Occupational Therapy's Role in Pressure Sore Management

Woman having occupational therapy

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When your loved one develops a pressure sore, your occupational therapist can play a critical role in his or her treatment.

However, each OT’s expertise in this particular area may vary. Some OTs dedicate their entire career to pressure sore management; some may only have a generalist’s knowledge.

This article aims to help you understand the possible scope of occupational therapy in providing screening and treatment for these wounds so that you can advocate for the best care possible for your loved one.

Why OT Can Be a Good Fit

Martina Tierney is an occupational therapist from Ireland, who has dedicated much of her 30-year career to specialized seating and pressure sore reduction. She created the Seating Matters chairs with a group of clinical peers and engineers.

Tierney says of an OT’s role: “An OT is uniquely trained to identify the holistic needs of the patient and provide a solution to meet the posture and pressure needs of the patient so as to prevent or reduce pressure ulcer incidence.

"As OTs our common goal is to increase a patient’s functional independence, we are all striving to reach our clinical goals and provide the greatest quality of life to patients as a result. When patients suffer a completely avoidable wound such as a pressure ulcer this can dramatically increase their recovery period and often leads to bed rest being the only option—as we all know, prolonged bed rest has significant negative psychological and physical side effects on a patient and their ability to perform tasks is diminished.”

OT Training in Pressure Sore Management

The accreditation standard for OT schools in the US is that its students have a generalist’s knowledge of OT settings and entry-level competency in OT delivery. At the very least, your OT should understand the nature of pressure sores and how the patient’s participation (or lack of participation) in activities contributed to the development of the sore and how the injury may be limiting their participation in day-to-day living

Many OTs who work in settings where pressure sores are prevalent will quickly gain more knowledge simply through experience. They may also participate in continuing education and conduct independent research on the topic. Some OTs may go on to become certified in areas related to pressure sores such as a Seating and Mobility Specialist (ATP/SMS).

The best way to learn about your OT’s experience is to start by asking them. You can learn the basics to help get that conversation going.

Possible OT Interventions

Occupational therapists can be involved in pressure sore management from the initial assessment of risk to treatment and follow-up. Here are some common interventions:

  • Assess the root cause of the sore, especially how the patient’s participation (or lack of participation) in activities contributed to the development of the sore
  • Assess how the pressure sore may be limiting their participation in day-to-day living and quality of life
  • Provide wound care
  • Recommend wheelchairs, cushions, mattresses, and other equipment
  • Provide education to clients and family members about pressure sore management
  • Provide treatment for managing incontinence (as moisture can be a major contributor to pressure sore development)
  • Assess nutritional intake
  • Set a schedule for repositioning/mobility and implement a strategy for it to be carried out
  • Provide education and support to staff

Is OT Effective?

OTs are involved in what is known as conservative management of pressure ulcers, which is especially effective for pressure ulcers caught in the early stages.

As pressure sores are such pervasive issues, hopefully, we continue to see new research come out on the manner, especially pertaining to the effectiveness of specific OT interventions.

“Tierney, one of the pioneers in this research, explains, “A clinical trial that I was involved in with the Ulster University has proven that proper seating can reduce pressure ulcers by 88.3% in just 12 weeks—by applying the Four Principles of Pressure Management in Seating—load the body, provide postural support, allow effective repositioning and use a proper cushion.” 

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