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Nasirian A, Erel V, Nuthi P, Gu Y, Allman M, Meza F, Sikka S, Wijesundara MBJ. Smart seat cushion feasibility pilot study: automated interface pressure modulation of individuals with spinal cord Injury. Disabil Rehabil Assist Technol 2024:1-10. [PMID: 38712763 DOI: 10.1080/17483107.2024.2349712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/22/2024] [Indexed: 05/08/2024]
Abstract
This study investigates the functionality and feasibility of a novel smart seat cushion system designed for wheelchair users with spinal cord injuries. The cushion, equipped with air cells that serve as both sensors and actuators, was tested on 24 participants for its real-time pressure mapping, automated pressure redistribution, and pressure offloading functions. A commercial pressure mat was concurrently used to validate the cushion's pressure modulation functions. Additionally, the perceived comfort of the cushion was evaluated using General Discomfort Assessment (GDA) and Discomfort Intensity (DIS) scores, which provided insights into participants' overall comfort and discomfort levels. Real-time pressure profiles generated by the cushion resembled commercial pressure mat readings. During tests with individuals with spinal cord injury, the cushion was able to dynamically generate and display the real-time pressure profile of a seated individual with strong precision (correlation to commercial pressure mat: r ranging from 0.76 to 0.88), providing effective input into pressure modulation functions. Pressure redistribution algorithms eliminated peak pressure and reduced the overall pressure at the interface. Pressure offloading algorithms automatically identified the regions with the highest interface pressure and subsequently relieved the pressure from those areas. User feedback showed that the cushion was comfortable after redistribution and offloading. This work demonstrated the feasibility of an advanced smart seat cushion system for wheelchair users with spinal cord injuries. The cushion was capable of redistributing pressure evenly across the seating surface, ensuring user's comfort. Additionally, it identifies and eliminates high-pressure points, further improving comfort and reducing the risk of pressure injuries.
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Affiliation(s)
- Aida Nasirian
- The University of TX at Arlington Research Institute, Fort Worth, TX, USA
| | - Veysel Erel
- The University of TX at Arlington Research Institute, Fort Worth, TX, USA
| | - Pavan Nuthi
- The University of TX at Arlington Research Institute, Fort Worth, TX, USA
| | - Yixin Gu
- The University of TX at Arlington Research Institute, Fort Worth, TX, USA
| | - Melissa Allman
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Faith Meza
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Seema Sikka
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
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2
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Hara K, Uemura T, Tachibana R, Kumashiro R, Yamaguchi M, Kawahara I, Fujioka M. Prevention of Postoperative Skin Disorders and Pressure Injuries in the Neurosurgical Park Bench Position Surgery: A Prospective Cohort Study. Cureus 2024; 16:e58552. [PMID: 38765353 PMCID: PMC11102086 DOI: 10.7759/cureus.58552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/22/2024] Open
Abstract
Background In neurosurgical procedures where the park bench position is employed, the risk of perioperative pressure injuries is elevated due to the limited contact surface area, with the head and part of the upper torso extending beyond the surgical table. This study aimed to examine the effects of preventative measures against such injuries, proposing a potential standard for postural fixation in these surgeries. Methods Conducted at a medical center, from January 2017 to March 2023, this prospective cohort study involved participants aged 20 and above who underwent neurosurgical procedures in the park bench position under general anesthesia. The focus was on comparing the incidence of pressure injuries between intervention and control groups. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results Out of 65 patients enrolled, 28 were assigned to each of the intervention and control groups. The control group experienced 17 instances of postoperative pressure injuries and skin disorders in areas prone to pressure, such as the axillary and greater trochanter regions. Conversely, the intervention group reported no such incidents, underscoring the efficacy of meticulous surgical positioning and management of bodily pressure, temperature, humidity, and microclimate. Conclusion Implementing preventive measures in neurosurgical park bench procedures significantly reduces the incidence of postoperative pressure injuries and skin disorders. These findings advocate for the adoption of standardized postural fixation protocols in such surgeries, potentially influencing global clinical practices in neurosurgery.
