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

项目概要/摘要 使用轮椅的脊髓损伤 (SCI) 患者的压力损伤是最常见的损伤之一 一生中遇到的危险的继发性健康问题。预防的关键组成部分 压力损伤是指增加座椅内运动以尽量减少骶骨下的长期压力的教育， 坐骨和骶尾部区域。然而，患者和医疗保健系统的持续负担压力 伤害凸显了教育与运动相关健康基本实践之间的脱节 行为。运动是该人群的一个可改变的风险因素，但该领域缺乏有效的策略来最好地 激发运动。将压力界面映射和运动结合使用的新策略 检测传感器与现有的智能手机技术相结合可以提供正确类型的反馈 改善座椅内的运动。通过提供正确的工具，我们可以影响个人的自我效能或信心 在他们的能力范围内，执行必要的动作来预防压疮。我们的最终目标是减少 通过提供有效的策略，使个人能够更好地进行自我管理，减少压力损伤的发生率 他们的皮肤健康。如果成功，这可以显着减轻个人、护理人员、 和医疗保健系统。该项目的目标是进一步开发两种新颖的个人使用 提供有效反馈以增加运动以防止压力损伤的技术（目标 1）。接下来， 我们将测试先进系统的可用性（目标 2）。最后，我们将评估每个单独的效果如何 系统加上组合系统会影响座椅内的运动，同时还会评估与以下方面相关的自我效能 完成建议的体重转移（目标 3）。通过比较自我效能得分与运动变化， 我们可以开始确定哪种系统或系统组合最能满足个人需求。这个 知识可以直接影响临床实践并促进预防压力性损伤的个性化护理 在轮椅使用者中。中心假设是通过正确的方式提供补偿性反馈 个人使用技术将增加轮椅使用者的座位内活动。该项目的理由是 基于确凿的证据表明，当患者参与并使用正确的工具并获得授权时 随着健康行为自我效能的提高，他们能够更成功地管理自己的健康。

PROJECT SUMMARY/ABSTRACT Pressure injuries in individuals with spinal cord injury (SCI) who use wheelchairs are one of the most dangerous secondary health problems encountered during the lifespan. A key component for the prevention of pressure injuries is education to increase in-seat movement to minimize prolonged pressure under the sacral, ischial, and sacrococcygeal areas. However, the continued patient and health care system burden of pressure injuries underscores a disconnect between education and the essential practice of movement-related health behaviors. Movement is a modifiable risk factor in this population, but the field lacks effective strategies to best motivate movement. New strategies that couple the use of pressure interface mapping and movement detecting sensors, combined with existing smartphone technology can provide the right type of feedback to improve in-seat movements. By providing the right tools, we can impact individual's self-efficacy, or confidence in their ability, to perform the necessary movements to prevent pressure ulcers. Our ultimate goal is to reduce the incidence of pressure injuries by providing an effective strategy so that individuals can better self-manage their skin health. If successful, this could significantly reduce the related burden to the individual, caregivers, and the healthcare system. The objective of this project is to further develop two novel personal-use technologies (Aim 1) that provide effective feedback to increase movement to prevent pressure injuries. Next, we will test the usability of the advanced systems (Aim 2). Finally, we will evaluate how well each separate system plus a combined system impacts in-seat movement while also assessing self-efficacy related to completing recommended weight shifts (Aim 3). By comparing self-efficacy scores with changes in movement, we can begin to determine which system or combination of systems best meets individual needs. This knowledge can directly impact clinical practice and facilitate individualized care for preventing pressure injuries in wheelchair users. The central hypothesis is that compensatory feedback, provided through the right personal-use technologies, will increase in-seat movement of wheelchair users. The rationale for this project is based on solid evidence that when patients are engaged and empowered with the right tools and have improved self-efficacy for health behaviors, they are able to manage their health with far greater success.