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: 9564792
• 负责人: MELISSA M. MORROW
• 金额: $ 53.01万
• 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 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9564792
• 关键词: Accelerometer; Advanced Development; Algorithms; Area; Behavior; Belief; Caregivers; Cellular Phone; Clinic; Cross-Over Trials; Dangerousness; Decubitus ulcer; Development; Education; Effectiveness; Esthesia; Feedback; Follow-Up Studies; Goals; Guidelines; Health; Health behavior; Healthcare Systems; Incidence; Individual; Injury; Interview; Knowledge; Label; Longevity; Measurement; Measures; Monitor; Movement; Participant; Patient Care; Patients; Pattern; Population; Prevention; Randomized; Reporting; Risk; Risk Factors; Safety; Self Efficacy; Self Management; Site; Skin; Solid; Spinal cord injury; System; Systems Development; Technology; Testing; Time; Weight; Wheelchairs; advanced system; base; clinical practice; design; empowered; handheld mobile device; improved; mobile application; modifiable risk; movement practice; novel; personalized care; pressure; prevent; recruit; research clinical testing; satisfaction; sensor; success; sustained attention; technology development; tool; usability; visual feedback

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.

项目总结/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。 在生命周期中遇到的危险的继发性健康问题。预防艾滋病毒/艾滋病的一个关键组成部分 压力性损伤的教育是增加座位上的运动，以尽量减少骶骨下的长期压力， 坐骨和骶尾骨区。然而，持续的病人和医疗保健系统的压力负担 伤害强调了教育与运动相关健康的基本实践之间的脱节 行为。在这一人群中，流动是一个可以改变的风险因素，但该领域缺乏有效的战略， 激励运动。结合使用压力界面映射和运动的新策略 检测传感器结合现有的智能手机技术可以提供正确的反馈类型， 改善了座椅内运动。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，执行必要的运动，以防止压力溃疡。我们的最终目标是减少 通过提供有效的策略，使个人能够更好地自我管理， 皮肤健康。如果成功，这将大大减轻个人、照顾者、 和医疗保健系统。该项目的目标是进一步开发两种新型的个人使用 技术（目标1），提供有效的反馈，以增加运动，防止压力伤害。接下来， 我们会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 系统加上组合系统影响座位上的运动，同时还评估与 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个系统或系统的组合最能满足个人的需要。这 知识可以直接影响临床实践，并促进预防压力损伤的个性化护理 在轮椅使用者中。核心假设是，通过权利提供的补偿性反馈 个人使用技术，将增加轮椅使用者在座位上的运动。该项目的基本原理是 基于确凿的证据，当患者参与并拥有正确的工具时， 提高健康行为的自我效能，他们能够更成功地管理自己的健康。