Safety and feasibility of Intermittent Electrical Stimulation for the prevention of Deep Tissue Injury
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Ahmetovic et al, 2015 [n=48; male and female] aimed to investigate the safety, feasibility, and acceptability of IES, for preventing DTI in different healthcare settings. Individuals at risk for DTI due to impaired sensation and decreased mobility were enrolled in the study. The IES system was comprised of a stimulator (Impulse EMS D7; Biomedical Life Sciences, Inc., Vista, CA) and self-adhesive 7.5×10 cm surface gel electrodes (Axelgaard Pals Platinum Neeurostimulation electrodes, Model 895340-4-40, Fallbrook, CA) applied either directly on the skin or through mesh pannels in a form-fitted garment. The stimulator, with a compliance voltage of 50 V and 100 mA through a 500-Ω resistor, was modified to include recording capabilities and safety features in case electrode shorting or peeling occurred. Trains of charge-balanced bi-phasic 300 μs pulses at 17.5 Hz with stimulation intensity sufficient to generate visibly fused muscle contractions were delivered to the gluteus maximus muscles on both sides of the buttocks for 10 s every 10 min. Each subject received IES 12 h a day, 4 days per week for 4 weeks or upon discharge. In cases where the participants chose to continue using the IES system beyond the designated period, regular skin monitoring was maintained. The authors conclude that the system proved to be safe and feasible in all clinical settings. No pressure ulcers were observed in any of the participants. The patients and caregivers did not find the application disruptive and indicated that the stimulation was acceptable as part of their daily routine in over 97% of the time.