An Exploratory Analysis of The Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History - Supplementary Data

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Sonenblum, Sharon Eve
Measel, Megan
Sprigle, Stephen
Greenhalgh, John
Cathcart, John McKay
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Supplementary to
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. Data in the supplement is associated with 43 full-time wheelchair users with and without a history of pelvic pressure injuries. Their buttocks 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 pressure injury 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 than participants without a history of PrIs. 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. Presence of spasms and fewer years using a wheelchair were associated with leaner muscle. 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, as well as the role of intramuscular fat infiltration in PrI development may help our understanding of PrI aetiology. It may also lead to clinically-useful diagnostic techniques that can identify changes in adipose and biomechanical risk to inform early preventative interventions.
National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) - 90IF0120-01-00, Donations from Ride Designs and the Robert H. Graebe Foundation
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