Epidemiologic Study on Clinical Features of Patient with Pressure Ulcer - A Prospective Study

OBJECTIVE: To investigate the characteristics, predictors, and consequences of pressure ulcers and to provide prospective epidemiologic data. METHOD: The prospective data of 100 patients with pressure ulcers were collected who were admitted to the department of rehabilitation medicine of 4 hospitals from 2002 June to 2003 September. We have collected the informations on clinical features of pressure ulcer prospectively. RESULTS: Quadriplegia/Tetraplegia was the most commonly involved type of injury, followed by hemiplegia, paraplegia. Most patients developed pressure ulcer before they were transferred to the rehabilitation unit. The average Braden scale scores was 13.06+/-3.46 and were 16 point or below in 80% of patients, and this point was considered as the cut-off score of the patients with high risk. Sacrum was the most common site of the ulcers and most ulcers were 2nd and 3rd stage. The ulcers were treated with conservative (82%) or surgical management (18%). The more severe and larger ulcers required the surgical management. CONCLUSION: The results of this prospective study on clinical features would be helpful for the understandings, prevention and management of pressure ulcers.

The Rigidity of Plastic Ankle-Foot Orthoses: Effect of Ankle Width

OBJECTIVE: This study was designed to analyse quantitatively the change in rigidity of plastic ankle foot orthoses (AFOs) corresponding with regulated ankle width and to find the appropriate ankle width for spastic ankles. METHOD: Five different plastic AFOs were fabricated according to the regulated ankle width. The resistance to dorsiflexion and plantar flexion movements was measured by bending the plastic AFOs at intervals of 2 degrees with the measuring device. Plantar flexion moments of hemiplegic spastic ankles were also measured. RESULTS: The rigidity of plastic AFOs increased nearly in proportion to the increase of the ankle width. The plantar flexion moments of hemiplegic spastic ankles increased in proportion to the severity of the spasticity. If the plastic AFOs would be used only for the prevention of toe dragging in swing phase, the ankle width of plastic AFOs could be reduced up to 60% which was enough to support the ankle in swing phase. CONCLUSION: These findings suggested that the degree of rigidity of plastic AFOs could be adjusted by trimming about the ankle to meet the individual patient's requirement. And this study could be helpful to quantify empirical approach of the prescription of plastic AFOs.