A literature review of pressure ulcer prevention: weight shift activity, cost of pressure care and role of the occupational therapist

Introduction: Pressure ulcers are a major concern for those who spend a prolonged period of time sitting. Weight shifts are one prevention strategy used to reduce the risk of tissue damage. Currently, the prevalence of pressure ulcers is high, suggesting that concordance with preventative methods is poor. Occupational therapy focuses on the use of functional activity to promote health and wellbeing. The aim of this literature review was to evaluate the role of functional activity in reducing seated interface pressure. Method: A comprehensive search of nine electronic databases (AMED, CINAHL, Ovid MEDLINE, Sport Discus, EMBASE, British Nursing Index, Cochrane Library, Google Scholar and OTDBASE) was conducted between January 2000 and October 2011. Findings: From the 24 articles included in the review, there is limited evidence evaluating the role of functional activity and weight shifts in reducing seated interface pressure. Limited evidence suggests poor concordance with weight shifts, with wheelchair users repositioning on average once every 1-2 hours. The cost of pressure ulcer care is considerable, with an average annual cost of 1.7 pound billion in the United Kingdom. Occupational therapists have a key preventative role. Conclusion: Further research is needed to explore the role of functional activity and to determine the effectiveness of weight shift activity in reducing seated interface pressure.