Effect of Power Seat Function Usage on Tissue Viability in Wheelchair Users with

电动座椅功能使用对轮椅使用者组织活力的影响

• 批准号: 7835591
• 负责人: Yih-Kuen Jan
• 金额: $ 7.33万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-08 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7835591
• 关键词: Acute; Affect; Back; Blood flow; Clinical; Decubitus ulcer; Development; Effectiveness; Frequencies; Goals; Guidelines; Health Care Costs; Hour; Ischemia; Longitudinal Studies; Methods; Pattern; Population; Powered wheelchair; Quality of life; Recommendation; Recovery; Skin; Spinal cord injury; Testing; Time; Tissue Viability; Tissues; Weight-Bearing state; Wheelchairs; base; clinical practice; design; insight; pressure; prevent; prospective; reactive hyperemia; response; soft tissue

DESCRIPTION (provided by applicant): Pressure ulcers significantly affect quality of life and overall healthcare costs of wheelchair users with spinal cord injury (SCI). Current clinical practice includes using wheelchair power seat function (PSF) to attain specific seating angles, durations, or frequencies that have been shown to reduce seating interface pressure in wheelchair users. PSF includes tilt (a change of seat angle orientation while maintaining the seat-to-back angle) and recline (a change of the seat-to-back angle). However, at what angle and timing PSF usage provides adequate pressure relief for enhancing skin blood flow and soft tissue viability is not clear. The long-term goal of this study is to determine the optimal PSF usage pattern for enhancing soft tissue viability, which may then help further advance the clinical guidelines of PSF usage for preventing pressure ulcers. Specific aim 1 is to investigate the acute blood flow response to PSF usage at various settings of tilt and recline angles. PSF usage has been demonstrated to reduce seating interface pressure in wheelchair users. However, the impact of PSF usage on skin blood flow and soft tissue viability requires further clarification. Common clinical recommendations of tilt (15, 30, and 45 degrees) and recline (100 and 120 degrees) angles will be examined. Total skin blood flow of a reactive hyperemic response will be used to assess soft tissue viability (ischemia) in this study. Specific aim 2 is to examine the effects of PSF usage at various settings of duration and frequency on the reactive hyperemic response to prolonged sitting-induced loads. Common clinical recommendations of duration (30 or 60 seconds) and frequency (15 or 30 minutes) of PSF usage will be compared to determine a proper setting for enhancing soft tissue viability in wheelchair users. Time to recovery of a reactive hyperemic response will be used to assess the effectiveness of PSF settings for relieving weight-bearing tissues. This study will demonstrate the feasibility of using skin blood flow to evaluate the effectiveness of PSF usage in enhancing tissue viability. The PIs' method will provide insight into the mechanism of blood flow response to PSF usage settings. Results from this study will provide objective evidence to support the use of PSF for needed pathological populations.

描述（由申请人提供）：压力溃疡会显着影响脊髓损伤（SCI）轮椅使用者的生活质量和整体医疗保健费用。当前的临床实践包括使用轮椅座椅功能（PSF）获得特定的座位角度，持续时间或频率，这些座位，已证明可以减轻轮椅使用者的座椅界面压力。 PSF包括倾斜（在保持座椅向后角度的同时改变座椅角度的变化）和倾斜（座椅向背面的变化）。但是，在何种角度和时间上，PSF的使用可提供足够的压力缓解，以增强皮肤血流和软组织生存能力。这项研究的长期目标是确定提高软组织生存能力的最佳PSF使用模式，这可能有助于进一步推进PSF使用的临床指南，以防止压力溃疡。具体目的1是在倾斜和倾斜角度的各种环境下研究对PSF使用的急性血流响应。已证明PSF的使用量可以减少轮椅使用者的座椅接口压力。但是，PSF使用对皮肤血流和软组织生存能力的影响需要进一步澄清。将检查倾斜度（15、30和45度）和倾斜（100和120度）角度的常见临床建议。在本研究中，反应性高血症反应的总皮肤血流将用于评估软组织生存能力（缺血）。具体目的2是检查持续时间和频率各种情况下PSF使用的影响，对长时间坐姿诱导的负载的反应性高血压反应。将比较持续时间（30或60秒）和PSF使用频率（15或30分钟）的常见临床建议，以确定适当的设置，以增强轮椅使用者的软组织生存能力。回收反应性高血症反应的时间将用于评估PSF设置可缓解重量组织的有效性。 这项研究将证明使用皮肤血流来评估PSF使用在增强组织生存能力方面的有效性。 PIS的方法将洞悉对PSF使用设置的血流反应机理。这项研究的结果将提供客观的证据，以支持PSF用于所需的病理种群。

项目成果

Development of intelligent model to determine favorable wheelchair tilt and recline angles for people with spinal cord injury.

开发智能模型以确定脊髓损伤患者有利的轮椅倾斜和倾斜角度。

• DOI: 10.1109/iembs.2011.6090377
• 发表时间: 2011
• 期刊: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
• 作者: Fu,Jicheng;Jan,Yih-Kuen;Jones,Maria
• 通讯作者: Jones,Maria

Wheelchair tilt-in-space and recline does not reduce sacral skin perfusion as changing from the upright to the tilted and reclined position in people with spinal cord injury.

• DOI: 10.1016/j.apmr.2013.01.004
• 发表时间: 2013-06
• 期刊: ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
• 影响因子: 4.3
• 作者: Jan, Yih-Kuen;Crane, Barbara A.
• 通讯作者: Crane, Barbara A.

Development of a Scalable Monitoring System for Wheelchair Tilt-in-Space Usage.

开发用于轮椅空间倾斜使用的可扩展监控系统。

• DOI: 10.4172/jpmr.1000129
• 发表时间: 2013
• 期刊: International journal of physical medicine & rehabilitation
• 作者: Yang,TimD;Hutchinson,SethA;Rice,LauraA;Watkin,KennethL;Jan,Yih-Kuen
• 通讯作者: Jan,Yih-Kuen

Investigation of peak pressure index parameters for people with spinal cord injury using wheelchair tilt-in-space and recline: methodology and preliminary report.

使用轮椅倾斜空间和斜倚研究脊髓损伤患者的峰值压力指数参数：方法和初步报告。

• DOI: 10.1155/2014/508583
• 发表时间: 2014
• 期刊: BioMed research international
• 作者: Lung,Chi-Wen;Yang,TimD;Crane,BarbaraA;Elliott,Jeannette;Dicianno,BradE;Jan,Yih-Kuen
• 通讯作者: Jan,Yih-Kuen