F-3-11-07
PRESSURE ULCERS AMONG HOSPITALIZED PATIENTS AT ISTANBUL PHYSICAL MEDICINE AND REHABILITATION (PMR) CENTER
GENCOSMANOGLU B., TURFAN M., DEMIREL G., BOZ S., BALCIK S. (Istanbul PMR Center, Istanbul, Turkey)
Purpose: The purpose of this study was to determine the characteristics of the hospitalized patients with pressure ulcers (PU) and evaluate these ulcers with respect to aerobic bacterial colonizations.
Method: Thirty patients with PU were investigated. Data was collected and analyzed with respect to age, gender, educational level, diagnosis, major risk factors, severity of ulcer and localization of ulcer. AU the PU were investigated for bacterial colonizations.
Results: There were 23 (77%) men and 7 (23%) women with a mean age of 35.1 years.
Spinal cord injury (SCI) was the most common diagnosis (83.3%) and compeleteness of the SCI was very high (84%). 48% of the SCI were thoracic lesions.
Twenty nine (96.6%) of the patients had PU at the early stages of their hospitalization. Twenty eight (93.3%) of them had mine incontinence and 26 (86.6%) had fecal incontinence.
Sacral region were the most common site for PU in our series (76.6%).
In 6 (20%) cases staphylococus aureus, in 5 (16.6%) cases E. Coli and in 8 (26.6%) cases more than one bacteria strains were isolated.
Conclusion: In our series PU were most commonly seen among SCI patients and there was a strong relationship between completeness of the lesion and PU formation.
Aerobic bacterial colonization was found in 90% of the cases.
We should give adequate emphasis to prevention of PU as a secondary complication of hospitalized patients with activity limitations.
F-3-11-08
NEW MEDIALLY-MOUNTED MOTOR-DRIVEN HIP JOINT FOR PARAPLEGICS
Shigeru Sonoda (Tokyo Metropolitan Rehabilitation Hospital, Tokyo, Japan), Eiichi Saitoh (Fujita Health University, Aichi, Japan), Ryuzaburou Imahori, Yutaka Tomira, Tetsuo Ota, Naoichi Chino (Keio University, Tokyo, Japan)
A motor-driven orthosis for paraplegics has been developed. This orthosis is composed of a medially-mounted motor-driven hip joint and bilateral knee-ankle-foot orthosis with a polypropylene foot and Swiss-lock type knee joint. The infinite axis of the hip joint of this orthosis is almost as high as the anatomical hip joint using the gear mechanism.
A paraplegic patient with an injury level of L1 walked using bilateral lofstrand crutches and this new orthosis with or without the motor system. The motor is initiated by pushing the button attached at the edge of the grab of the crutches. A longer stride width, faster speed and smaller rotation angle of the trunk was obtained in motor walking compared with non-motor walking. Although adding the motor may increase instability, the patient did not feel fearful of falling.
In comparison with the functional electrical stimulation (FES) that has been applied to paraplegics, motor orthosis has some advantages in walking in paraplegic patients. It can be used even in patients with lower motor lesions, but is rather noisy. It can regulate the degree of hip flexion movement even in patients with spasticity. Thus, motor orthosis is an alternative means to enable paraplegics to walk.
