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    A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries.

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    Authors
    Liu, Liang Q.
    Moody, Julie
    Dyson, Sue E. cc
    Traynor, Michael
    Gall, Angela
    Issue Date
    2014-06-26
    
    Metadata
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    Abstract
    Context: Electrical stimulation (ES) can confer benefit to pressure ulcer (PU) prevention and treatment in spinal cord injuries (SCI). However, clinical guidelines regarding the use of ES for PU management in SCI remain limited. Objectives: To critically appraise and synthesize the research evidence on ES for PU prevention and treatment in SCI. Method: Review was limited to peer-reviewed studies published in English from 1970 to July 2013. Studies included randomized controlled trials (RCTs), non-RCTs, prospective cohort studies, case series, case control and case report studies. Target population included adults with SCI. Interventions of any type of ES were accepted. Any outcome measuring effectiveness of PU prevention and treatment was included. Methodological quality was evaluated using established instruments. Results: Twenty-seven studies were included, 9/27 studies were RCTs. Six RCTs were therapeutic trials. ES enhanced PU healing in all eleven therapeutic studies. Two types of ES modalities were identified in therapeutic studies (surface electrodes, anal probe), 4 types of modalities in preventive studies (surface electrodes, ES shorts, sacral anterior nerve root implant, neuromuscular electrical stimulation implant). Conclusion: The methodological quality of the studies was poor, in particular for prevention studies. A significant effect of ES on enhancement of PU healing is shown in limited Grade I evidence. The great variability in ES parameters, stimulating locations and outcome measure leads to an inability to advocate any one standard approach for PU therapy or prevention. Future research is suggested to improve the design of ES devices, standardize ES parameters and conduct more rigorous trials.
    Citation
    Liu, Liang Q. and Moody, Julie and Dyson, Sue E. and Traynor, Michael and Gall, Angela (2014) A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries. Journal of Spinal Cord Medicine, 37 (6).
    Journal
    Journal of Spinal Cord Medicine
    URI
    http://hdl.handle.net/10545/622792
    DOI
    10.1179/2045772314Y.0000000226
    Additional Links
    http://eprints.mdx.ac.uk/13284/
    Type
    Article
    ISSN
    1079-0268
    ae974a485f413a2113503eed53cd6c53
    10.1179/2045772314Y.0000000226
    Scopus Count
    Collections
    Health and Social Care Research Centre

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