title: Effects of Electrical Stimulation on Risk Factors for Developing Pressure Ulcers in People with a Spinal Cord Injury: A Focused Review of Literature.
abstract: Pressure ulcers (PUs) are a common and serious problem for wheelchair users, such as individuals with a spinal cord injury (SCI), resulting in great discomfort, loss of quality of life, and significant medical care costs. Therefore, it is of utmost importance to prevent PUs. In this literature overview, the effects of electrical stimulation (ES) on the risk factors for developing PUs in people with an SCI are examined and synthesized from January 1980 to January 2015. Thirty-four relevant studies of PU prevention in SCI were identified. Four were randomized clinical trials, 24 were case series, 6 had other designs. Three types of ES modalities were identified. The methodological quality varied from poor to fairly strong, with a large variety in used ES parameters. Twenty-three studies were identified describing short-term effects of ES on interface pressure, oxygenation, and/or blood flow, and 24 studies described the long-term effects of ES on muscle volume, muscle strength, and histology. Whereas there is a lack of controlled studies on the effects of ES on PU incidence, which disallows definite conclusions, there is moderate evidence to suggest that ES-induced muscle activation has a positive influence on several risk factors for developing PUs in people with an SCI.
authors.affiliation: From the Amsterdam Rehabilitation Research Center | Reade, Amsterdam, the Netherlands (CAJS, SdG, TWJJ); Centre for Human Movement Sciences, University of Groningen University Medical Center, Groningen, the Netherlands (SdG); Meander Medical Center, Department of Rehabilitation Medicine, Amersfoort, the Netherlands (JMS-S); and MOVE Research Institute Amsterdam, Department of Human Movement Sciences, VU University, Amsterdam, the Netherlands (TWJJ).
authors.forename: Christof A J
authors.initials: CA
authors.lastname: Smit
authors.forename: Sonja
authors.initials: S
authors.lastname: de Groot
authors.forename: Janneke M
authors.initials: JM
authors.lastname: Stolwijk-Swuste
authors.forename: Thomas W J
authors.initials: TW
authors.lastname: Janssen
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000628:therapy; D016896:Treatment Outcome