RCT on Wheeled Mobility for Preventing Pressure Ulcers

描述（由申请人提供）：摘要压疮是美国和世界各地越来越多的老年长期护理（LTC）居民面临的一个重大医疗保健问题。压力性溃疡降低生活质量，造成毁灭性的功能丧失，增加老年人群的死亡风险，并增加医疗保健费用。在美国，压疮的管理成本每年可能超过64亿美元，高风险LTC人群的患病率约为12%。在皮特，我们一直在研究座垫对压疮发病率的影响，并发现当皮肤保护座垫与适当安装的轮椅一起使用时，发病率显着降低。我们的数据现在使我们质疑是否有一个合适的轮椅也有显着影响压疮的发病率。为了调查这个问题，我们提出了一项新的研究，RCT轮椅2（RCT-WC 2），其中受试者将被随机分配到对照组，接受皮肤保护垫和轮椅训练，用于他们的设施提供的轮椅，或接受皮肤保护垫，轮椅训练和新的定制轮椅的治疗组。我们预计治疗组的压疮发生率较低。 公共卫生相关性：拟议的临床试验旨在证明轮椅在预防压疮（褥疮）方面的重要作用。虽然大多数压力性溃疡是可以预防的，但它们在疗养院很常见，因为它们的原因很难确定。拟议的试验，如果成功的话，将指导从业人员通过展示如何有效地应用轮椅和座垫技术来改善预防护理实践

DESCRIPTION (provided by applicant): Abstract 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