Pressure Relief System for Preventing Pressure Ulcers

描述（由申请人提供）：摘要：长时间坐在轮椅上而没有适当的重新定位会导致坐骨结节和尾骨压力过大，显著增加压疮（PU）的风险，这在成本和生活质量以及长期坐轮椅人群的功能活动方面带来了巨大的负担。 长期护理住院患者的压力未得到缓解已被确定为发生PU的主要病因。我们建议评估一种新的轮椅座椅设计，其中座椅的后部可以相对于座椅的前部动态地向下倾斜，以便能够释放坐骨上的坐界面压力。该机制引入了一个新的概念，在控制坐，并已被证明有能力在很大程度上释放坐骨下的坐界面压力，并促进组织活力。因此，我们计划评估这种坐着的机制，以减少PU的风险和加速PU愈合率在轮椅上的脊髓损伤（SCI）患者。从长远来看，我们希望它有助于提高生活质量，并促进长期轮椅使用者的功能状态。 具体目标1：评估坐在建议的轮椅上时，臀部-大腿与座椅之间、背部与靠背之间的坐姿界面压力分布以及座椅和背部上的载荷转移，并与普通轮椅坐姿进行比较。 具体目标2：通过测量配备建议机制的轮椅坐立期间的组织灌注和皮肤温度变化来评价组织活力，并与常规轮椅坐立加临床推荐的俯卧撑方案进行比较。针对具体目标1和2的研究将在两组患有SCI的轮椅使用者（慢性和急性）中进行。 具体目标3：评估使用配备建议机制的轮椅时PU愈合率，并与常规轮椅坐姿加俯卧撑的愈合率进行比较。一组患有脊髓损伤的轮椅使用者将被纳入其中，他们在休息区有PU。当使用拟定的坐姿机制并与使用常规轮椅的类似患者对照组进行比较时，将进行PU愈合过程评价。 具体目标4：评估使用配备建议机制的轮椅与以常规姿势加上临床推荐的俯卧撑方案坐着时的坐姿偏好。纳入上述研究的慢性脊髓损伤患者将被要求完成一份问卷，对建议机制中的舒适度和耐受性进行主观评价，并将其与普通轮椅进行比较。

DESCRIPTION (provided by applicant): Abstract: Prolonged sitting without proper repositioning in a wheelchair results in excessive pressure over the ischial tuberosities and coccyx significantly increasing the risk of pressure ulcers (PU), which impose a tremendous burden in terms of cost and the quality of life and the functional activities of the long-term wheelchair-bound population. Unrelieved pressure has been identified as the major etiological factor of developing PU for long-term care residents. We propose to evaluate a new seat design for wheelchair, in which the back part of the seat can be dynamically tilted downward with respect to the front part of the seat to be able to release the sitting interface pressure over the ischium. The mechanism introduces a novel concept in controlled sitting and has been demonstrated the capability to largely release the sitting interface pressure under the ischium and promote tissue viability. Therefore, we plan to evaluate this sitting mechanism in reducing the PU risk and accelerating PU healing rate in wheelchair-bound spinal cord injury (SCI) patients. In the long run, we expect it to help increase the quality of the life and promote functional status for long time wheelchair users. Specific aim 1: To evaluate sitting interface pressure distributions between the buttock-thighs and seat, between the back and backrest, and the load shift on the seat and back, during sitting in the proposed wheelchair and compare with those of usual wheelchair sitting. Specific aim 2: To evaluate tissue viability by way of measuring tissue perfusion and skin temperature changes during sitting with wheelchair equipped with the proposed mechanism and compare with those of usual wheelchair sitting plus clinically recommended Push-up regimen. Research for specific aim 1 and 2 will be carried out on 2 groups of wheelchair users with SCI, chronic and acute. Specific aim 3: To evaluate PU healing rate when using wheelchair equipped with the proposed mechanism and compare with those of usual wheelchair sitting plus push-ups. A group of wheelchair users with SCI who have PU developed in sitting area will be included. PU healing process evaluation will be carried out when using the proposed sitting mechanism and comparing that with a controlled group of similar patients using regular wheelchair. Specific aim 4: To evaluate the preferences in sitting posture when sitting with wheelchair equipped with the proposed mechanism versus sitting in the usual posture plus clinically recommended Push-up regimen. Chronic SCI patients included in the above studies will be asked to complete a questionnaire for subjective evaluation about the comfort and tolerance related sitting in the proposed mechanism and compare it with the usual wheelchair.