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Rehabilitation Practice and Science

Translated Title

半邊偏癱中風病人於股骨大轉子及薦椎骨在不同擺位之壓力分布

Abstract

Pressure ulcers frequently develop in hemiplegic stroke patients who are immobilized and bedridden. Common sites for pressure ulcers include the sacrum, greater trochanter of the femur, lateral malleolus, and the heel. Such ulcers cause extra burdens for the whole medical team, the caregiver, and the patients themself. The ulcers also increase more medical cost at the same time. Patients with pressure ulcers also become depressed and less motivated to undergo rehabilitation. The prevention of pressure ulcer formation has thus become an important issue among stroke patients.The most important factor in pressure ulcer formation is the direct pressure of the mattress on the skin. When the external pressure exceeds the capillary closing pressure, the tissue becomes ischemic and necrotic. Our study was designed to determine the external pressure applied to the skin of hemiplegic stroke patients at the greater trochanter of the femur and sacrum in different bed positions. The patient and control groups were positioned flat, semirecumbent (30, 60, and 80 degrees respectively), and bilateral side-lying. The pressure distributions were recorded and analyzed. The results revealed that, in the supine and semirecumbent positions, the pressure applied to the sacrum increased while the upright angle increased in hemiplegic patients. In the side-lying position, the pressure at the greater trochanter on the hemiplegic side was significantly higher than that on the unaffected side. These findings indicate that when hemiplegic stroke patients are in a semirecumbent position with an angle of more than 30 degrees or side-lying on the affected side, we should check the skin condition of the femoral greater trochanter and sacrum frequently to lower the incidence of pressureulcer.

Language

Traditional Chinese

First Page

175

Last Page

182

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