| Summary: | Introduction:
Pressure sores are the most common complication post spinal cord injury. Pressure sores of the sacral area commonly occur and often lead to patients being placed on bed rest. Bed rest periods delay rehabilitation, and may lead to other complications associated with immobility. Physiotherapy is crucial for these patients to decrease complications and increase function. This study set out to establish the treatment interventions physiotherapists provide to patients with sacral pressure sores and the factors that they take into consideration when deciding whether the patient should receive physiotherapy in bed (in the ward) or in the gym environment.
Methods:
This was a cross sectional survey administered to physiotherapists working in neurological rehabilitation units around South Africa that treat patients with spinal cord injuries. A self-administered questionnaire was used for data collection. The questionnaires were sent to all eligible physiotherapists via email. All the data was captured onto an excel spread sheet. Data collected were presented as frequencies and percentages with the aid of tables, pie charts and bar graphs as was appropriate.
Results:
Thirty-nine physiotherapists responded which showed a response rate of 76%.The majority of the respondents were female (98%). There were 11 rehabilitation facilities represented in the study with the majority of the respondents being from the private sector (69%) and 31% from the public sector. The most common practice for patients with sacral pressure sores is to be placed onto bed rest (98%). Nineteen physiotherapists stated that they did not have set protocols for the treatment of patients with sacral pressure sores. The most common physiotherapy interventions (70%) when the patient is on bed rest are upper limb strengthening, lower limb passive movements, positioning into prone and side lying as well as upper limb passive movements and passive stretching. The same were done when the patient was brought to the gym except that bed mobility training then also formed part of
common intervention as well as the use of the tilt table for passive standing. The treatment environment was dependant mostly on doctors’ orders and the size, grade and duration of the pressure sores. The choice of treatment techniques was guided mostly by past clinical experience or the successful experience of colleagues.
Conclusion:
There is a need for the development of standardised protocols when treating spinal cord injured patients with sacral pressure sores to possibly ensure maximal healing and rehabilitation.
Key words: Physiotherapy management of paraplegic patients, sacral pressure sores, bed rest
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