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Affiliation(s)
- Kentaro Hara
- Operation Center Division, National Hospital Organization Nagasaki Medical Center, Nagasaki, JPN
- Healthcare Management Research Center, Chiba University Hospital, Chiba, JPN
| | - Takahiro Uemura
- Operation Center Division, National Hospital Organization Nagasaki Medical Center, Nagasaki, JPN
| | - Reika Tachibana
- Operation Center Division, National Hospital Organization Nagasaki Medical Center, Nagasaki, JPN
| | - Ryosuke Kumashiro
- Operation Center Division, National Hospital Organization Nagasaki Medical Center, Nagasaki, JPN
| | - Michiko Yamaguchi
- Department of Anesthesiology, National Hospital Organization Nagasaki Medical Center, Nagasaki, JPN
| | - Ichiro Kawahara
- Department of Neurosurgery, Japan Community Health Care Organization Isahaya General Hospital, Nagasaki, JPN
| | - Masaki Fujioka
- Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, JPN
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van Helden TMN, van Neck JW, Versnel SL, Mureau MAM, van Dishoeck AM. The clinical applicability of sensor technology with body position detection to combat pressure ulcers in bedridden patients. Med Eng Phys 2024; 124:104096. [PMID: 38418025 DOI: 10.1016/j.medengphy.2023.104096] [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: 03/06/2023] [Revised: 11/29/2023] [Accepted: 12/21/2023] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Pressure Ulcers (PUs) are a major healthcare issue leading to prolonged hospital stays and decreased quality of life. Monitoring body position changes using sensors could reduce workload, improve turn compliance and decrease PU incidence. METHOD This systematic review assessed the clinical applicability of different sensor types capable of in-bed body position detection. RESULTS We included 39 articles. Inertial sensors were most commonly used (n = 14). This sensor type has high accuracy and is equipped with a 2-4 hour turn-interval warning system increasing turn compliance. The second-largest group were piezoresistive (pressure) sensors (n = 12), followed by load sensors (n = 4), piezoelectric sensors (n = 3), radio wave-based sensors (n = 3) and capacitive sensors (n = 3). All sensor types except inertial sensors showed a large variety in the type and number of detected body positions. However, clinically relevant position changes such as trunk rotation and head of bed elevation were not detected or tested. CONCLUSION Inertial sensors are the benchmark sensor type regarding accuracy and clinical applicability but these sensors have direct patient contact and (re)applying the sensors requires the effort of a nurse. Other sensor types without these disadvantages should be further investigated and developed. We propose the Pressure Ulcer Position System (PUPS) guideline to facilitate this.
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Affiliation(s)
- Tim M N van Helden
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
| | - Johan W van Neck
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Sarah L Versnel
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Marc A M Mureau
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Anne-Margreet van Dishoeck
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
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Cesca N, Szczepanski A, Malik W, Cheema M, Allen B, Dutta T, Cameron JI, Gabison S. Facilitators and barriers to pressure injury prevention, management and education: Perspectives from healthcare professionals-A qualitative study. Int Wound J 2024; 21:e14371. [PMID: 37658675 PMCID: PMC10781891 DOI: 10.1111/iwj.14371] [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: 06/11/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023] Open
Abstract
This study aims to (1) characterize healthcare professionals' (HCPs') experiences related to the prevention and management of pressure injuries (PIs) and (2) explore the educational needs of individuals with a past or current history of PIs and their caregivers from the perspective of HCPs. This is a qualitative descriptive study. HCPs (n = 18) were interviewed using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and coded using NVivo. Three overarching themes encompassing various dimensions were identified: (1) Facilitators related to PI prevention and management, (2) Challenges related to PI prevention and management and (3) Recommendations for improving patient and caregiver PI education. HCPs identified a greater number of challenges than facilitators related to PI care. This study emphasizes the importance of a patient-centred and interprofessional approach to patient education for PI prevention and management. Meaningful interventions focused on the patient may improve health literacy and empower patients and caregivers in PI care. Investing in preventive measures and raising awareness are crucial to reducing PI incidence. The findings have implications for HCPs and researchers seeking to enhance patient care and promote effective PI prevention strategies.
