| Deep tissue injury (DTI) is a particularly serious subtype of pressure ulcer that first starts in the muscle layers over bony prominences as a result of unrelieved loading. Intermittent electrical stimulation (IES) induced muscle contractions have shown potential for prevention of DTI through contraction induced pressure shift and tissue perfusion. As part of this thesis, we conducted a clinical safety and feasibility study of the IES system and found that it was generally safe, feasible and acceptable in long term care and rehabilitation hospital settings. Furthermore, I demonstrated that prolonged IES did not cause muscle fatigue in neurologically intact and subjects with spinal cord injury. The therapeutic benefit of IES is critically dependent on its ability to induce muscle contraction, and thus this is an important parameter to monitor to ensure optimal performance of the IES system. I found a linear relationship between peak twitch tension and peak to peak M-wave amplitude in neurologically intact and subjects with spinal cord injury, suggesting that electromyography may be a useful non-invasive technique for providing feedback in an adaptable IES system. This thesis work helps to lay the foundation for future effectiveness study and in the development of an intelligent stimulator. |
