1
|
Couzens L, Peterson B, Innes E, Stevens CJ. The effect of wheelchair cushion properties on the microclimate at the cushion-user interface: A systematic review and meta-analysis. Aust Occup Ther J 2024; 71:612-626. [PMID: 38296464 DOI: 10.1111/1440-1630.12932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/19/2023] [Accepted: 12/21/2023] [Indexed: 08/03/2024]
Abstract
INTRODUCTION Pressure injuries are a preventable yet highly prevalent health concern. Wheelchair cushion prescription can have significant implications for wheelchair users' risk of pressure injury development, which can impact functional abilities and quality of life. The efficacy of a wheelchair cushion to redistribute pressure has been well-researched, but the efficacy to manage the microclimate is less clear, particularly in warm-hot environments. The aim of this study was to systematically review studies examining the effect of wheelchair cushions on temperature, moisture and thermal perception to determine which cushions are superior to improve these responses. METHOD A systematic review with meta-analyses of randomised cross-over and randomised control trials of wheelchair cushion interventions on measures of temperature, moisture, and thermal perception was conducted. RESULTS Eight studies were identified that met the eligibility criteria and six meta-analyses were conducted. Pooled analyses identified a significantly lower temperature on foam-gel cushions compared to air cushions (MD = 0.80, 95% CI: 0.31, 1.29; p = 0.002) and a significantly lower temperature on foam-gel cushions compared to foam cushions (SMD = 0.76, 95%CI; 0.45, 1.06; p < 0.00001). Pooled analyses also demonstrated significantly lower relative humidity (i.e., moisture) on foam cushions compared to foam-gel cushions (p = 0.02). Differences in thermal perception were inconclusive due to limited data found. CONCLUSION It is clear that not one cushion is ideal in managing all aspects of microclimate, as foam-gel cushions were the superior cushion to manage temperature and foam cushions were the superior cushion to manage moisture. This article provides occupational therapists and other health professionals with evidence-based information to assist with wheelchair cushion prescription that minimises the temperature and moisture accumulation, and associated risk of pressure injury for wheelchair users.
Collapse
Affiliation(s)
- Lisa Couzens
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Benjamin Peterson
- School of Health, Medical and Applied Sciences, CQ University, Rockhampton, Queensland, Australia
| | - Ev Innes
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Christopher J Stevens
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| |
Collapse
|
2
|
Yao X, He Y, Udomboonyanupap S, Hessenberger N, Song Y, Vink P. Measuring pressure distribution under the seat cushion and dividing the pressure map in six regions might be beneficial for comfort studies of aircraft seats. ERGONOMICS 2023; 66:1594-1607. [PMID: 36524386 DOI: 10.1080/00140139.2022.2157495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Seat pressure maps are often used to evaluate comfort of the users. In this study, we explored the relationships between pressure maps and comfort/discomfort of users in aircraft seats with a focus on a new 6-division method on the pressure maps collected at the bottom of the cushions. An experiment was designed where three cushions with identical shapes but different stiffnesses were prepared. 33 subjects joined the experiment and after sitting on each cushion in 4 postures, they completed comfort questionnaires. Pressure maps on the top as well as the bottom of cushions were collected and analysed. Results indicated that measures on the proposed 6 divisions, especially on the distal posterior thigh regions and regions close to ischial tuberosity of the bottom pressure maps, had larger correlation values to comfort scores compared to other division methods. Practitioner summary: The relations between comfort/discomfort and seat pressure maps collected from the top/bottom of three cushions were studied with 33 subjects in four postures. The distal posterior thigh and ischial tuberosity regions in the proposed 6-division of the bottom pressure maps had larger correlation values to comfort/discomfort compared to other methods.
