Pressure ulcers are a significant healthcare problem for the growing number of older long-term care (LTC) residents in the United States and around the world. Pressure ulcers diminish quality of life, exact a devastating loss of function, increase the risk of death in geriatric populations and raise healthcare costs. Costs for the management of pressure ulcers in the US likely exceeds $6.4 billion annually, with a prevalence of approximately 12% in the high risk LTC population. At Pitt, we have been studying the effects of seat cushions on pressure ulcer incidence and have found that when a skin protection seat cushion is used with a properly fitted wheelchair there is a significant reduction in incidence. Our data has now led us to question whether having a properly fitted wheelchair also has a significant effect on pressure ulcer incidence. To investigate this question, we are proposing a new study, RCT Wheelchair 2 (RCT-WC2), in which subjects will be randomized into a control group that receives a skin protection cushion and wheelchair training for use in their facility supplied wheelchair, or a treatment group that receives a skin protection cushion, wheelchair training and a new custom-fitted wheelchair. We expect that the treatment group will have a lower incidence of pressure ulcers.

Public Health Relevance

The proposed clinical trial is aimed at demonstrating the important role wheelchairs play in preventing pressure ulcers (bed sores). Although most pressure ulcers can be prevented, they are common in nursing home settings because their causes are difficult to identify. The proposed trial, if successful, will guide practitioners toward improving preventive care practices by demonstrating how to effectively apply wheelchair and seat cushion technology

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD041490-09
Application #
8510687
Study Section
Special Emphasis Panel (ZRG1-MOSS-F (15))
Program Officer
Quatrano, Louis A
Project Start
2001-12-01
Project End
2015-07-31
Budget Start
2013-08-01
Budget End
2014-07-31
Support Year
9
Fiscal Year
2013
Total Cost
$503,848
Indirect Cost
$168,158
Name
University of Pittsburgh
Department
Physical Medicine & Rehab
Type
Schools of Allied Health Profes
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Brienza, David; Kelsey, Sheryl; Karg, Patricia et al. (2010) A randomized clinical trial on preventing pressure ulcers with wheelchair seat cushions. J Am Geriatr Soc 58:2308-14