Pressure ulcer in a man with tetraplegia and a poorly fitting wheelchair: a case report with clinical and policy implications.
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Biomedical subjects
Publications and source records attributed to M Batavia.
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BACKGROUND: The purpose of this study was to determine the effect of circumferential wrist pressure on reproduction accuracy of wrist placement in healthy young and elderly adults. A convenience sample of 20 young adults having a mean age of 22.9 years and 20 elderly adults with a mean age of 68.2 years participated in the study. METHOD: Blindfolded subjects were asked to actively self-select a neutral wrist position (reference) and then, when signaled, to actively reproduce the previously selected position. Wrist joint reproduction accuracy was assessed under four pressure conditions: no contact, wrist contact, 10 mm Hg, and 20 mm Hg. A single axis dynamic wrist electrogoniometer measured three dependent variables: absolute, constant, and variable errors. Data were analyzed by means of multivariate analysis of variance (MANOVA) for repeated measures. RESULTS: No significant differences in reproduction accuracy under the four pressure conditions for young or elderly adults were found. CONCLUSIONS: Healthy young and elderly adults may utilize existing intrinsic feedback and central control mechanisms to achieve accuracy during a reproduction task. Some subjects in both age groups who entered into the study with high error scores benefited from circumferential pressure by possibly relying on peripheral mechanisms. Further studies are needed to determine the effect of circumferential pressure on subjects with poor reproduction performance.
An augmented auditory feedback device is described. The device can be easily and economically constructed and implemented during a patient's physical rehabilitation. The rationale is to provide an external source of information to the user in order to correct errors during weight-bearing activities. Possible applications of the augmented auditory feedback device include increasing symmetry and weight distribution during sitting, standing, and gait. Instructions regarding its construction are provided, and a case study using the device is presented. Improved midline alignment and weight distribution in sitting for a 2-hour duration was achieved by a stroke patient using the augmented auditory feedback device in conjunction with physical therapy.