Invacare Matrx Libra

Transcription

1 Invacare Matrx Libra Clinical Evidence

2 Introdction The Matrx Libra cshion is designed to optimise each of the following three featres, offering the highest level of skin protection and positioning, even for sers with previos or existing skin breakdown. Immersion The srface area on the Matrx Libra cshion is maximised thanks to its specially molded anatomical shape; incldes a contored pelvic well, a waterfall front edge allowing fll length thigh spport withot compromising the popliteal area, and rear cshion radis for spport and contor behind the pelvis. Off-loading The pelvic well on the Matrx Libra has been designed with a raised trochanteric shelf to elevate the pelvis, prevent the ischial tberocities from bottoming ot throgh the flid sac and redistribting forces away from the sensitive bony prominences to the hips and thighs. Envelopment The Matrx Libra has a niqe three chamber flid sac that has been designed with Flo-tech technology; a lower continos section for maximm conformity and a divided top layer to prevent migration of the flid. The non-temperatre sensitive silicone flid provides a consistent performance in all climates and reqires no kneading or maintenance. The silicone flid provides exceptional dynamic shear redction. Cshion constrction 2 he Matrx Libra provides sperior postral spport and T stability, and reqires no ongoing maintenance in order to perform as designed. The foam base is constrcted of highly drable and lightweight HR foam made with Ultra-Fresh for antimicrobial and odor control. Three cover options are available to optimise micro-climate and moistre protection. 3

3 Adjstability Shear Management There are a nmber of accessories available that allow The Matrx Libra cshion to be modified (cstomised) to accommodate or correct postral isses or postral changes over time. The Matrx Libra cshion provides optimal shear redction by addressing both static and dynamic shear withot compromising postre. Dynamic: Flow of materials redces tension between bony prominences and tisses dring fnctional activities, wheelchair proplsion, and accommodates movement within a specific range. Static: Spport srface contor that prevents sliding and downward migration of the pelvis. Anterior (front) wedge(s) Tapered wedge(s) Use on both sides to help prevent sliding Use Use Use on one side only to facilitate foot contact on the low side and foot spport on the high side e.g. Hemiplegic client nder front corner to encorage addction Lateral (side) wedge(s) Can be sed to create a deeper contor nder rear corner to address pelvic obliqity Spplementary flid sac Secre by threading on to the lateral strap of the flid overlay and position on the trochanteric shelf (not in well) Can be sed to address pelvic obliqity alone or in combination with a tapered wedge, or bilaterally to create a deeper contor Clinical Evidence Several independent stdies have been completed over the past few years on the Matrx Libra cshion and we have highlighted them in this booklet, for ease of reference. Over the next few pages, yo will find an overview of each of the stdies mentioned below: 4 Assessment of the Change in State of Health in Reference to Di fferent Postral Spport Systems: Otcome of Research Evalation Libra of pelvis postral systems in spinal cord injry patients: Otcome of research Wheelchair Cshion Testing for PDAC Hman Sbject Test Adjstable Skin Protection and Positioning 5

