Authors (including presenting author) :
Chan CW(1), Yip KT(2), Leung TY(1), Wong SY(2), Lam SL(2), Chiang KH(2), Lai WK(2).
Affiliation :
(1) Physiotherapy Department, Cheshire Home, Shatin, (2) Physiotherapy Department, Shatin Hospital
Introduction :
Cycle exerciser is a common physiotherapy modality to relieve spasticity, improve musculoskeletal function and promote cardiovascular fitness for chronic infirmary patients. Physiotherapist must be cautious in exercise safety because most of them had developed deformities, weakness, cognitive deficit and impaired skin sensation. Patients subject to pressure from abducted leg on side of the wheelchair, which increases with cycling motion. Rolled towels were applied as cushions to relieve the friction previously. However, towels might slip out during cycling motion. A continuous quality improvement programme had been implemented to prevent cycling related injury in Physiotherapy department of Cheshire Home, Shatin. Self-designed, and locally made foam paddings were used instead of rolled towels. The paddings had wipeable cover for easy cleansing and with velcro straps for better fixation.
Objectives :
A prospective study was carried out to assess the effectiveness of protective paddings in preventing cycling-related pressure injury. Feedbacks from staffs and patients regarding the paddings were collected.
Methodology :
Patients with risks of cycling related injury were identified by physiotherapists. The risks factors were abducted leg in sitting due to muscle weakness, spastic tone, contracture or joint deformities. Paddings were applied between leg and side of wheelchair. Incidence of cycling related pressure injury and number of utilizations of safety measure were counted for four months since April 2019. Convenience of application of the paddings was asked among physiotherapy staffs and patients were interviewed for their comfort.
Result & Outcome :
79 patients attended physiotherapy gymnasium session in the review period. No incidence of pressure injury related to fifteen to thirty- minute cycling exercise was noted. Twenty (25.3%) patients required paddings to prevent pressure injury. The paddings corrected the position of body part and biomechanics of joint mobilization. All physiotherapy staffs expressed that the paddings were easy to be applied and cleaned. Fourteen (70%) patients were communicable. They all felt comfortable with the protective paddings. As an improvement process, physiotherapist noted down patients who required the paddings on an exercise precaution sheet in routine practice to alert all physiotherapy staffs. The protective paddings can be further extended to be used and reviewed in other rehabilitation settings.