Collapse
Affiliation(s)
- Xinhe Yao
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Yufei He
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Sumalee Udomboonyanupap
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | | | - Yu Song
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Peter Vink
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| |
Collapse
|
3
|
Kulvicius T, Zhang D, Nielsen-Saines K, Bölte S, Kraft M, Einspieler C, Poustka L, Wörgötter F, Marschik PB. Infant movement classification through pressure distribution analysis. COMMUNICATIONS MEDICINE 2023; 3:112. [PMID: 37587165 PMCID: PMC10432534 DOI: 10.1038/s43856-023-00342-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Aiming at objective early detection of neuromotor disorders such as cerebral palsy, we propose an innovative non-intrusive approach using a pressure sensing device to classify infant general movements. Here we differentiate typical general movement patterns of the "fidgety period" (fidgety movements) vs. the "pre-fidgety period" (writhing movements). METHODS Participants (N = 45) were sampled from a typically-developing infant cohort. Multi-modal sensor data, including pressure data from a pressure sensing mat with 1024 sensors, were prospectively recorded for each infant in seven succeeding laboratory sessions in biweekly intervals from 4 to 16 weeks of post-term age. 1776 pressure data snippets, each 5 s long, from the two targeted age periods were taken for movement classification. Each snippet was pre-annotated based on corresponding synchronised video data by human assessors as either fidgety present or absent. Multiple neural network architectures were tested to distinguish the fidgety present vs. fidgety absent classes, including support vector machines, feed-forward networks, convolutional neural networks, and long short-term memory networks. RESULTS Here we show that the convolution neural network achieved the highest average classification accuracy (81.4%). By comparing the pros and cons of other methods aiming at automated general movement assessment to the pressure sensing approach, we infer that the proposed approach has a high potential for clinical applications. CONCLUSIONS We conclude that the pressure sensing approach has great potential for efficient large-scale motion data acquisition and sharing. This will in return enable improvement of the approach that may prove scalable for daily clinical application for evaluating infant neuromotor functions.
Collapse
Affiliation(s)
- Tomas Kulvicius
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
- Department for Computational Neuroscience, Third Institute of Physics-Biophysics, Georg-August-University of Göttingen, Göttingen, Germany.
| | - Dajie Zhang
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Karin Nielsen-Saines
- Division of Pediatric Infectious Diseases, David Geffen UCLA School of Medicine, Los Angeles, CA, USA
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Marc Kraft
- Department of Medical Engineering, Technical University Berlin, Berlin, Germany
| | - Christa Einspieler
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Luise Poustka
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
| | - Florentin Wörgötter
- Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
- Department of Medical Engineering, Technical University Berlin, Berlin, Germany
| | - Peter B Marschik
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
4
|
Mannella D, Bellusci M, Graziani F, Ferraresi C, Muscolo GG. Modelling, design and control of a new seat-cushion for pressure ulcers prevention. Proc Inst Mech Eng H 2022; 236:9544119211068908. [PMID: 35068250 DOI: 10.1177/09544119211068908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Pressure ulcers are a frequent complication in patients having limited activity and mobility (e.g., elderly people, spinal cord injury patients, people with disabilities, etc.). The aim of this work is the conceptual design, modelling and control of a new seat cushion for pressure ulcers prevention. The whole system (constituted by the seat cushion equipped with a real-time pressure mapping with closed-loop control) is designed to identify the critical points on the human skin, before pressure ulcers creation, and to be able to distribute the contact pressure between the human and cushion avoiding wound creation. The seat cushion is constituted by soft air-cells actuated by air flow. To define the shape and size of the soft air-cells, finite element simulations are carried out, analysing the internal volume reduction with external loads application to reproduce the variable stiffness. The data obtained by finite element analysis are used to simulate inflation and deflation of the soft bubble air-cells. Finally, the control systems of a single air-cell and of the whole cushion are designed and simulated. The novelty of our work consists in the conception of a seat cushion able to recognise higher and lower risk zones of pressure ulcer generation on the human skin and to provide compensation automatically. This work can therefore be considered in line with the sustainable development goals recently launched by the EU Commission.
Collapse
Affiliation(s)
- Daniele Mannella
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino, Piemonte, Italy
| | - Marco Bellusci
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino, Piemonte, Italy
| | - Francesco Graziani
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino, Piemonte, Italy
| | - Carlo Ferraresi
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino, Piemonte, Italy
| | | |
Collapse
|