Evaluation of postural systems of the pelvis in a person with Limb-Girdle Muscular Dystrophy: results of the analysis of three cushions in the promotion of dynamic balance

Abstract

Introduction: Pressure ulcer cushions are specialised devices for pressure redistribution and management of tissue load and microclimate. They should maintain postural alignment, facilitate movement, create a stable base, relieve pain and be comfortable. They can be composed exclusively of one material such as foam, gel, air and fluid, or a combination of two or more of these materials. Research has focused on weight distribution and has neglected the dynamic behaviour of the cushion during everyday activities. Objectives: To evaluate the effectiveness in maintaining dynamic balance of three types of medium-high range cushions with different compositions. Material and Methods: Study with a female person with Girdle-Limb Muscular Dystrophy, using: a foam and air cushion (A), a foam and fluid bag cushion (B) and an air cushion (C). Data were collected in two moments: 1) anthropometric, kinematic and dynamic data collection, through direct measurement of reach, video recording and accelerometer, and pressures exerted on the cushions, employing a protocol of movements and cushion randomisation; 2) evaluation of user perception with a questionnaire and visual analogue pain scale, after four hours of staying on the cushion. Results: Cushion A revealed better results at the level of maximum reach, peak pressure in the initial position, coefficient of variation and mean pressure in frontal trunk flexion. Cushion B showed more positive results in the contact area, coefficient of variation and mean pressure in the initial position, peak pressure in frontal trunk flexion, acceleration variation and subjective analysis. Conclusion: The anti-sores cushions that combine two materials in their composition are more effective in promoting dynamic balance, with the advantage of the cushion composed of foam and fluid.