RESUMEN
BACKGROUND: Despite studies showing that gait is affected in adolescent idiopathic scoliosis (AIS), it remains unclear whether gait oxygen consumption is altered. RESEARCH QUESTION: The aims of the present study were to compare energy consumption during gait between subjects with AIS and healthy controls, and to examine the effect of brace use on gait energy expenditure. METHODS: This prospectively designed study included 15 AIS and 15 healthy girls, whose ages ranged from 10 to 16 years old and Cobb angles from 20 and 45°. At the end of the first month of brace use for the first time in individuals with AIS, oxygen consumption was measured with and without brace use on a treadmill at a gait speed of 4â¯km.h-1 using a metabolic analyzer. RESULTS: There was no statistically significant difference in gross and net gait oxygen consumption measurements between AIS and healthy individuals or between individuals with AIS with or without brace use (pâ¯>⯠0.05). SIGNIFICANCE: After one month of brace treatment, AIS is not associated with an additional metabolic load with or without the brace during gait when compared to healthy subjects.
Asunto(s)
Tirantes/provisión & distribución , Marcha/fisiología , Consumo de Oxígeno/fisiología , Escoliosis/complicaciones , Adolescente , Estudios de Casos y Controles , Niño , Femenino , Humanos , Masculino , Estudios ProspectivosRESUMEN
Cervical collars are necessary to stabilize the cervical spine of trauma patients but are known to contribute to the development of occipital pressure ulcers. A quality improvement project that began on one nursing unit stimulated the development of evidence-based practice guidelines and a multidisciplinary research study. As a result, a standardized plan of care and cervical collar recommendations were implemented, resulting in a sharp decline in the incidence of occipital pressure ulcers.
Asunto(s)
Tirantes/efectos adversos , Vértebras Cervicales/lesiones , Hueso Occipital , Úlcera por Presión/prevención & control , Gestión de la Calidad Total/organización & administración , Tirantes/provisión & distribución , Educación Continua en Enfermería , Diseño de Equipo , Medicina Basada en la Evidencia , Humanos , Inmovilización/efectos adversos , Inmovilización/instrumentación , Inmovilización/métodos , Incidencia , Difusión de la Información , Enfermeras Clínicas , Evaluación en Enfermería , Investigación en Evaluación de Enfermería , Personal de Enfermería en Hospital/educación , Planificación de Atención al Paciente , Grupo de Atención al Paciente , Guías de Práctica Clínica como Asunto , Úlcera por Presión/epidemiología , Úlcera por Presión/etiología , Factores de Riesgo , Cuidados de la Piel/métodos , Cuidados de la Piel/enfermería , Centros TraumatológicosRESUMEN
The rigid cervical collar has been a great addition to the successful management of cervical spine injuries. But the collar has been known to offer a false sense of security in terms of totally preventing additional and further spinal cord compromise and damage. Also, with increased length of collar wear, there is development of skin pressure points and ulcer formation, possible delay in weaning from a ventilator, potential for exposure to transmission of blood-borne diseases. Photographs are used to demonstrate examples of related skin breakdown, show proper collar fit, present the result of ineffective cervical immobilization, and show how to stabilize the head and neck during a collar change. These problem areas are addressed with the dos and don'ts for nursing management.