4 Materials and methods 1 a Assessment of the Change in State of Health in Reference to Different Postral Spport Systems: Otcome of Research AUTHORS: Mariele Colcci, Rita DeSantis, Giovanni Galeoto and Maria Grazia Soave PUBLISHED: Sapienza Università, Di Roma DATE: 2014/2015 Stdy aim and design The main aim of this stdy was to nderstand how different wheelchair cshions (postral systems) may have an impact on sers occpational performance and how this affects the overall state of health and qality of life. The sbject poplation for this stdy inclded nine wheelchair sers (N=9; 55% males, 45% females) recrited at the Occpational Therapy Clinic of the Physiatrist Department of the General Hospital of Rome Umberto I. The sample selection was recrited regardless of their pathology, since the objective was to categorise wheelchair cshions based on their individal characteristics and highlight which one provided a good compromise regarding comfort, pressre redistribtion, stability, postre, lightness, temperatre, adaptability to movement and activities. This stdy considered the following cshions to be tested: Roho Contor Select (air cshion); (pre-shaped foam cshion with flid bag); Jay Balance (pre-shaped foam cshion with flid bag). A BodiTrak package and FSA system were sed to collect data in static and dynamic positions and register for each cshion test, per sbject, the following vales: minimm pressre, maximm pressre, average between the varios points of the sensor, variance, standard deviation, variation coefficient (in percent), horizontal and vertical pressre centre (in centimetres). A postral assessment considering the clinical sitation and needs of the sbject was carried ot to collect a series of data that inclded the diagnosis, skin condition, possible srgeries, se or not of orthoses or braces, cognitive aspect, visal-aditory characteristics and how transfers are performed. Sbjects seated position in the wheelchair was also analysed, sing the following anatomical points and postre as a reference: pelvis, sholder girdle and pper limbs, torso and lower limbs. A specific Postral Assessment Form was sed to register all this data. SF-12 was sbmitted three times to each sbject (after the weekly trial of each cshion) to assess the impact of each wheelchair cshion on the state of health (from a physical and mental viewpoint). To complete the wheelchair cshion assessment, a qestionnaire was formlated sing the sbject at the centre of the decision-making process, by researching his/ her opinion regarding: Stability Temperatre (perspiration and accmlation of heat) Adaptability to movement and activities Ease of transfers wheelchair-bed/ bed-wheelchair Stability dring limited personal hygiene activities (shaving/applying makep, face washing and tooth brshing) For each parameter, an opinion was reqested based on the following scale: Completely Satisfied; Fairly Satisfied; Not Sre; Fairly Unsatisfied; Completely Unsatisfied. Table 1 - Overview of the 4-week trial process FIRST MEETING SECOND MEETING THIRD MEETING FOURTH MEETING Project presentation; Signing of informed consent regarding generic risks and personal data processing. Postral assessment in seated and spine position. First cshion test: Pressre-mapping data collection of the cshion in static state and in dynamic state on a 40 m straight line; Observation of seated postre after the activity. Compiling qestionnaires relevant to the degree of satisfaction and health state for the cshion sed dring week 1. Tested cshion retrned. Second cshion test: Pressre-mapping data collection of the cshion in static state and in dynamic state on a 40 m straight line; Observation of seated postre after the activity. Compiling qestionnaires relevant to the degree of satisfaction and health state for the cshion sed dring week 2. Tested cshion retrned. Third cshion test: Pressre-mapping data collection of the cshion in static state and in dynamic state on a 40 m straight line; Observation of seated postre after the activity. Compiling qestionnaires relevant to the degree of satisfaction and health state for the cshion sed dring week 3. Tested cshion retrned. Data collection on sbjects opinions on the different cshions sed for the test. 6 7

5 Key reslts Pressre reading b Postral assessment Table 2 and 3 shows the average pressre readings of the three cshions in two different sitations. Static (data measred after 30 seconds from sitting on the srface) and Dynamic (data measred dring proplsion). The application of a Postral Assessment form, focsed on several points (e.g. sbject general data collection, nerological profile; mobility eqipment sed). Table 4 otlines the average body alignment of sbjects body segments, with each cshion, while seated on the wheelchair. Table 2 Average pressre exercised on the three cshions after 30 seconds from sitting on the srface. Roho Contor Select Invacare Matrx Libra Average Pressre (mmhg) (SD 7.21) (SD 10.53) Horizontal Pressre Centre (cm) (SD 1.65) Vertical Pressre (cm) (SD 5.05) (SD 2.62) (SD 4.56) (SD 2.35) (SD 4.38) Table 3 Average pressre exercised on the three cshions dring proplsion. Average Pressre (mmhg) Horizontal Pressre Centre (cm) Vertical Pressre (cm) Table 4 - Average alignment of sbjects body segments. Roho Contor Select Invacare Matrx Libra Head 100% 100% 100% Sholders 55% 88% 77% Torso 44% 77% 77% Pelvis 11% 66% 55% Lower limbs 77% 77% 88% Jay Balance (SD 9.72) Roho Contor Select Invacare Matrx Libra Jay Balance (SD 11.27) (SD 12.75) (SD 10.36) (SD 1.49) (SD 1.44) (SD 1.49) (SD 4.87) (SD 4.27) (SD 4.38) Jay Balance State of Health (SF-12) Qestionnaire Table 5 smmarises the reslts achieved throgh the application of SF-12 Qestionnaire. Highest scores will mean better general health condition. Reslts show that was the cshion that performed better. Table 5 - SF-12 Qestionnaire reslts. SF-12 PCS (concepts relevant to physical morbidities) MCS (morbidities and psychological and mental etiologies) 8 was the cshion that scored best for the position of the pelvis, having a direct inflence on the position of spine, sholder and head. Roho Contor Select Invacare Matrx Libra Jay Balance (SD 10.29) (SD 8.89) (SD 11.16) (SD 4.01) (SD 7.01) (SD 8.05) 9

