damage, revealing the potential clinical applications for technologies to monitor PU risk and inform personalised care.