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Affiliation(s)
- Nicole Cesca
- Department of Physical Therapy, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- KITE Research InstituteToronto Rehabilitation Institute—University Health NetworkTorontoOntarioCanada
| | - Ann Szczepanski
- Department of Physical Therapy, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- KITE Research InstituteToronto Rehabilitation Institute—University Health NetworkTorontoOntarioCanada
| | - Walee Malik
- Department of Physical Therapy, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- KITE Research InstituteToronto Rehabilitation Institute—University Health NetworkTorontoOntarioCanada
| | - Manpreet Cheema
- Department of Physical Therapy, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- KITE Research InstituteToronto Rehabilitation Institute—University Health NetworkTorontoOntarioCanada
| | - Brady Allen
- Department of Physical Therapy, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- KITE Research InstituteToronto Rehabilitation Institute—University Health NetworkTorontoOntarioCanada
| | - Tilak Dutta
- KITE Research InstituteToronto Rehabilitation Institute—University Health NetworkTorontoOntarioCanada
- Institute of Biomedical EngineeringUniversity of TorontoTorontoOntarioCanada
| | - Jill I. Cameron
- KITE Research InstituteToronto Rehabilitation Institute—University Health NetworkTorontoOntarioCanada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Sharon Gabison
- Department of Physical Therapy, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- KITE Research InstituteToronto Rehabilitation Institute—University Health NetworkTorontoOntarioCanada
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Indraswari ADW, Aisyiyah U, Kurniawan K, Surboyo MDC. Prediction Pressure Ulcers in High Care Unit Patients: Evaluating Risk Factors and Predictive Scale Using a Prospective Cross-Sectional Study. Avicenna J Med 2024; 14:39-44. [PMID: 38694142 PMCID: PMC11057897 DOI: 10.1055/s-0043-1777420] [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: 05/04/2024] Open
Abstract
Background The incidence of ulcer pressure in the high care unit (HCU) was relatively high and could be reliably predicted using tools such as the Norton and Jackson/Cubbin scales. However, other risk factors, such as age, gender, consciousness, systemic condition, duration of treatment, and use of restraint, may contribute to the occurrence of ulcer pressure. This study was conducted to analyze the relationship of various risk factors for pressure ulcers and prediction of ulcer pressure, using Norton and Jackson/Cubbin scale, to incident pressure ulcers in HCU patient. Methods This study utilized a prospective cross-sectional study design to analyze various risk factors for ulcer pressure development in a patient admitted to the HCU, including age, gender, blood profile, consciousness, duration of treatment, and use of restraint. The Norton and Jackson/Cubbin scale was employed to predict pressure ulcers. The relationship between the risk factors and the prediction of pressure ulcer incidents was evaluated using multiple logistic binary regression analysis. Result Both the Norton and Jackson/Cubbin scales predicted a lower risk of pressure ulcer development (60.98 and 99.02%, respectively). This prediction is consistent with the low incidence of pressure injuries found, which is only 4.39%. Furthermore, the relationship between the identified risk factor (gender, duration of treatment in HCU and use of restraint) and the prediction and incident of pressure ulcer was not significant ( p > 0.05). Thus, it is suggested that these risk factors may not strong predictors of pressure ulcer development. Conclusion This study's result indicated no significant relationship exists between possible identified risk factors and the development of pressure ulcers in HCU patients. However, the Norton and Jackson/Cubbin scales were reliable predictors of pressure ulcer occurrence, with both scales predicting a lower risk of pressure ulcer development.
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Affiliation(s)
| | - Umi Aisyiyah
- Committee of Nursing, Fatmawati Hospital, Cilandak - South Jakarta, Indonesia
| | - Kurniawan Kurniawan
- Intensive Care Unit, Fatmawati Hospital, Cilandak – South Jakarta, Indonesia
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Chen B, Yang Y, Cai F, Zhu C, Lin S, Huang P, Zhang L. Nutritional status as a predictor of the incidence of pressure injury in adults: A systematic review and meta-analysis. J Tissue Viability 2023:S0965-206X(23)00043-8. [PMID: 37117126 DOI: 10.1016/j.jtv.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/12/2023] [Accepted: 04/15/2023] [Indexed: 04/30/2023]
Abstract
AIM Pressure injuries are a significant health care problem worldwide, and many factors influence their occurrence and development. The purpose of this systematic review and meta-analysis was to investigate the role of nutritional status in the development rate of pressure injuries as a potentially modifiable risk factor. METHODS Study designs included cohort (prospective and retrospective), case-control, and RCTs if the association between nutrition status and pressure injuries was reported. Databases searched included: PubMed, CINAHL, Embase, Scopus, Web of Science, and Cochrane Library on April 20th, 2022. The data were analyzed using OR and random effect model in Revman5.3 and STATA 15 Software. Report this systematic review and meta-analysis according to the PRISMA 2020 statement. RESULTS A total of 22 separate studies were retained in this systematic review. Of these, 16 articles were included in the meta-analysis. Three studies were assessed as low risk and sixteen as a moderate risk of bias. All RCTs were B quality. The odds ratio of the incidence of pressure injuries in malnourished and non-malnourished patients was 3.66(95% CI: 2.77-4.83). In the three RCTs studies(n = 870), the odds ratio of the incidence of pressure ulcers in patients with standard nutrition to those with specific nutritional interventions was 1.35(95%CI:1.02-1.78). CONCLUSIONS This systematic review and meta-analysis showed that nutritional status is significantly associated with pressure injuries. Malnutrition can increase the incidence of pressure injuries, and specific nutritional interventions can reduce the incidence of pressure injuries compared to standard nutrition.
