pregled literature
Rok Blatnik (Author), Darja Rugelj (Reviewer), Urška Puh (Mentor)

Abstract

Uvod: Invalidski voziček predstavlja pri večini pacientov z okvaro hrbtenjače primarno sredstvo za premikanje. Pritisk pri sedenju je še vedno glavni in najbolj pomemben razlog za nastanek razjed zaradi pritiska in slabšo kakovost življenja. Z uporabo funkcije nagiba sedežne enote in/ali naslonjala za hrbet ter antidekubitusnih blazin lahko pri sedenju zmanjšamo pritisk in s tem tveganje za nastanek razjed zaradi pritiska. Namen: Namen diplomskega dela je bil s pregledom literature ugotoviti učinke nagiba sedežne enote in/ali naslonjala za hrbet ter antidekubitusnih blazin v invalidskem vozičku na pritisk in prekrvavitev pri pacientih z okvaro hrbtenjače in zdravih ljudeh. Metode: Narejen je bil pregled literature v podatkovnih zbirkah PubMed (MEDLINE) in CINAHL. Rezultati: V pregled je bilo vključenih 19 raziskav. V devetih so preučevali učinke nagiba sedežne enote in/ali naslonjala za hrbet in v sedmih raziskavah učinke antidekubitusnih blazin. V treh raziskavah so preučevali učinke nagiba ter učinke antidekubitusnih blazin. Izsledki kažejo, da na zmanjšanje pritiska vplivata nagib sedežne enote 20° od horizontalne ravnine navzgor ter nagib naslonjala za hrbet 120° od horizontalne ravnine navzgor. Povečanje nagiba sedežne enote ne vpliva na povečanje pritiska na področju križnice. Povečanje prekrvavitve na področju sedničnih grč se v koži doseže z nagibom sedežne enote 15° ter v mišicah z nagibom sedežne enote 25 ali 35° v kombinaciji z nagibom naslonjala 120°. Z razbremenitvijo, ki traja 3 min se doseže višji krvni pretok v primerjavi z 1 min. Iz rezultatov je prav tako mogoče razbrati, da blazine napolnjene z zrakom najbolj učinkovito znižajo in razporedijo pritisk ter se prilagodijo na spremembo položaja sedenja. Sklep: Z nagibom sedežne enote 20° se doseže prvo pomembno zmanjšanje pritiska. Nagib sedežne enote 35° je najmanjši nagib pri katerem se najvišji povprečni pritisk približa vrednosti 60 mmHg, ki je bila določena kot zgornja mejna vrednost za nastanek razjed zaradi pritiska. Izboljšanje prekrvavitve na področju sedničnih grč je prvič prisotno pri nagibu sedežne enote 15°. Blazine polnjene z zrakom so v primerjavi s preostalimi blazinami najbolj zmanjšale pritisk, kljub temu pa so vrednosti najvišjih povprečnih pritiskov v pokončnem sedečem položaju na teh blazinah še vedno presegale mejno vrednost pritiska za nastanek razjed.

Keywords

diplomska dela;fizioterapija;okvara hrbtenjače;zmanjšanje pritiska;nagib sedežne enote;nagib naslonjala za hrbet;antidekubitusne blazine;razjede zaradi pritiska;prekrvavljenost tkiva;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [R. Blatnik]
UDC: 615.8
COBISS: 5333099 Link will open in a new window
Views: 1165
Downloads: 549
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Other data

Secondary language: English
Secondary title: Effect of tilt, recline and wheelchair cushions in patients with spinal cord injury and healthy people
Secondary abstract: Introduction: Most patients with spinal cord injury use a wheelchair as their primary means of mobility. When sitting, the pressure still represents the main and most important reason for pressure ulcers formation and low quality of life. By using the tilt in space and/ or back recline functions and wheelchair cushions, the pressure can be reduced when sitting and thus the risk of tissue collapse. Purpose: The aim of literature review was to investigate the effect of tilt in space and/or back recline functions and wheelchair cushions on pressure relief and blood flow in patients with spinal cord injury and healthy people. Methods: The literature review was conducted by obtaining articles in databases PubMed (MEDLINE) and CINAHL. Results: 19 studies were included in the review. In nine studies the effects of tilt in space and/ or back recline functions, and in seven studies the effects of wheelchair cushions were investigated. All three variables were investigated in three studies. The reduction of pressure was achieved by 20° of tilt and 120° recline from the horizontal plane in posterior direction. Increase in tilt angles had no effect on pressure at the sacrum area. Increase in skin perfusion was achieved by 15° of tilt and increase in muscle perfusion by 25 or 35°of tilt in combination with 120° recline. Three minutes long unloading session was more affective in increasing blood flow than one minute. Air cushions were more effective at pressure relief, pressure redistribution and were more efficient in decrease of adverse effects of sitting posture on pressure distribution. Conclusion: The first significant reduction in pressure is achieved by 20° of tilt. At 35° of tilt the maximum mean pressure gets closer to 60 mmHg which is frequently used as a threshold for tissue damage. 15° of tilt enhances skin perfusion over ischial tuberosity. Air cushions are most effective to relief pressure but the values of maximum mean pressure in upright seating position still exceeds 60 mmHg.
Secondary keywords: diploma theses;physiotherapy;spinal cord injury;pressure relief;tilt-in-space system;reclining system;wheelchair cushions;pressure ulcers;tissue perfusion;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Dipl. delo (bolonjski študij), Univ. v Ljubljani, Zdravstvena fak., Oddelek za fizioterapijo
Pages: 35 str.
ID: 10909712