Personalized modeling for real-time pressure ulcer prevention in sitting posture
Personalized modeling for real-time pressure ulcer prevention in sitting posture
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DOI：
10.1016/j.jtv.2017.06.002
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发表时间：
2018-02-01
影响因子：
2.5
通讯作者：
Payan, Yohan
中科院分区：
文献类型：
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作者：
Luboz, Vincent;Bailet, Mathieu;Payan, Yohan
对每个截瘫患者来说，压力性溃疡是一个重要的风险，也是一个重大的公共卫生问题。压疮是由于臀部软组织受到骨结构的过度压迫，尤其是坐骨和骶骨。目前的预防技术主要是基于日常皮肤检查，以发现红色斑块或损伤。然而，大多数压疮发生在体内，很难早期发现。估计软组织内部的应变可以帮助评估压疮的风险。受试者特异性生物力学模型可用于评估测量皮肤表面压力的内部应变。然而，一个真实的三维非线性有限元臀部模型，由于皮肤、脂肪和肌肉的组织材料不同，需要几分钟到几小时的时间来计算，因此无法在实时的日常预防环境中使用。在本文中，我们建议通过使用基于适当的压力和应变场正交分解的降阶建模技术（ROM）以及机器学习方法来优化这些计算。ROM允许在模型内部交互式地评估应变（即在不到一秒的时间内），以测量臀部以下的任何压力场。在我们的案例中，只有19种压力模式的变化模式，与评估应变场的全尺寸模拟相比，观察到误差偏差为1%。因此，这种简化的模型可能是在日常设置中交互式压疮预防的第一步。(C) 2017组织活力学会。Elsevier Ltd.出版。版权所有。
lschial pressure ulcer is an important risk for every paraplegic person and a major public health issue. Pressure ulcers appear following excessive compression of buttock's soft tissues by bony structures, and particularly in ischial and sacral bones. Current prevention techniques are mainly based on daily skin inspection to spot red patches or injuries. Nevertheless, most pressure ulcers occur internally and are difficult to detect early. Estimating internal strains within soft tissues could help to evaluate the risk of pressure ulcer. A subject-specific biomechanical model could be used to assess internal strains from measured skin surface pressures. However, a realistic 3D non-linear Finite Element buttock model, with different layers of tissue materials for skin, fat and muscles, requires somewhere between minutes and hours to compute, therefore forbidding its use in a real-time daily prevention context. In this article, we propose to optimize these computations by using a reduced order modeling technique (ROM) based on proper orthogonal decompositions of the pressure and strain fields coupled with a machine learning method. ROM allows strains to be evaluated inside the model interactively (i.e. in less than a second) for any pressure field measured below the buttocks. In our case, with only 19 modes of variation of pressure patterns, an error divergence of one percent is observed compared to the full scale simulation for evaluating the strain field. This reduced model could therefore be the first step towards interactive pressure ulcer prevention in a daily set-up. (C) 2017 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.