Long-Term Prevention of Pressure Ulcers in High-Risk Patients: A Single Case Study of the Use of Gluteal Neuromuscular Electric Stimulation Kath M. Bogie,

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Long-Term Prevention of Pressure Ulcers in High-Risk Patients: A Single Case Study of the Use of Gluteal Neuromuscular Electric Stimulation Kath M. Bogie, DPhil, Xiaofeng Wang, MS, Ronald J. Triolo, PhD Archives of Physical Medicine and Rehabilitation Volume 87, Issue 4, Pages 585-591 (April 2006) DOI: 10.1016/j.apmr.2005.11.020 Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 1 Percutaneous gluteal stimulation system. Archives of Physical Medicine and Rehabilitation 2006 87, 585-591DOI: (10.1016/j.apmr.2005.11.020) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 2 Unprocessed pressure data maps for static mode seated pressure distribution. Each image shows a representative interface pressure distribution at the cushion-subject interface (single frame from a 400-frame dataset). (A) Baseline, (B) initial daily use (postconditioning), (C) 6 months of daily use, and (D) 40 months of regular use. Images are orientated such that the thighs are toward to the left of the image and the right thigh toward the top. Each pixel corresponds to a calibrated interface pressure value (see legend). Archives of Physical Medicine and Rehabilitation 2006 87, 585-591DOI: (10.1016/j.apmr.2005.11.020) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 3 Unprocessed pressure data maps for dynamic mode seated pressure distribution (snapshots). Each image shows a representative interface pressure distribution at the cushion-subject interface (single frame from a 400-frame dataset). (A) Initial daily use, (B) 6 months of daily use, and (C) 40 months of regular use. Images are orientated such that the thighs are toward to the left of the image and the right thigh toward the top. Each pixel corresponds to a calibrated interface pressure value (see legend). Archives of Physical Medicine and Rehabilitation 2006 87, 585-591DOI: (10.1016/j.apmr.2005.11.020) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 4 LASR analysis maps for static mode seated pressure distributions showing areas of significant change over time, adjusted for simultaneous testing at multiple locations. (A) Baseline versus initial daily use (postconditioning), (B) initial versus 6 months of daily use, and (C) 6 months of use versus 40 months of use; (left) difference map, (right) FDR P maps. Archives of Physical Medicine and Rehabilitation 2006 87, 585-591DOI: (10.1016/j.apmr.2005.11.020) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 5 LASR analysis maps for dynamic mode seated pressure distributions showing areas of significant change over time adjusted for simultaneous testing at multiple locations (snapshots). (A) Initial use versus 6 months of daily use, and (B) 6 months of use versus 40 months of use; (left) difference map, (right) FDR P maps. Archives of Physical Medicine and Rehabilitation 2006 87, 585-591DOI: (10.1016/j.apmr.2005.11.020) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 6 Long-term changes in ischial region tissue oxygen level. Note the horizontal axis units are natural log (ln) months, thus maximum value 4.5=ln (90mo). Archives of Physical Medicine and Rehabilitation 2006 87, 585-591DOI: (10.1016/j.apmr.2005.11.020) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 7 Computed tomography scans of gluteal muscle thickness showing the transverse section through top of the head of the femur. (A) At baseline, maximum thickness of 9mm (left) and 10mm (right). (B) At 1-year follow-up, maximum thickness 14mm (left) and 17mm (right). (C) At 5-year follow-up, maximum thickness 16mm (left) and 17mm (right). Archives of Physical Medicine and Rehabilitation 2006 87, 585-591DOI: (10.1016/j.apmr.2005.11.020) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions