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Gruenerbel L, Heinrich F, Böhlhoff-Martin J, Röper L, Machens HG, Gruenerbel A, Schillinger M, Kist A, Wenninger F, Richter M, Steinbacher L. Wearable Prophylaxis Tool for AI-Driven Identification of Early Warning Patterns of Pressure Ulcers. Bioengineering (Basel) 2023; 10:1125. [PMID: 37892855 PMCID: PMC10603913 DOI: 10.3390/bioengineering10101125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/01/2023] [Accepted: 09/18/2023] [Indexed: 10/29/2023] Open
Abstract
As today's society ages, age-related diseases become more frequent. One very common but yet preventable disease is the development of pressure ulcers (PUs). PUs can occur if tissue is exposed to a long-lasting pressure load, e.g., lying on tissue without turning. The cure of PUs requires intensive care, especially for the elderly or people with preexisting conditions whose tissue needs longer healing times. The consequences are heavy suffering for the patient and extreme costs for the health care system. To avoid these consequences, our objective is to develop a pressure ulcer prophylaxis device. For that, we built a new sensor system able to monitor the pressure load and tissue vital signs in immediate local proximity at patient's predilection sites. In the clinical study, we found several indicators showing correlations between tissue perfusion and the risk of PU development, including strongly reduced SpO2 levels in body tissue prior to a diagnosed PU. Finally, we propose a prophylaxis system that allows for the prediction of PU developments in early stages before they become visible. This work is the first step in generating an effective system to warn patients or caregivers about developing PUs and taking appropriate preventative measures. Widespread application could reduce patient suffering and lead to substantial cost savings.
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Affiliation(s)
- Lorenz Gruenerbel
- Fraunhofer Institute for Electronic Microsystems and Solid State Technologies EMFT, 80686 Munich, Germany; (F.W.); (M.R.)
| | - Ferdinand Heinrich
- Fraunhofer Institute for Electronic Microsystems and Solid State Technologies EMFT, 80686 Munich, Germany; (F.W.); (M.R.)
| | - Jonathan Böhlhoff-Martin
- Department for Plastic Surgery and Hand Surgery, Technical University Munich, Hospital Rechts der Isar MRI, 81675 Munich, Germany (L.S.)
| | - Lynn Röper
- Department for Plastic Surgery and Hand Surgery, Technical University Munich, Hospital Rechts der Isar MRI, 81675 Munich, Germany (L.S.)
| | - Hans-Günther Machens
- Department for Plastic Surgery and Hand Surgery, Technical University Munich, Hospital Rechts der Isar MRI, 81675 Munich, Germany (L.S.)
| | | | - Moritz Schillinger
- Artificial Intelligence in Communication Disorders, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany (A.K.)
| | - Andreas Kist
- Artificial Intelligence in Communication Disorders, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany (A.K.)
| | - Franz Wenninger
- Fraunhofer Institute for Electronic Microsystems and Solid State Technologies EMFT, 80686 Munich, Germany; (F.W.); (M.R.)
| | - Martin Richter
- Fraunhofer Institute for Electronic Microsystems and Solid State Technologies EMFT, 80686 Munich, Germany; (F.W.); (M.R.)
| | - Leonard Steinbacher
- Department for Plastic Surgery and Hand Surgery, Technical University Munich, Hospital Rechts der Isar MRI, 81675 Munich, Germany (L.S.)
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Kim SS, Park JS, Choi D, Shin Y, Jo K, Kim Y, Kim SO, Kweon H, Lee A, Bae YH. Effect of changing the lying posture angle by changing the bed posture on the average pressure, maximum pressure, and pressure area in the hip region. Technol Health Care 2022; 31:943-954. [PMID: 36442161 DOI: 10.3233/thc-220376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND: An electric bed can easily change posture from a lying position and was effective in preventing pressure ulcer. OBJECTIVE: This study aimed to identify the optimal posture for the prevention of pressure ulcers by analyzing pressure changes applied to the pelvic region. METHODS: Pressure changes resulting from lateral rotations of the body using an electronic adjustable bed and changes in the posture and angles of the trunk and knees were assessed. Twelve conditions with varying angles of the trunk and knees (15–35∘ in 5∘ increments) and varying lateral angles (20–35∘ in 5∘ increments) were tested. The pressure (maximum and average) and contact area in the pelvic region of 20 individuals without disabilities were calculated. RESULTS: The conditions in which the average and maximum pressures did not increase according to the increase in angle were 25∘ for the upper body and knee angles and 35∘ for the side. CONCLUSIONS: The body pressure changed according to the posture rather than according to physical characteristics. Lateral rotation combined with changes in the angles of the trunk and knees effectively prevented pressure ulcers. Changes in the posture at various angles prevented an increased pressure on the body.
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Affiliation(s)
- Sung Shin Kim
- Clinical Rehabilitation Research, National Rehabilitation Center, Seoul, Korea
| | - Jun Sik Park
- Rehabilitation and Assistive Technology, National Rehabilitation Center, Seoul, Korea
| | - Dongil Choi
- Rehabilitation and Assistive Technology, National Rehabilitation Center, Seoul, Korea
| | - Yumi Shin
- Rehabilitation and Assistive Technology, National Rehabilitation Center, Seoul, Korea
| | - Kyeyeob Jo
- Division of Nursing, National Rehabilitation Center, Seoul, Korea
| | - Youngkyung Kim
- Division of Nursing, National Rehabilitation Center, Seoul, Korea
| | - Sun Ok Kim
- Division of Nursing, National Rehabilitation Center, Seoul, Korea
| | - Hyosun Kweon
- Clinical Rehabilitation Research, National Rehabilitation Center, Seoul, Korea
| | - Anna Lee
- Healthcare and Public Health, National Rehabilitation Center, Seoul, Korea
| | - Young-Hyeon Bae
- Healthcare and Public Health, National Rehabilitation Center, Seoul, Korea
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Literature Review of Machine-Learning Algorithms for Pressure Ulcer Prevention: Challenges and Opportunities. INFORMATICS 2021. [DOI: 10.3390/informatics8040076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Pressure ulcers are associated with significant morbidity, resulting in a decreased quality of life for the patient, and contributing to healthcare professional burnout, as well as an increase of health service costs. Their prompt diagnosis and treatment are important, and several studies have proposed solutions to help healthcare professionals in this process. This work analyzes studies that use machine-learning algorithms for risk assessment and management of preventive treatments for pressure ulcers. More specifically, it focuses on the use of machine-learning algorithms that combine information from intrinsic and extrinsic pressure-ulcer predisposing factors to produce recommendations/alerts to healthcare professionals. The review includes articles published from January 2010 to June 2021. From 60 records screened, seven articles were analyzed in full-text form. The results show that most of the proposed algorithms do not use information related to both intrinsic and extrinsic predisposing factors and that many of the approaches separately address one of the following three components: data acquisition; data analysis, and production of complementary support to well-informed clinical decision-making. Additionally, only a few studies describe in detail the outputs of the algorithm, such as alerts and recommendations, without assessing their impacts on healthcare professionals’ activities.
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