Comparison of Cervical Range-of-Motion Restriction and Craniofacial Tissue-Interface Pressure With 2 Adjustable and 2 Standard Cervical Collars
| Autor: | Christine M. Austin, James W. Youdas, Savannah M. Zins, Lisa L. Douglas, Paul M. Huddleston, Mark A. Pichelmann, Aaron B. Rindflesch, Therese M. Jacobson, Ross W. Terman, Anne G. Miers, Brian D. Lahr, Adriana M. Delgado, Stephanie F. Heller, Ann N. Tescher |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Orthotic Devices medicine.medical_specialty Supine position Adolescent Collar Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Range of Motion Articular Aged Pressure Ulcer Orthodontics business.industry Repeated measures design 030208 emergency & critical care medicine Occiput Equipment Design Middle Aged Orthotic device Surgery medicine.anatomical_structure Cervical Vertebrae population characteristics Female Cervical collar Neurology (clinical) Range of motion business 030217 neurology & neurosurgery Cervical vertebrae |
| Zdroj: | SPINE. 41:E304-E312 |
| ISSN: | 0362-2436 |
| DOI: | 10.1097/brs.0000000000001252 |
| Popis: | STUDY DESIGN Randomized controlled trial. OBJECTIVE The aim of the study was to compare and contrast the restrictiveness and tissue-interface pressure (TIP) characteristics of 2 standard and 2 adjustable cervical collars. SUMMARY OF BACKGROUND DATA This study compared the restrictiveness and TIP of 4 commercially available cervical collars (2 standard and 2 adjustable). Adjustable collars offer potential advantages of individualized fit for patients and decreased inventory for institutions. The overall goal was to determine whether the adjustable collars provided the same benefits of cervical range-of-motion (CROM) restriction as the standard collars without increasing TIP and risk of pressure-related complications. METHODS A total of 48 adult volunteer subjects (24 men and 24 women) were fitted with 4 collars (Aspen, Aspen Vista, Miami J, and Miami J Advanced) in random order. Data collection included assessment of CROM restrictiveness and measurement of TIP on the mandible and occiput in upright and supine positions. The experimental, repeated measures design stratified the sample by body mass index (BMI) and sex. RESULTS All collars restricted CROM as compared with no collar (P ≤ 0.001 each). Aspen was more restrictive than Aspen Vista and Miami J in 4 movement planes (P ≤ 0.003 each), but not significantly different from Miami J Advanced. The Miami J standard collar was associated with significantly lower peak TIPs on all sites and in all positions compared with Aspen (P ≤ 0.001), Miami J Advanced (P < 0.001), and Aspen Vista (P = 0.01 for mandible site and upright position, P < 0.001 for remaining sites and positions). Increased peak TIP correlated with high BMI across all collar types, but was significantly lower for the Miami J collar than the Aspen collar. CONCLUSION All collars, compared with no collar, significantly restricted CROM. Although the collar-to-collar comparisons were statistically significant, the differences may have little clinical significance in the acutely injured trauma patient. The Miami J standard collar had the lowest overall TIP in both sites and positions. Ongoing effort should be devoted to staff education in proper sizing and fit, particularly for patients with high BMI. |
| Databáze: | OpenAIRE |
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