Clinical Sciences/Health Conditions
Tian Yue Ding, MD
Medical resident
University of Saskatchewan / University of Montreal
Regina, Saskatchewan, Canada
Islam Krazdi, MSc, PhD candidate
PhD candidate
Université de Montréal
Montreal, Quebec, Canada
Jean-Marc Mac-Thiong, MD, PhD
Orthopedic Surgeon, Principal Investigator
Université de Montréal / Hôpital du Sacré-Cœur de Montréal / Centre Hospitalier Universitaire Sainte-Justine
Montreal, Quebec, Canada
Juan David Cifuentes Hernandez, MD
Clinical Fellow
Hôpital du Sacré-Coeur de Montréal (Quebec, Canada) / Unidad de Medicina Física y Rehabilitación, Clínica Las Américas (Medellin, Colombia) / Grupo de Rehabilitación en Salud, Universidad de Antioquia (Medellin, Colombia)
Montreal, Quebec, Canada
Natan Bensoussan, MD, MSc candidate
Physiatrist
Université de Montréal / Hôpital du Sacré-Cœur de Montréal
Montreal, Quebec, Canada
Andréane Richard-Denis, MD, MSc
Physiatrist, Principal Investigator
Université de Montréal / Hôpital du Sacré-Cœur de Montréal / Centre de recherche interdisciplinaire en réadaptation du Montreal métropolitain
Montreal, Quebec, Canada
Individuals with spinal cord injury (SCI) are at high risk for pressure injuries (PI), with reported incidence rates reaching 40% during acute and rehabilitation care. No objective physiological marker currently reflects at bedside tissue integrity or perfusion risk in this population. Regional tissue oxygen saturation (rSO₂), measured using near-infrared spectroscopy (NIRS), has shown reliability as an indicator of tissue perfusion in other clinical contexts. This study assessed changes in sacral and ischial rSO₂ following mobilization during acute SCI hospitalization.
Design:
A pilot prospective observational study included ten adults with acute SCI (AIS A–D) and ten healthy controls. rSO₂ was measured continuously using NIRS (validated error ±4%) at the sacrum and ischium as participants moved through three positions: supine, lateral decubitus, and supine. Readings were recorded every two seconds, and time to stabilization (stable rSO₂ for 1 minute) was measured after each position change. Descriptive analyses summarized demographic data and rSO₂ trends.
Results:
SCI patients (mean age 57.5 years; 9 males) and healthy controls (mean age 30.5 years; 8 males) showed rSO₂ fluctuations with mobilization. In patients, mean sacral rSO₂ increased from 64.6 ± 4.8% to 66.7 ± 4.3% during unloading (+2.1 ± 2.7%) and decreased slightly below baseline after return to supine (63.2 ± 4.3%, −1.3 ± 2.7%). Controls had higher baseline values (75.0 ± 5.8%) with smaller positional changes. Ischial rSO₂ showed minimal variation in both groups. Stabilization times were longer in patients (≈1 minute) than controls (< 45 seconds), particularly at the sacrum.
Conclusion:
Both groups exhibited rSO₂ changes with mobilization, but SCI patients demonstrated lower baseline oxygenation, smaller unloading responses, and delayed stabilization, suggesting altered vascular or autonomic regulation. This novel method could represent a promising bedside tool to quantify tissue perfusion and autonomic regulation to support PI prevention after acute SCI.
