Study on the Changes of Voiding Methods of Patients with SCI after Discharge: Focusing on the Patients Participating in the Regular Urinary Tract Surveillance Program

OBJECTIVE: To examine how consistently patients with spinal cord injured (SCI) after discharge use the clean intermittent catheterization (CIC). METHOD: The participants were 146 SCI patients hospitalized for regular urinary tract surveillance program, who resided in a community for over one year after discharge. The mean age was 40.3 years old and the mean time after injury was 6.2 years, consisted of 118 males and 28 females, and of 68 tetraplegics and 78 paraplegics. RESULTS: At discharge, the CIC as a voiding methods was used by 97 patients, Valsalva or reflexic voiding by 43, indwelling catheterization by 3, and diaper voiding by 3. Atfollow-up, CIC was used by 96, Valsalva or reflexic voiding by 37, indwelling catheterization by 7, and diaper voiding by 6. Among 97 patients who used CIC at discharge, 83 consistently used the CIC (compliance=85.5%). The patients with tetraplegia showed 82.9% of compliance while the patients with paraplega showed 88.0% of compliance, but there was no statistical difference. CONCLUSION: The compliance with the CIC method was comparatively high (85.5%). The CIC method can be effectively applied to the management of neurogenic bladder for the SCI patients residing in a community after discharge.

The Effects of Pressure Relief Methods at Wheelchair Seated Spinal Cord Injured Patients

OBJECTIVE: To find most effective pressure relief method in wheelchair seated spinal cord injured patients and to evaluate effectiveness of trunk lateral bending, trunk pulling and trunk forward flexion methods in practical environment METHOD: Twenty spinal cord injury patients were included in this study. After 5 cm air-filled cushion (ROHO(R)) was placed on wheelchair seat, patients were seated on wheelchair with neurtal position and interface pressure of buttock was measured by X-sensor 4.0 system. Patients took a posture lateral bending, trunk pulling, forward flexion methods. Mean and maximal pressure of buttock were measured at each pressure relief methods. RESULTS: Mean and maximal pressure of buttock were reduced by 90degrees trunk forward flexion (p<0.05). In trunk lateral bending method, pressure was reduced in non-weight bearing side of buttock, but pressure was highly elevated in weight bearing side. In trunk pulling method, pressure was elevated in both weigth bearing and non-weight bearing side. CONCLUSION: 90degrees trunk forward flexion method can be recommended to wheelchiar seated spinal cord injured patients for pressure relief of buttock.