RCT on Wheeled Mobility for Preventing Pressure Ulcers

描述(由申请人提供)：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问题。压疮降低了生活质量，造成毁灭性的功能丧失，增加了老年人口的死亡风险，并提高了医疗成本。在美国，压疮的管理费用每年可能超过64亿美元，在长期TC高危人群中的患病率约为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，发病率会显著降低。我们的数据现在让我们质疑，拥有一把合适的轮椅是否也对压疮的发生率有显著影响。为了研究这个问题，我们提出了一项新的研究，RCT轮椅2(RCT-WC2)，在该研究中，受试者将被随机分成对照组，接受皮肤保护垫和轮椅培训，以便在他们设施提供的轮椅上使用；或者治疗组，接受皮肤保护垫，轮椅培训和新的定制轮椅。我们预计，治疗组的压疮发生率将较低。 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(床疮)方面发挥的重要作用。尽管大多数压疮是可以预防的，但它们在疗养院环境中很常见，因为它们的原因很难确定。这项拟议的试验如果成功，将通过演示如何有效地应用轮椅和座垫技术来指导医生改进预防护理实践。

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