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Affiliation(s)
- Bei Chen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, China.
| | - Yufan Yang
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Fuman Cai
- College of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Chunjing Zhu
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shaoqin Lin
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Pan Huang
- College of Nursing, Wenzhou Medical University, Wenzhou, China.
| | - Liping Zhang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
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Clever HM, Grady PL, Turk G, Kemp CC. BodyPressure - Inferring Body Pose and Contact Pressure From a Depth Image. IEEE TRANSACTIONS ON PATTERN ANALYSIS AND MACHINE INTELLIGENCE 2023; 45:137-153. [PMID: 35344483 DOI: 10.1109/tpami.2022.3158902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Contact pressure between the human body and its surroundings has important implications. For example, it plays a role in comfort, safety, posture, and health. We present a method that infers contact pressure between a human body and a mattress from a depth image. Specifically, we focus on using a depth image from a downward facing camera to infer pressure on a body at rest in bed occluded by bedding, which is directly applicable to the prevention of pressure injuries in healthcare. Our approach involves augmenting a real dataset with synthetic data generated via a soft-body physics simulation of a human body, a mattress, a pressure sensing mat, and a blanket. We introduce a novel deep network that we trained on an augmented dataset and evaluated with real data. The network contains an embedded human body mesh model and uses a white-box model of depth and pressure image generation. Our network successfully infers body pose, outperforming prior work. It also infers contact pressure across a 3D mesh model of the human body, which is a novel capability, and does so in the presence of occlusion from blankets.
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Abstract
Pressure ulcers (PU) are one of the most frequent hazards of long-term bedridden patients. With the continuous increase of aging, the number of long-term bedridden disabled and semi-disabled elderly people is increasing. At the same time, there is a serious shortage of professional pressure ulcer nursing staff. There is also a lack of flexible turning equipment for PU prevention. The research in the field of pressure ulcer prevention at home and abroad is carried out steadily, and the equipment for turning over by pneumatic or mechanical drive is developed. However, these devices often have insurmountable defects, such as complex structure, cost constraints, difficult control, weak body feeling, and so on. Under these circumstances, a set of pneumatic turnover mattresses based on clinical nursing methods have been developed. The mattress is divided into a turnover area and two support areas. The turnover airbag is linked with the support airbag to improve the patient’s comfort when passively turning over. The turnover amplitude and interval can be adjusted to provide a personalized turnover experience for bedridden patients. To improve the safety of the turning mattress during automatic turning, we also add a temperature sensor based on the principle of infrared reflection to monitor the status of bedridden patients, which can realize real-time temperature measurement, monitoring of getting out of bed and monitoring of the turning process.
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Luo TT, Sun ZH, Li CX, Feng JL, Xiao ZX, Li WD. Monitor for lactate in perspiration. J Physiol Sci 2021; 71:26. [PMID: 34445952 PMCID: PMC10717619 DOI: 10.1186/s12576-021-00811-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/07/2021] [Indexed: 12/18/2022]
Abstract
Sweat is a noninvasive biological fluid on the surface of human skin and has attracted increasing attention as a diagnostic specimen for disease and biomarker detection. Sweat metabolite quantification is possible due to progress in sweat analysis techniques; nevertheless, the role of sweat monitoring in energy metabolism, physiological or pathological state assessment, health status assessment, and the development and outcome of metabolism-related diseases remains unclear. This review provides a comprehensive overview of the literature on human sweat lactate concentration. The first, second, and third sections of this review present an introduction of sweat lactate, methods for the collection and storage of sweat lactate samples, and methods of detection and analysis of sweat lactate, respectively. The fourth section elaborates upon the current state of clinical application of sweat lactate monitoring and its prospects for health surveillance. The last section focuses on the challenges and future directions of this novel technology for detecting lactate in sweat.
