Development of Technologies to Increase In-Seat Movement to Prevent Sitting-Acquired Pressure Injuries in Wheelchair Users

开发增加座椅内运动的技术，以防止轮椅使用者发生坐姿压力损伤

• 批准号: 10289178
• 负责人: M. Susan Hallbeck
• 金额: $ 41.47万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10289178
• 关键词: Accelerometer; Administrative Supplement; Adult; Alzheimer' s Disease; Alzheimer' s disease care; Area; Assisted Living Facilities; Award; Behavior; Caregivers; Caring; Cellular Phone; Cessation of life; Clinic; Cohort Studies; Dementia; Development; Disease; Elderly; Feedback; Focus Groups; Funding; Future; Goals; Group Structure; Guidelines; Health; Health Care Costs; Health system; High Prevalence; Home; Incidence; Interview; Lead; Measurement; Measures; Methods; Minnesota; Monitor; Movement; Needs Assessment; Pain; Participant; Patient Care; Patients; Performance; Prevention; Process; Quality of life; Risk; Risk Reduction; Role; Sepsis; Site; Skin; Spinal Dysraphism; Spinal cord injury; Surveys; Symptoms; System; Tablets; Target Populations; Technology; Testing; Time; United States National Institutes of Health; Universities; Weight; Wheelchairs; Work; base; cognitive disability; decubitus ulcer; design; disability; effectiveness testing; empowered; experience; improved; injury prevention; mobile application; new technology; pressure; prevent; satisfaction; sensor; success; technology development; tool; usability; user centered design; visual feedback; wound healing

SUMMARY/ABSTRACT Adults with Alzheimer’s disease are at an increased risk of developing pressure injuries (commonly known as pressure ulcers). In a recent study by PI Sonenblum, 7% of adults with Alzheimer’s disease from a large EMR- based cohort study developed pressure injuries, and Alzheimer’s disease was the mobility related disability with the highest prevalence of pressure injuries behind spinal cord injury and spina bifida. Pressure injuries lead to high healthcare costs, further disability, decreased quality of life, pressure injury pain in older adults, and can result in death when sepsis is present. Wheelchair use is responsible for 36% to 50% of pressure injuries, and wheelchair use is common among adults with Alzheimer’s both living at home or in assisted living facilities. Further, the latest NPIAP/EPUAP guidelines highlight that older adults with Alzheimer’s disease and its related dementias continue to be under-assessed and under-treated for pressure injuries and related symptoms. Thus, there exists a need to improve the way we care for patients with Alzheimer’s disease who use wheelchairs to better prevent seating-acquired pressure injuries. A key component for the prevention of pressure injuries is minimizing prolonged pressure under the sacral, ischial, and sacrococcygeal areas through movement and shifting of the body. Our team has developed two novel technologies that provide feedback to increase body movement to prevent pressure injuries. Both systems (WiSAT and AW-Shift) utilize advanced sensors placed either under or atop a wheelchair cushion that communicate to a mobile application (app) that can be viewed by the wheelchair user and/or caregiver on a smart phone or tablet. The systems provide feedback to the user to motivate the performance of pressure relieving behaviors. Our current NIH funded project is testing the effectiveness of the two systems to improve pressure-reducing in-seat body movement in adults with spinal cord injury and related disorders. Both systems have gone through an extensive user- centered design process with wheelchair users without significant cognitive disability, and the systems have been tailored for personal use by the wheelchair user. We propose that these systems could have a significant role in improving the management the skin health of adults with Alzheimer’s disease who use or sit in wheelchairs for long periods of time. However, both systems need to be tailored to the needs of adults with Alzheimer’s disease and/or their caregivers. We propose to perform a thorough needs assessment of key stakeholders followed by a tailoring of the system to user needs. Finally, we will perform usability testing of both systems in the target population to determine the user experience and guide further development and testing.

摘要/摘要 患有阿尔茨海默病的成年人患压力性损伤的风险增加(俗称 压疮)。在Pi Sonenblum最近的一项研究中，7%的阿尔茨海默病患者来自大型EMR- 基于队列的研究发现了压力性损伤，阿尔茨海默病是与行动能力相关的残疾 压力性损伤患病率最高，仅次于脊髓损伤和脊柱裂。压力伤 导致高昂的医疗费用，进一步的残疾，生活质量下降，老年人的压力性损伤疼痛， 当出现脓毒症时可能会导致死亡。轮椅的使用造成了36%到50%的压力 伤害和轮椅使用在阿尔茨海默氏症成人中很常见，既住在家里，也住在辅助生活中 设施。此外，最新的NPIAP/EPUAP指南强调，患有阿尔茨海默病的老年人和 与其相关的痴呆症继续得不到充分评估和治疗，因为压力伤害和有关 症状。因此，有必要改善我们照顾阿尔茨海默病患者的方式 使用轮椅可以更好地防止座位获得性压力损伤。预防艾滋病的一个关键组成部分 压力性损伤通过以下途径最大限度地减少了骶骨、坐骨和骶尾部下的持续压力 身体的运动和移动。我们的团队开发了两项新技术，为 增加身体活动，以防止压力性损伤。这两个系统(WiSAT和AW-Shift)都使用高级 放置在轮椅垫下面或上面的传感器，它们与移动应用程序(APP)通信，该移动应用程序 可由轮椅使用者和/或护理者在智能手机或平板电脑上查看。这些系统提供了 反馈给用户，以激励压力释放行为的表现。我们目前由美国国立卫生研究院资助 该项目正在测试这两个系统的有效性，以改善减少压力的座椅内车身运动 成人脊髓损伤及相关疾病。这两个系统都经历了广泛的用户- 以轮椅使用者为中心的设计流程，没有明显的认知障碍，并且该系统具有 由轮椅使用者为个人使用量身定做。我们认为，这些系统可能会有显著的 在改善使用或坐着治疗阿尔茨海默病成人皮肤健康方面的作用 长时间坐轮椅。然而，这两个系统都需要根据成年人的需求进行量身定做 阿尔茨海默氏症和/或他们的照顾者。我们建议对关键问题进行彻底的需求评估 利益攸关方随后根据用户需求对系统进行了定制。最后，我们将执行可用性测试 这两个系统都在目标人群中确定用户体验并指导进一步开发和 测试。

项目成果

The usability of two mobile health assistive technologies for wheelchair-related in-seat movement and pressure.

两种移动健康辅助技术用于轮椅相关的座位运动和压力。

• DOI: 10.1177/20556683231211808
• 发表时间: 2023-01
• 期刊: JOURNAL OF REHABILITATION AND ASSISTIVE TECHNOLOGIES ENGINEERING
• 影响因子: 2
• 作者: Jordan, Kathleen;Vos-Draper, Tamara;Morrow, Melissa;Sonenblum, Sharon
• 通讯作者: Sonenblum, Sharon

Visualization of user interactions with a pressure mapping mobile application for wheelchair users at risk for pressure injuries.

• DOI: 10.1080/10400435.2020.1862938
• 发表时间: 2022-07-04
• 期刊: Assistive technology : the official journal of RESNA
• 作者: Goodwin BM;Olney CM;Ferguson JE;Hansen AH;Eddy B;Goldish G;Morrow MM;Vos-Draper TL
• 通讯作者: Vos-Draper TL

Validating a wheelchair in-seat activity tracker.

• DOI: 10.1080/10400435.2021.1893237
• 发表时间: 2022-09-03
• 期刊: Assistive technology : the official journal of RESNA
• 作者: Ahad N;Sonenblum SE;Davenport MA;Sprigle S
• 通讯作者: Sprigle S