Pressure mapping to assess seated pressure distributions and the potential risk for skin ulceration in a population of sledge hockey players and control subjects

Abstract

Purpose: Ice sledge (or sled) hockey is a fast-paced sport that enables individuals with physical disabilities to play ice hockey. As the attraction to the sport continues to rise, the need for developing better equipment and installing preventative measures for injury will become increasingly important. One such injury includes skin pressure ulceration. Method: A total of 26 subjects including active controls and those with spinal cord injury, multiple sclerosis, limb amputation and traumatic brain injury were studied using a pressure mapping device at the 2012 National Disabled Veterans Winter Sports Clinic to determine the risk for skin pressure ulceration and the impact of cushioning and knee angle positioning on seated pressure distributions. Results: Sledge hockey athletes may be at increased risk for skin pressure ulceration based on seated pressure distribution data. This experiment failed to demonstrate a benefit for specialty cushioning in either group. Interestingly, knee angle positioning, particularly, knee extension significantly lowered the average seated pressures. Conclusions: When considering the risk for skin pressure ulceration, knee angle positioning is of particular clinical importance. More research is warranted, specifically targeting novel cushion and sledge designs and larger groups of individuals with sensory loss and severe spinal deformities.

Implications for Rehabilitation

• Ice sledge (or sled) hockey is a fast-paced and growing adaptive sport played at the Paralympic level.

• Rehabilitation professionals should consider the potential for skin ulceration in this population of athletes.

• The effects of cushioning used in the sledge design warrants further investigation.

• Knee angle positioning; particularly, knee extension significantly lowers seated pressures and may reduce the potential for skin ulceration.

• Brain injury
• hockey
• multiple sclerosis
• paraplegia
• spinal cord injury
• sports
• tetraplegia
• veterans

Acknowledgements

This study was approved by the Department of Veterans Affairs Pittsburgh Health Care System Institutional Review Board.