RCT on Wheeled Mobility for Preventing Pressure Ulcers

摘要压疮是美国和世界各地越来越多的老年长期护理（LTC）居民面临的一个重要的医疗保健问题。压疮会降低生活质量，导致毁灭性的功能丧失，增加老年人群的死亡风险，并提高医疗成本。在美国，每年用于压疮治疗的费用可能超过64亿美元，在高风险LTC人群中患病率约为12%。在皮特，我们一直在研究坐垫对压疮发病率的影响，并发现当皮肤保护坐垫与适当安装的轮椅一起使用时，发病率显著降低。我们的数据现在让我们质疑，一个合适的轮椅是否对压疮的发病率也有显著的影响。为了调查这个问题，我们提出了一项新的研究，RCT轮椅2 (RCT- wc2)，在这项研究中，受试者将被随机分为对照组，对照组接受皮肤保护垫和轮椅训练，以便在他们的设施提供的轮椅上使用，或者治疗组接受皮肤保护垫，轮椅训练和新的定制轮椅。我们预计治疗组的压疮发生率会较低。

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