Ultrasound shown to be a viable risk assessment tool for Deep Tissue Injuries
October 5, 2016 (St. Louis, MO.) A recent study concluded ultrasound (US) is a good, viable measurement method to assess anatomical structures and identify one of the key risk factors of deep tissue injury. The study authors believe ultrasound examinations hold the potential to develop a patient-specific, bedside biomechanical risk factor assessment tool to screen and classify risk level. The use of a hand-held ultrasound could help clinicians choose appropriate interventions, such as appropriate wheelchair cushions, or tilt and recline power wheelchairs to reduce the risk of deep tissue injury.
Medical Engineering and Physics published the study, “Feasibility of Freehand Ultrasound to Measure Anatomical Features Associated with Deep Tissue Injury Risk” in July, 2016. Dr. David Brienza, University of Pittsburgh, was the principle investigator for this study, with contributions from Dr. Amit Gefen, Tel Aviv University. The work was funded by a grant from ROHO, Inc. and Kara Kopplin, Senior Director of Efficacy and Research at ROHO, Inc. was the industry collaborator and co-author. Both Dr. Brienza and Dr. Gefen are members of ROHO’s Scientific Advisory Board, which Dr. Gefen chairs and Ms. Kopplin convenes. In addition, Dr. Emily Woods, D.C., ROHO Research Assistant, and Dr. Thomas Kramer, D.C. assisted in developing the ultrasound data collection methodology and feasibility in their St. Louis clinic.
The study shows that ultrasound can be used to easily see and measure a key patient-specific risk for deep tissue injury using ultrasound instead of seated MRIs, which are prevalent in the scientific literature. No previous studies have assessed the US as a risk assessment tool in comparison to the data from seated MRIs, which are currently the research standard.
Currently, seated MRIs are the standard research tools for assessing the risk of deep tissue injury from sustained compression of the soft tissues by the pelvic bones during sitting. An image is taken to capture the shape and thickness of the soft tissues and the pelvic bone structure, and the distortion of the tissues can be seen and measured during sitting. Additionally, biomechanical computer models can quantify the internal tissue stresses which contribute to deep tissue injury. However, this approach is not convenient or financially practical in the clinical setting. Ultrasound technology, in contrast, is more economical, more available, and can be used at the bedside or in the seating clinic.
The study analyzed the differences between the test modalities of MRI and US, and the differences of measurement outcomes. While the MRI images display the entire pelvic bone, the US shows only the portion of the bone that actually must be measured as one indication of DTI risk, describing the ‘sharpness’ of the bone surface. As a result, the US can “see” more clearly the physiological status of the patient in this important region of the body, underneath the ischial tuberosities, the ITs, or “sit bones.”
“ROHO, Inc. was pleased to partner with both the University of Pittsburgh and Tel Aviv University to conduct this study, which can provide an important bridge from academic research to a possible clinical risk assessment to ultimately help clinicians provide better, individualized solutions to wheelchair users and patients who chronically sit, thereby delivering better outcomes for value-based health care,” explained Kopplin.
Pressure injuries affect more than three million people a year in the U.S. alone, and 1 in 5 wheelchair users will develop a pressure injury. Deep tissue injuries are difficult to detect and the most likely to result in death. In fact, more people die each year in the U.S. from pressure injuries than car accidents. This risk can be minimized through early detection of this particular risk, which can lead to proper prescription and use of effective wheelchair and seat cushion solutions. Ultrasound can now be considered a “best practice” tool in early DTI detection for anyone who uses a wheelchair.
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ROHO®, a business unit of Permobil, has been committed to enhancing the lives of the physically challenged for over 45 years. ROHO fosters independence for individuals with limited mobility through the relentless advancement of shape-fitting, tissue protection solutions, so they may overcome everyday challenges and explore life without compromise.
Founded in Sweden, Permobil has its North American headquarters in Lebanon, Tennessee. Permobil acquired ROHO®, the global leader in skin protection and positioning solutions for individuals with disabilities, in April 2015 and TiLite, a leading manufacturer of innovative and customized manual wheelchairs, in May 2014. More information regarding Permobil’s storied history and complete product line may be obtained at www.permobil.com.
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-permobil’s founder Dr. Per Uddén 1967
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