Development of Technologies to Increase In-Seat Movement to Prevent Sitting-Acquired Pressure Injuries in Wheelchair Users

开发增加座椅内运动的技术，以防止轮椅使用者发生坐姿压力损伤

• 批准号: 9564792
• 负责人: MELISSA M. MORROW
• 金额: $ 53.01万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9564792
• 关键词: Accelerometer; Advanced Development; Algorithms; Area; Behavior; Belief; Caregivers; Cellular Phone; Clinic; Cross-Over Trials; Dangerousness; Decubitus ulcer; Development; Education; Effectiveness; Esthesia; Feedback; Follow-Up Studies; Goals; Guidelines; Health; Health behavior; Healthcare Systems; Incidence; Individual; Injury; Interview; Knowledge; Label; Longevity; Measurement; Measures; Monitor; Movement; Participant; Patient Care; Patients; Pattern; Population; Prevention; Randomized; Reporting; Risk; Risk Factors; Safety; Self Efficacy; Self Management; Site; Skin; Solid; Spinal cord injury; System; Systems Development; Technology; Testing; Time; Weight; Wheelchairs; advanced system; base; clinical practice; design; empowered; handheld mobile device; improved; mobile application; modifiable risk; movement practice; novel; personalized care; pressure; prevent; recruit; research clinical testing; satisfaction; sensor; success; sustained attention; technology development; tool; usability; visual feedback

PROJECT SUMMARY/ABSTRACT Pressure injuries in individuals with spinal cord injury (SCI) who use wheelchairs are one of the most dangerous secondary health problems encountered during the lifespan. A key component for the prevention of pressure injuries is education to increase in-seat movement to minimize prolonged pressure under the sacral, ischial, and sacrococcygeal areas. However, the continued patient and health care system burden of pressure injuries underscores a disconnect between education and the essential practice of movement-related health behaviors. Movement is a modifiable risk factor in this population, but the field lacks effective strategies to best motivate movement. New strategies that couple the use of pressure interface mapping and movement detecting sensors, combined with existing smartphone technology can provide the right type of feedback to improve in-seat movements. By providing the right tools, we can impact individual's self-efficacy, or confidence in their ability, to perform the necessary movements to prevent pressure ulcers. Our ultimate goal is to reduce the incidence of pressure injuries by providing an effective strategy so that individuals can better self-manage their skin health. If successful, this could significantly reduce the related burden to the individual, caregivers, and the healthcare system. The objective of this project is to further develop two novel personal-use technologies (Aim 1) that provide effective feedback to increase movement to prevent pressure injuries. Next, we will test the usability of the advanced systems (Aim 2). Finally, we will evaluate how well each separate system plus a combined system impacts in-seat movement while also assessing self-efficacy related to completing recommended weight shifts (Aim 3). By comparing self-efficacy scores with changes in movement, we can begin to determine which system or combination of systems best meets individual needs. This knowledge can directly impact clinical practice and facilitate individualized care for preventing pressure injuries in wheelchair users. The central hypothesis is that compensatory feedback, provided through the right personal-use technologies, will increase in-seat movement of wheelchair users. The rationale for this project is based on solid evidence that when patients are engaged and empowered with the right tools and have improved self-efficacy for health behaviors, they are able to manage their health with far greater success.

项目摘要/摘要 使用轮椅的脊髓损伤（SCI）的个体的压力损伤是最大的之一 寿命中遇到的危险的二级健康问题。预防的关键组成部分 压力伤害是教育以增加座位运动，以最大程度地减少s骨下的长时间压力， 坐骨和sa虫区域。但是，持续的患者和医疗保健系统压力负担 伤害强调了教育与运动相关健康的基本实践之间的脱节 行为。运动是该人群中可修改的风险因素，但该领域缺乏有效的策略来最佳 激励运动。新的策略，这些策略是使用压力接口映射和移动的新策略 检测传感器，结合现有的智能手机技术可以为 改善座位运动。通过提供正确的工具，我们可以影响个人的自我效能或自信 以他们的能力，执行必要的运动以防止压力溃疡。我们的最终目标是减少 通过提供有效的策略，压力伤害的发生率使个人可以更好地自我管理 他们的皮肤健康。如果成功的话，这可能会大大减轻个人的相关负担，照顾者， 和医疗保健系统。该项目的目的是进一步发展两个新颖的个人使用 技术（AIM 1）提供有效的反馈以增加运动以防止压力损伤。下一个， 我们将测试高级系统的可用性（AIM 2）。最后，我们将评估每个分开的情况 系统以及组合系统会影响座位运动，同时还评估了与 完成建议的体重移动（AIM 3）。通过比较自我效能感与运动的变化， 我们可以开始确定哪种系统或组合最能满足个人需求。这 知识可以直接影响临床实践，并促进个性化护理以防止压力损伤 在轮椅使用者中。中心假设是通过权利提供的补偿性反馈 个人使用技术将增加轮椅使用者的座位运动。这个项目的理由是 基于可靠的证据表明，当患者参与并授权正确的工具并具有 提高了健康行为的自我效能感，他们能够以更大的成功来管理自己的健康。