6 Wheelchair Cshion Sbject Satisfaction Qestionnaire Table 6 smmarises the average score achieved per item assessed. The highest score a cshion wold be able to achieve per item is 5 (completely satisfied) and 30 in total. achieved the highest average total score and stood ot for balance, body heat, adaptability to movement and activities, stability dring proplsion and A.D.L. Table 6 Wheelchair Cshion Sbject Satisfaction Qestionnaire reslts. Roho Contor Select Balance 3.22 ± ± ± 0.70 Body heat 3.88 ± ± ± 0.60 Adaptability to movement and activities 3.66 ± ± ± 1.13 Easiest transfer in/ot of wheelchair 4.00 ± ± ± 1.30 Stability dring proplsion 3.44 ± ± ± 0.70 Stability dring A.D.L ± ± ± ± ± ± 4.03 TOTAL Key findings c ostral analysis reslts indicated that the Matrx Libra P provided sperior pelvic and sholder alignment. Pressre mapping reslts were generally comparable between the prodcts evalated. Reslts also indicated that the sbjects postre was maintained better following activity on the Matrx Libra cshion. Regarding ser satisfaction following a one-week trial period on each 10 Jay Balance cshion, in every category, scores indicated greater ser satisfaction with the Matrx Libra cshion. It was reported that following the stdy period, seven of the nine sers indicated that they wold select the Matrx Libra cshion as their prodct of choice. Note: If yo wold like to have access to the fll stdy, please contact s. 11

7 2 Evalation of pelvis postral systems in spinal cord injry patients: Otcome of Research Key reslts Table 7 - Average pressre exercised on each cshion in static and dynamic position. The following tables resme the main reslts achieved by this stdy. b AUTHORS: Serena Dattoli, Mariele Colcci, Maria Grazia Soave, Rita De Santis, Leandro Segaletti, Cladia Corsi, Marco Tofani, Donatella Valente and Giovanni Galeoto. PUBLISHED: The Jornal of Spinal Cord Medicine, DOI: / DATE: 2018 Static Roho Contor Select Jay Balance Mean (mmhg) ± ± ± COP (cm) ± ± ± CVP (cm) ± ± ± Stdy aim and design a Dynamic Mean (mmhg) ± ± ± COP (cm) ± ± ± Compare three commercial wheelchair cshions to determine the best for treatment of patients sffering from spinal cord injry below the cervical spine. The sbject poplation for this stdy inclded 13 wheelchair sers (N= % males, 15.4% females) recrited at the Occpational Therapy Clinic of the Physiatrist Department of the General Hospital of Rome Umberto I and Occpational Therapy Clinic of CPO Hospital in Ostia. This stdy considered the following cshions to be tested: Roho Contor Select (air cshion); (foam cshion with flid bag); Jay Balance (foam cshion with flid bag). The design of this stdy was very similar to the one sed in Assessment of the Change in State of Health in Reference to Different Postral Spport Systems: Otcome of Research. Sbjects were sbmitted to a postral assessment, tried each cshion for one week and filled SF-12 and self-satisfaction qestionnaires. Boditrak and FSA system were sed to collect data for pressre-mapping. CVP (cm) ± ± ± Table 8 - Postral assessment reslts; percentage of how close each body segment was to the ideal postre. Roho Contor Select Jay Balance Head 91.7% 100% 100% Sholders 58.3% 91.7% 83.3% Torso 50% 66.7% 66.7% Pelvis 33.3% 50% 66.7% Lower limbs 83.3% 83.3% 91.7% 12 13

