Skin blood perfusion (BP) changes under ischial tuberosity (IT) during gluteal neuromuscular stimulation (GNMS) in spinal cord injury (SCI)

Conference poster

Liu, L., Gall, A. and Ferguson-Pell, M. 2015. Skin blood perfusion (BP) changes under ischial tuberosity (IT) during gluteal neuromuscular stimulation (GNMS) in spinal cord injury (SCI). 18th Annual Meeting of the European Pressure Ulcer Advisory Panel. Ghent, Belgium 16 - 18 Sep 2015
TypeConference poster
TitleSkin blood perfusion (BP) changes under ischial tuberosity (IT) during gluteal neuromuscular stimulation (GNMS) in spinal cord injury (SCI)
AuthorsLiu, L., Gall, A. and Ferguson-Pell, M.
Abstract

Introduction: The IT is one of the most vulnerable site for pressure ulcer (PrU) development in SCI who use wheelchairs [1]. Previous studies suggest that decreased volume of blood in the tissues below the injury in SCI contributes to their susceptibility to PrU [2,3]. Electrical stimulation (ES) was reported to increase tissue blood flow in SCI [4,5]. Various techniques are available to measure tissue/skin blood parameters, yet most of them utilise rigid probes, which could potentially cause local tissue damage. Therefore we aimed to assess gluteal skin blood perfusion changes using a thin flexible optical probe during GNMS in seated SCI.
Methods: A total of 18 adults with suprasacral complete SCI were included. GNMS was delivered via sacral nerve root stimulation (SNRS) or surface ES. Skin BP was measured using a tissue reflectance spectrometer (TRS) to measure index of hemoglobin (IHB) and oxygenation (IOX) under the ITs. We used a two-tailed paired t-test to compare IHB and IOX before and during stimulations.
Results: The IHB and IOX during stimulation were significantly higher than baseline in 6 participants who had SNRS using magnetic stimulator (IHB 1.05±0.01 before vs. 1.08±0.01 during stimulation, P=0.03; IOX 0.18 ± 0.08 before vs. 0.46 ± 0.12, P=0.01 during stimulation). Similarly, the significant difference in IHB and IOX were obtained in 6 participants who had SNRS via a SARS implant (IHB (1.01 ± 0.01 before vs. 1.07 ±0.01 during stimulation, P=0.004), IOX (0.79±0.3 before vs. 2.2±0.5 during stimulation, P=0.03).
Although IHB and IOX increased in those 6 participants who had surface ES, the difference of both indices were not significant between baseline and during FES.(IHB 1.05 ± 0.003 before vs. 1.06 ±0.01 during stimulation, P=0.07, and oxygenation (IOX 0.59±0.19 before stimulation vs. 0.93±0.24 during stimulation, P=0.12).
Conclusion: SNRS or surface FES of gluteal muscles can induce sufficient gluteus maximus contraction and significantly increase skin blood perfusion.
Clinical relevance: Using such thin flexible probe has advantages of avoiding local tissue damage. Moreover, the SNRS via a SARS implant may be more convenient and efficient for frequently activating the gluteus maximus in SCI population for PrU prevention.

Conference18th Annual Meeting of the European Pressure Ulcer Advisory Panel
Proceedings Title18th Annual Meeting of the European Pressure Ulcer Advisory Panel
Publication process dates
Deposited25 Sep 2015
Accepted21 May 2015
Output statusPublished
Web address (URL)https://www.codan-consulting.com/en/wp-content/uploads/2016/05/EPUAP-2015-abstract-book_web-small.pdf
LanguageEnglish
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