An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History

Aim: The goals of this study were 1) to identify the relationship between adipose (subcutaneous and intramuscular) characteristics and pressure injury (PrI) history in wheelchair users and 2) to identify subject characteristics, including biomechanical risk, that are related to adipose characteristi...

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Autores principales: Sharon Eve Sonenblum, Megan Measel, Stephen H. Sprigle, John Greenhalgh, John McKay Cathcart
Formato: article
Lenguaje:EN
Publicado: Frontiers Media S.A. 2021
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MRI
Acceso en línea:https://doaj.org/article/e5d8785ab768486d942d624ff1592ea2
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spelling oai:doaj.org-article:e5d8785ab768486d942d624ff1592ea22021-12-01T12:37:51ZAn Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History2296-418510.3389/fbioe.2021.753897https://doaj.org/article/e5d8785ab768486d942d624ff1592ea22021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fbioe.2021.753897/fullhttps://doaj.org/toc/2296-4185Aim: The goals of this study were 1) to identify the relationship between adipose (subcutaneous and intramuscular) characteristics and pressure injury (PrI) history in wheelchair users and 2) to identify subject characteristics, including biomechanical risk, that are related to adipose characteristics.Materials and Methods: The buttocks of 43 full-time wheelchair users with and without a history of pelvic PrIs were scanned in a seated posture in a FONAR UPRIGHT® MRI. Intramuscular adipose (the relative difference in intensity between adipose and gluteus maximus) and the subcutaneous adipose characteristics (the relative difference in intensity between subcutaneous adipose under and surrounding the ischium) were compared to PrI history and subject characteristics.Results: Participants with a history of PrIs had different subcutaneous fat (subQF) characteristics than participants without a history of PrIs. Specifically, they had significantly darker adipose under the ischium than surrounding the ischium (subQF effect size = 0.21) than participants without a history of PrIs (subQF effect size = 0.58). On the other hand, only when individuals with complete fat infiltration (n = 7) were excluded did individuals with PrI history have more fat infiltration than those without a PrI history. The presence of spasms (μ intramuscular adipose, 95% CI with spasms 0.642 [0.430, 0.855], without spasms 0.168 [−0.116, 0.452], p = 0.01) and fewer years using a wheelchair were associated with leaner muscle (Pearson Corr = −0.442, p = 0.003).Conclusion: The results of the study suggest the hypothesis that changes in adipose tissue under the ischial tuberosity (presenting as darker SubQF) are associated with increased biomechanical risk for pressure injury. Further investigation of this hypothesis, and the role of intramuscular fat infiltration in PrI development, may help our understanding of PrI etiology. It may also lead to clinically useful diagnostic techniques that can identify changes in adipose and biomechanical risk to inform early preventative interventions.Sharon Eve SonenblumMegan MeaselStephen H. SprigleStephen H. SprigleJohn GreenhalghJohn McKay CathcartFrontiers Media S.A.articleadiposepressure injurypressure ulcerMRIbiomechanical riskwheelchairBiotechnologyTP248.13-248.65ENFrontiers in Bioengineering and Biotechnology, Vol 9 (2021)
institution DOAJ
collection DOAJ
language EN
topic adipose
pressure injury
pressure ulcer
MRI
biomechanical risk
wheelchair
Biotechnology
TP248.13-248.65
spellingShingle adipose
pressure injury
pressure ulcer
MRI
biomechanical risk
wheelchair
Biotechnology
TP248.13-248.65
Sharon Eve Sonenblum
Megan Measel
Stephen H. Sprigle
Stephen H. Sprigle
John Greenhalgh
John McKay Cathcart
An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History
description Aim: The goals of this study were 1) to identify the relationship between adipose (subcutaneous and intramuscular) characteristics and pressure injury (PrI) history in wheelchair users and 2) to identify subject characteristics, including biomechanical risk, that are related to adipose characteristics.Materials and Methods: The buttocks of 43 full-time wheelchair users with and without a history of pelvic PrIs were scanned in a seated posture in a FONAR UPRIGHT® MRI. Intramuscular adipose (the relative difference in intensity between adipose and gluteus maximus) and the subcutaneous adipose characteristics (the relative difference in intensity between subcutaneous adipose under and surrounding the ischium) were compared to PrI history and subject characteristics.Results: Participants with a history of PrIs had different subcutaneous fat (subQF) characteristics than participants without a history of PrIs. Specifically, they had significantly darker adipose under the ischium than surrounding the ischium (subQF effect size = 0.21) than participants without a history of PrIs (subQF effect size = 0.58). On the other hand, only when individuals with complete fat infiltration (n = 7) were excluded did individuals with PrI history have more fat infiltration than those without a PrI history. The presence of spasms (μ intramuscular adipose, 95% CI with spasms 0.642 [0.430, 0.855], without spasms 0.168 [−0.116, 0.452], p = 0.01) and fewer years using a wheelchair were associated with leaner muscle (Pearson Corr = −0.442, p = 0.003).Conclusion: The results of the study suggest the hypothesis that changes in adipose tissue under the ischial tuberosity (presenting as darker SubQF) are associated with increased biomechanical risk for pressure injury. Further investigation of this hypothesis, and the role of intramuscular fat infiltration in PrI development, may help our understanding of PrI etiology. It may also lead to clinically useful diagnostic techniques that can identify changes in adipose and biomechanical risk to inform early preventative interventions.
format article
author Sharon Eve Sonenblum
Megan Measel
Stephen H. Sprigle
Stephen H. Sprigle
John Greenhalgh
John McKay Cathcart
author_facet Sharon Eve Sonenblum
Megan Measel
Stephen H. Sprigle
Stephen H. Sprigle
John Greenhalgh
John McKay Cathcart
author_sort Sharon Eve Sonenblum
title An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History
title_short An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History
title_full An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History
title_fullStr An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History
title_full_unstemmed An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History
title_sort exploratory analysis of the role of adipose characteristics in fulltime wheelchair users’ pressure injury history
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/e5d8785ab768486d942d624ff1592ea2
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