Development of a low-cost advanced modular pressure relief cushion

描述（由申请人提供）： 它总是更好地防止压力溃疡，而不是治疗之一。压疮需要数周或数月才能愈合，导致疼痛并进一步降低许多行动不便的人的功能，包括脊髓损伤（SCI）的退伍军人和老年人。减少压疮的技术包括改善局部压力分布的垫子。许多研究表明，虽然没有一个单一的垫子可以满足每个用户的需求，压力缓解垫是一个关键组成部分，在所有的轮椅座椅系统。一个合适的轮椅垫可以最大限度地发挥个人的功能，行动不便，并降低压疮的发展风险。提供合适的垫子是任何压疮预防计划的一个非常重要的部分。 拟议的试点研究将开发和测试一个原型垫，使用先进的动态材料，以创建一个模块化的支持设备。该系统独特的模块化设计有两个优点;首先，每个坐垫都可以以极低的成本定制，以满足个人的座椅要求。其次，由于衬垫部件是可移除的，所以衬垫可以被修理而不是更换，从而增加耐用性。 将使用一系列凝胶球构建原型模块化衬垫，并按照ISO 16840-2指南评估物理性能，以确定标准化就座测试方案下的负载特性。热力学刚性缓冲加载压头（TRCLI）将用于评估负载下的缓冲微环境。还将使用CONFORMat压力测绘系统测量界面压力分布。标准高性能缓冲垫将用作对照品，并使用相同的方案进行测试。将按照ISO 16840-3指南进行耐久性测试，以模拟一年的日常使用。成本分析将进行，以确保我们的缓冲将是低成本以及高性能。临床人员和轮椅使用者将参与整个研究，以确保模块化垫在临床护理中获得高度认可。 公共卫生相关性： 卓越的护理是退伍军人事务部的一项重要使命。压疮是许多长期残疾退伍军人再次住院的主要原因，特别是那些行动能力有限或受限的退伍军人。减少压疮的技术包括压力缓解垫。虽然没有一个单一的垫子可以满足每个用户的需求，压力缓解垫是一个关键组成部分，在所有轮椅座椅系统。 我们的初步工作表明，高性能凝胶填充聚合物球可以被纳入一个低成本的模块化缓冲设计，这有可能提供压力缓解和姿势稳定。在拟议的初步研究中，对组配式缓冲垫设计进行系统生物力学评估，将为开发缓冲垫以在临床初步研究中进行评价提供所需信息。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低成本高性能缓冲垫，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.