8 c Key reslts b Table 9 SF-12 Qestionnaire reslts. Roho Contor Select PCS (Physical Component Smmary) (SD 9.10) (SD 5) MCS (Mental Composite Score) (SD 10.06) SF (SD 9.03) Jay Balance (SD 9.4) (SD 9.11) Table 10 Qestionnaire reslts on sbjects satisfaction on sing the cshion. Roho Contor Select Stability 3.08 ± ± ± Temperatre 3.75 ± ± ± Adaptability to activities 3.50 ± ± ± ± ± ± ± ± ± ± 1 4 ± ± ± ± ± 0.t112 Transfers Stability dring ADL Stability in movement Total 14 Key findings ressre-mapping data in static and P dynamic positions sggests that a cshion composed with foam provides a better pressre distribtion. None of the cshions significantly changed the postral alignment pre and post-activity. Sbjects indicated they were less able to maintain stability with an air cshion. Dring the trial period, statistically significant differences showed that the Matrx Libra was considered the cshion that provided more stability. Based on the satisfaction qestionnaire reslts, sbjects showed more satisfaction by sing the Matrx Libra cshion compared to the others. Note: If yo wold like to have access to the fll stdy, please contact s. Jay Balance 15

9 3 Libra Wheelchair Cshion Testing for PDAC Hman Sbject Test Adjstable Skin Protection and Positioning AUTHORS: Miller, G and EC Service, Inc. DATE: 2014 Stdy aim and design Hman Sbject Pressre Mapping was condcted by an accredited lab EC Service Inc. to determine eligibility for Adjstable Skin Protection and Positioning coding (US Medicare). The sbject poplation for this stdy inclded ten volnteers - three amblatory and seven paraplegic (with different injry levels). The test was done nder controlled conditions with a BodiTrak pressre mat system (BT 1510 model with FSA software - version , calibrated to 300 mmhg) which was sed to collect pressre-mapping data. The test consisted of a comparison between a reference foam, a new Matrx Libra cshion and an aged Matrx Libra cshion. Two Matrx Libra cshions of each size were provided by the manfactrer and one of each size nderwent simlated aging (simlating 18 months of se). Once the appropriate size cshion was determined for each ser, they were adjsted to achieve the best fit possible sing accessories when necessary. Sbjects were transferred onto the cshion/pressre mat and the technician began recording the data. Each sbject was tested on the new and aged cshions, and on the reference foam (five trials with each). After data collection was complete, the following calclations were done: Peak Pressre Index - the average of the cells with the greatest sm of pressres Peak Pressre - the highest recorded reading on the pressre map or within a specified zone Average Pressre - the average of the entire pressre map or zone for sensors with a pressre greater than or eqal to 5 mmhg Contact Area - the area with pressre readings greater than or eqal to 10 mmhg a Key reslts b Table 11 - Peak Pressre Index (mmhg) For each Peak Pressre Index (PPI) test, the cell in the sacro-ischial zone with the highest pressre was identified, the greatest sm of pressres in the identified and adjacent cells were determined and the average of the five trials was calclated for each sbject. The average PPI on the test cshion is divided by the average PPI on the reference foam cshion and mltiplied by 100 to give the percentage comparison of peak pressre indexes. For adjstable/skin protection cshions, the comparative vales mst be less than 85%. Reslts showed that the Matrx Libra achieved a comparative pressre of 76.7% when new and 74.8% after aging. Volnteer New Aged Reference Foam ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± 30.3 AVERAGE % DIFFERENCE 76.7% 74.8% 16 17

10 Trsted Soltions, Passionate People Key reslts b Table 12 - Peak Pressre (mmhg) per sbject Volnteer New Aged Reference Foam ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± 37.2 Key conclsion This stdy has demonstrated that a Matrx Libra cshion performs better than standard reference foam. Reslts have also demonstrated that Matrx Libra cshion passed the reqirements for an adjstable skin protection and positioning cshion with a comparative pressre of 76.7% when new and 74.8% after ageing. c 18 ote: If yo wold like to have access to the fll stdy, N please contact s. 19

11 Invacare International GmbH Benkenstrasse Witterswil Switzerland Tel: Invacare International GmbH All rights reserved. All information qoted is believed to be correct at time of print. Matrx Libra Clinical Evidence - 07/2018