Development of a low-cost advanced modular pressure relief cushion

描述(由申请人提供)： 预防压疮总是比治疗压疮好。压疮需要几周或几个月的时间才能痊愈，导致疼痛，并进一步降低许多行动不便的人的功能，包括患有脊髓损伤(SCI)的退伍军人和老年人。减少压疮的技术包括改善区域压力分布的垫子。许多研究表明，虽然没有单一的坐垫可以满足每个用户的需求，但减压坐垫是所有轮椅座椅系统中的关键部件。适当的轮椅垫可以最大限度地发挥活动受限的个人的功能，并降低发生压疮的风险。提供合适的垫子是任何压疮预防计划中非常重要的一部分。拟议的试点研究将开发和测试一个原型缓冲，它使用先进的动态材料来创建一个模块化的支撑装置。该系统独特的模块化设计有两个优点：第一，每个座垫都可以非常低的成本根据个人座椅需求进行定制。其次，由于气垫部件是可拆卸的，因此气垫可以修复而不是更换，从而增加了耐用性。将按照国际标准化组织16840-2指南构建使用一系列凝胶球的原型模块坐垫，并评估其物理性能，以确定标准化座椅测试协议下的加载特性。使用热力学刚性缓冲加载压力仪(TRCLI)来评价载荷作用下的缓冲微环境。界面压力分布也将使用CONFORMat压力测绘系统进行测量。标准的高性能缓冲将被用作控制，并使用相同的协议进行测试。耐久性测试将按照国际标准化组织16840-3指南进行，以模拟一年的日常使用。我们将进行成本分析，以确保我们的缓冲将是低成本和高性能的。临床人员和轮椅使用者将参与整个研究，以确保模块化垫子在临床护理中获得高度接受。 公共卫生相关性： 卓越的护理是退伍军人管理局的重要使命。压疮是许多长期残疾的退伍军人，特别是行动不便或行动受限的退伍军人再次住院的主要原因。减少压力溃疡的技术包括减压垫。虽然没有单一的坐垫可以满足每个用户的需求，但减压坐垫是所有轮椅座椅系统中的关键部件。我们的初步工作表明，高性能凝胶填充的聚合物球可以整合到低成本的模块化缓冲设计中，这种设计具有缓解压力和稳定体位的潜力。在拟议的先导研究中，对模块化软垫设计进行系统的生物力学评估将提供在临床先导研究中开发软垫所需的信息。该项目将加强为退伍军人提供的医疗保健，使他们能够受益于使用先进技术开发出低成本、高性能的缓冲，以有效缓解压力。

DESCRIPTION (provided by applicant): It is always better to prevent a pressure ulcer rather than treat one. Pressure ulcers take weeks or months to heal, causing pain and further reducing function for many people with limited mobility, including veterans with spinal cord injury (SCI) and the elderly. Techniques to reduce pressure ulcers include cushions which improve regional pressure distribution. Many studies have shown that although no single cushion can meet every user's need, a pressure relieving cushion is a critical component in all wheelchair seating systems. An appropriate wheelchair cushion can maximize function for individuals with mobility restrictions and decrease the risk of pressure ulcer development. The provision of suitable cushions is a very important part of any pressure ulcer prevention program. The proposed pilot study will develop and test a prototype cushion that uses advanced dynamic materials to create a modular support device. The unique modular design of this system has two advantages; firstly each cushion can be customized for individual seating requirements at very low cost. Secondly, since cushions components are removable, the cushion can be repaired rather than replaced, thus increasing durability. Prototype modular cushions using a range of gel balls will be constructed and the physical properties evaluated following ISO 16840-2 guidelines to determine loading characteristics under standardized seating test protocols. A thermodynamic rigid cushion loading indenter (TRCLI) will be used to evaluate the cushion microenvironment under load. Interface pressures distributions will also be measured using the CONFORMat pressure mapping system. Standard high-performance cushions will be used as controls and tested using the same protocol. Durability testing will be carried out following ISO 16840-3 guidelines to simulate daily use for one year. A cost analysis will be carried out to make sure that our cushion will be low-cost as well as high performance. Clinical personnel and wheelchair users will be involved throughout the study to ensure that the modular cushion will achieve high acceptance in clinical care. PUBLIC HEALTH RELEVANCE: Excellence in care is an important mission of the VA. Pressure ulcers are a leading cause of re-hospitalization for many veterans with long-term disability, particularly those with limited or restricted mobility. Techniques to reduce pressure ulcers include pressure relieving cushions. Although no single cushion can meet every user's need, a pressure-relieving cushion is a critical component in all wheelchair seating systems. Our preliminary work has shown that that high-performance gel filled polymer spheres can be incorporated into a low-cost modular cushion design, which has the potential to provide both pressure relief and postural stability. Systematic biomechanical assessment of the modular cushion design in the proposed pilot study will provide the information needed to develop the cushion for evaluation in a clinical pilot study. The project will enhance health care provision for veterans, allowing them to benefit from the use of advanced technology to develop a low-cost high performance cushion for effective pressure relief.