Reduce the Risk Factors of Pressure Ulcers in SCI Patients

项目描述（由申请人提供）：申请人的长期研究目标是利用先进技术帮助改善轮椅使用者的生活质量，特别是那些因脊髓损伤（SCI）而残疾的人。更具体地说，申请人的目标是通过减少或消除风险因素来预防软组织破裂，这是坐轮椅最常见的继发性并发症。在美国，140万依靠轮椅移动的人中有近50%在伊斯基亚和大转子等压力点区域发生严重的组织破坏。这对受影响人口的生活质量产生了不利影响，并给保健造成了巨大的经济负担。在这项研究中，申请人专注于开发和优化复杂的计算有限元（FE）建模理论和技术，以研究软组织对外部坐姿负荷的反应。建议的有限元模型将模拟承重条件，在真实的坐。预计这些模型不仅将成为更好地了解软组织对坐姿负荷的反应的强大工具，而且还将促进开发针对软组织破坏的改进预防和治疗策略。目的1：开发和完善建立股骨-大腿有限元模型几何形状的方法。该方法实现了一个真实的代表性的解剖几何体的臀部大腿结构，在实际坐着。将建立这些模型的四个版本，分别代表男性和女性，每个版本包括健全和慢性脊髓损伤（SCI）个体。还将对这些模型进行校准和验证。目标二：在FE模型中实现健康、受伤和SCI条件下生物软组织（包括人体和实验动物）的实验获得的力学特性;研究FE建模对材料特性变化和组织层之间接触行为的敏感性;并研究完整和SCI人群中骨骼组织特性的变化。目标3：使用经验证的FE模型评估慢性SCI患者坐姿下的坐骨神经组织内部力学环境，并将FE模型预测结果与健全对照组的预测结果进行比较。与公共卫生的相关性：这项研究将提供一个更好的了解坐轮椅软组织破裂的病因，并帮助找到更好的治疗和预防策略。

DESCRIPTION (provided by applicant): The applicant's long term research objectives are to use advanced technology to help improve the quality of life of wheelchair users, especially those with disabilities from spinal cord injury (SCI). More specifically, the applicant sets his target at preventing the soft tissue breakdown, the most common secondary complication of wheelchair sitting, by reducing or eliminating risk factors. In the US, nearly 50% of the 1.4 million people who rely on wheelchairs for mobility develop serious tissue breakdown at pressure point areas such as the ischia and the greater trochanters. This has a detrimental impact on the quality of life of the affected population and imposes a tremendous economic burden to health care. In this study, the applicant focuses on development and optimization of the sophisticated computational finite-element (FE) modeling theory and technology to investigate the soft tissue response to external sitting loads. The proposed FE models will simulate the load-bearing condition as in real sitting. It is expected that the models will not only be powerful tools for better understanding the response of soft tissues to sitting loads, but they will also facilitate development of improved prevention and treatment strategies against the soft tissue breakdown. Aim 1: To develop and refine the methodology for establishing the geometry of FE models for the buttock-thigh. The methodology implements a true representation of the anatomical geometry of buttock-thigh structure in actual sitting. Four versions of these models will be established representing males and females, each including able-bodied and chronic spinal cord injury (SCI) individuals. The models will also be calibrated and validated. Aim 2: To implement into the FE model the experimentally acquired mechanical properties of biological soft tissue (both human and experimental animal) under healthy, wounded, and SCI conditions; to investigate the sensitivity of the FE modeling to the variation of the material properties and the contact behavior among tissue layers; and to investigate the variation of buttock tissue properties in intact and SCI populations. Aim 3: To evaluate the buttock tissue internal mechanical environment in the sitting posture in individuals with chronic SCI using the validated FE models, and compare the FE model predictions with those obtained from the able-bodied controls. Relevance to Public Health: This research will provide a better understanding of the etiology of soft tissue breakdown in wheelchair sitting and help finding better strategies of treatment and prevention.