A specialist seating assessment clinic: changing pressure relief practice

Abstract

Study design: Description of a clinical service, evaluation of pressure relief practices.

Objectives: To describe a specialist seating assessment clinic and a change in clinical practice arising from its work.

Setting: National Spinal Injuries Centre, Stoke Mandeville Hospital, UK.

Methods: Retrospective review of the ischial transcutaneous oxygen measurements of 50 newly injured and chronic spinal cord-injured (SCI) individuals seen in a specialist seating assessment clinic. Tissue oxygenation was measured in the sitting position (loaded) and during pressure relief (unloaded).

Results: Mean duration of pressure relief required to raise tissue oxygen to unloaded levels was 1 min 51 s (range 42 s-3 min 30 s).

Conclusion: These results confirmed the clinical perception that brief pressure lifts of 15-30 s are ineffective in raising transcutaneous oxygen tension (TcPO(2)) to the unloaded level for most individuals. Sustaining the traditional pressure relief by lifting up from the seat for the necessary extended duration is neither practical nor desirable for the majority of clients. It was found that alternative methods of pressure relief were more easily sustainable and very efficient.