An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users' Pressure Injury History
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. T...
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Published in | Frontiers in bioengineering and biotechnology Vol. 9; p. 753897 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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29.11.2021
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Abstract | 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.
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.
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],
= 0.01) and fewer years using a wheelchair were associated with leaner muscle (Pearson Corr = -0.442,
= 0.003).
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. |
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AbstractList | 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. 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. 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. 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. 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], = 0.01) and fewer years using a wheelchair were associated with leaner muscle (Pearson Corr = -0.442, = 0.003). 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. |
Author | Greenhalgh, John Sprigle, Stephen H Measel, Megan Sonenblum, Sharon Eve Cathcart, John McKay |
AuthorAffiliation | 2 Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta , GA , United States 5 School of Health Sciences, Ulster University, Northern Ireland, Coleraine , United Kingdom 1 Rehabilitation Engineering and Applied Research Laboratory, The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta , GA , United States 4 FONAR Corporation, Melville , NY , United States 3 College of Design, Georgia Institute of Technology, Atlanta , GA , United States |
AuthorAffiliation_xml | – name: 1 Rehabilitation Engineering and Applied Research Laboratory, The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta , GA , United States – name: 3 College of Design, Georgia Institute of Technology, Atlanta , GA , United States – name: 5 School of Health Sciences, Ulster University, Northern Ireland, Coleraine , United Kingdom – name: 4 FONAR Corporation, Melville , NY , United States – name: 2 Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta , GA , United States |
Author_xml | – sequence: 1 givenname: Sharon Eve surname: Sonenblum fullname: Sonenblum, Sharon Eve organization: Rehabilitation Engineering and Applied Research Laboratory, The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States – sequence: 2 givenname: Megan surname: Measel fullname: Measel, Megan organization: Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States – sequence: 3 givenname: Stephen H surname: Sprigle fullname: Sprigle, Stephen H organization: College of Design, Georgia Institute of Technology, Atlanta, GA, United States – sequence: 4 givenname: John surname: Greenhalgh fullname: Greenhalgh, John organization: FONAR Corporation, Melville, NY, United States – sequence: 5 givenname: John McKay surname: Cathcart fullname: Cathcart, John McKay organization: School of Health Sciences, Ulster University, Northern Ireland, Coleraine, United Kingdom |
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Cites_doi | 10.33393/jcb.2020.2121 10.1007/s10439-011-0496-x 10.1155/2014/309570 10.1007/s00125-004-1637-7 10.4103/0970-0358.155260 10.4103/1673-5374.221170 10.4239/wjd.v6.i4.626 10.3390/nu5062019 10.1111/apha.13298 10.1152/ajpendo.00111.2013 10.1097/00002060-199603000-00004 10.1016/j.jtv.2020.01.004 10.1080/21623945.2018.1525252 10.1038/ijo.2013.200 10.1016/j.apmr.2018.11.006 10.1155/2012/753165 10.1002/j.2048-7940.1987.tb00541.x 10.1111/eci.12519 10.1016/j.jtv.2013.03.001 10.1007/s10237-014-0582-8 10.1016/S0029-6465(22)00099-8 10.3109/17483107.2011.580900 10.1093/ajcn/71.4.885 10.1016/j.jtv.2013.03.003 10.1152/japplphysiol.01035.2007 10.1126/scisignal.2001227 10.1097/01.asw.0000653152.36482.7d 10.1016/j.mcna.2006.05.018 |
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Copyright | Copyright © 2021 Sonenblum, Measel, Sprigle, Greenhalgh and Cathcart. Copyright © 2021 Sonenblum, Measel, Sprigle, Greenhalgh and Cathcart. 2021 Sonenblum, Measel, Sprigle, Greenhalgh and Cathcart |
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Keywords | pressure injury spinal cord injury wheelchair MRI adipose biomechanical risk pressure ulcer |
Language | English |
License | Copyright © 2021 Sonenblum, Measel, Sprigle, Greenhalgh and Cathcart. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Yi-Ting Tzen, University of Texas Southwestern Medical Center, United States Reviewed by: Jicheng Fu, University of Central Oklahoma, United States Anke Scheel-Sailer, Swiss Paraplegic Center, Switzerland This article was submitted to Biomechanics, a section of the journal Frontiers in Bioengineering and Biotechnology Edited by: Peter Pivonka, Queensland University of Technology, Australia |
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Snippet | The goals of this study were 1) to identify the relationship between adipose (subcutaneous and intramuscular) characteristics and pressure injury (PrI) history... Aim: The goals of this study were 1) to identify the relationship between adipose (subcutaneous and intramuscular) characteristics and pressure injury (PrI)... Aim: The goals of this study were 1) to identify the relationship between adipose (subcutaneous and intramuscular) characteristics and pressure injury (PrI)... |
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StartPage | 753897 |
SubjectTerms | adipose Bioengineering and Biotechnology biomechanical risk MRI pressure injury pressure ulcer wheelchair |
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Title | An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users' Pressure Injury History |
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