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Affiliation(s)
- Ting-Ting Luo
- School of Nursing, Institute of Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhong-Hai Sun
- Department of Surgery, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Chu-Xin Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jin-Lian Feng
- School of Nursing, Institute of Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhao-Xiu Xiao
- Department of Cardiac Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei-Dong Li
- School of Nursing, Institute of Health, Guangdong Pharmaceutical University, Guangzhou, China.
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Hajari N, Lastre-Dominguez C, Ho C, Ibarra-Manzano O, Cheng I. Longitudinal In-Bed Pressure Signals Decomposition and Gradients Analysis for Pressure Injury Monitoring. SENSORS 2021; 21:s21134356. [PMID: 34202252 PMCID: PMC8272200 DOI: 10.3390/s21134356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022]
Abstract
Pressure injury (PI) is a major problem for patients that are bound to a wheelchair or bed, such as seniors or people with spinal cord injuries. This condition can be life threatening in its later stages. It can be very costly to the healthcare system as well. Fortunately with proper monitoring and assessment, PI development can be prevented. The major factor that causes PI is prolonged interface pressure between the body and the support surface. A possible solution to reduce the chance of developing PI is changing the patient's in-bed pose at appropriate times. Monitoring in-bed pressure can help healthcare providers to locate high-pressure areas, and remove or minimize pressure on those regions. The current clinical method of interface pressure monitoring is limited by periodic snapshot assessments, without longitudinal measurements and analysis. In this paper we propose a pressure signal analysis pipeline to automatically eliminate external artefacts from pressure data, estimate a person's pose, and locate and track high-risk regions over time so that necessary attention can be provided.
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Affiliation(s)
- Nasim Hajari
- Multimedia Research Centre, Department of Computing Science, University of Alberta, Edmonton, AB T6G 2E8, Canada;
- Correspondence:
| | - Carlos Lastre-Dominguez
- Department of Electronics Engineering, Universidad de Guanajuato, Salamanca 36885, Mexico; (C.L.-D.); (O.I.-M.)
| | - Chester Ho
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2E8, Canada;
| | - Oscar Ibarra-Manzano
- Department of Electronics Engineering, Universidad de Guanajuato, Salamanca 36885, Mexico; (C.L.-D.); (O.I.-M.)
| | - Irene Cheng
- Multimedia Research Centre, Department of Computing Science, University of Alberta, Edmonton, AB T6G 2E8, Canada;
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Tan X, Ahmed-Kristensen S, Cao J, Zhu Q, Chen W, Nanayakkara T. A Soft Pressure Sensor Skin to Predict Contact Pressure Limit Under Hand Orthosis. IEEE Trans Neural Syst Rehabil Eng 2021; 29:536-545. [PMID: 33577452 DOI: 10.1109/tnsre.2021.3059015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Customized static orthoses in rehabilitation clinics often cause side effects, such as discomfort and skin damage due to excessive local contact pressure. Currently, clinicians adjust orthoses to reduce high contact pressure based on subjective feedback from patients. However, the adjustment is inefficient and prone to variability due to the unknown contact pressure distribution as well as differences in discomfort due to pressure across patients. This paper proposed a new method to predict a threshold of contact pressure (pressure limit) associated with moderate discomfort at each critical spot under hand orthoses. A new pressure sensor skin with 13 sensing units was configured from FEA results of pressure distribution simulated with hand geometry data of six healthy participants. It was used to measure contact pressure under two types of customized orthoses for 40 patients with bone fractures. Their subjective perception of discomfort was also measured using a 6 scores discomfort scale. Based on these data, five critical spots were identified that correspond to high discomfort scores (>1) or high pressure magnitudes (>0.024 MPa). An artificial neural network was trained to predict contact pressure at each critical spot with orthosis type, gender, height, weight, discomfort scores and pressure measurements as input variables. The neural networks show satisfactory prediction accuracy with R2 values over 0.81 of regression between network outputs and measurements. This new method predicts a set of pressure limits at critical locations under the orthosis that the clinicians can use to make orthosis adjustment decisions.
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