Strains and stresses in sub-dermal tissues of the buttocks are greater in paraplegics than in healthy during sitting
Strains and stresses in sub-dermal tissues of the buttocks are greater in paraplegics than in healthy during sitting
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DOI：
10.1016/j.jbiomech.2007.10.011
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发表时间：
2008-01-01
影响因子：
2.4
通讯作者：
Gefen, Amit
中科院分区：
文献类型：
--
作者：
Linder-Ganz, Eran;Shabshin, Noga;Gefen, Amit
压力相关的深层组织损伤 (DTI) 是一种严重的压疮，始于骨突出（例如坐骨结节，IT）上方的肌肉组织，并通过脂肪和皮肤向外发展，瘫痪患者不会注意到。我们最近表明，可以通过将 Open-MRI 扫描与特定对象的有限元 (FE) 分析相结合来评估易受 DTI 影响的个体肌肉和脂肪的内部应变和应力（Linder-Ganz 等人，生物力学杂志，2007 年）；然而，文献中仍然缺少来自截瘫患者的皮下软组织拉伤/应力。我们假设截瘫者臀部的病理解剖结构增加了 IT 下的内部软组织负荷，使这些患者本质上容易受到 DTI 的影响。因此，我们使用耦合 MRI-FE 方法比较了 6 名健康人和 6 名截瘫患者的 IT 下臀肌和脂肪组织的应变和应力峰值。截瘫患者臀肌的峰值主压缩、主张力、von Mises 和剪切应变分别比健康人高 1.2、3.1、1.4 和 1.4 倍（p
A pressure-related deep tissue injury (DTI) is a severe pressure ulcer, which initiates in muscle tissue overlying a bony prominence (e.g. the ischial tuberosities, IT) and progresses outwards through fat and skin, unnoticed by the paralyzed patient. We recently showed that internal strains and stresses in muscle and fat of individuals at anatomical sites susceptible to DTI can be evaluated by integrating Open-MRI scans with subject-specific finite element (FE) analyzes (Linder-Ganz et al., Journal of Biomechanics, 2007); however, subdermal soft tissue strains/stresses from paraplegics are still missing in literature. We hypothesize that the pathoanatomy of the buttocks in paraplegia increases the internal soft tissue loads under the IT, making these patients inherently susceptible to DTI. We hence compared the strain and stress peaks in the gluteus muscle and fat tissues under the IT of six healthy and six paraplegic patients, using the coupled MRI-FE method. Peak principal compression, principal tension, von Mises and shear strains in the gluteus were 1.2-, 3.1-, 1.4- and 1.4-fold higher in paraplegics than in healthy, respectively (p