Manual Wheelchair Virtual Seating Coach
Abstract
Objectives and Rationale: The clinical literature indicates that performing a push-up or pressure relief every 15 minutes for 2 minutes or more can reduce the likelihood of developing pressure ulcers. Some clinicians and consumers believe that this may be too onerous, and that “active seating” is adequate; “active seating” is defined as user-initiated frequent position changes in various directions to differing degrees. Educational tools (e.g., user guides, oral instruction, web-sites, apps) have proven very effective in increasing the knowledge of pressure ulcers among manual wheelchair users, but do little to improve compliance. Current reminders to shift weight based on timers or simple pressure or contact switches have only proved modestly effective. There has been little research to develop technology interventions to promote positive behavioral changes among manual wheelchair users to promote active sitting and regular pressure relief. Our study will provide insight into how people with spinal cord injury (PwSCI) actually move in the seats of their manual wheelchairs in their natural contexts and environments. Successful completion of this proposal will lead to the development of a practical manual wheelchair virtual coach, and the preparations necessary to conduct a clinical trial. Applicability of the Future Clinical Study: Despite the availability and usage of clinic-based assessment tools and pressure distributing cushions, there remains a tremendous problem of PwSCI incurring pressure ulcers when using manual wheelchairs. PwSCI who are active sitters and/or who perform regular pressure relief tend to be at lower risk for developing pressure ulcers. Service members and Veterans with spinal cord injuries are susceptible to pressure ulcers that can dramatically impact health as well as the ability to continue on active duty or to succeed as a Veteran through employment or supporting community activities. This study could present an effective tool for reducing the risk of developing pressure ulcers by helping PwSCI to manage their health. What persons with SCI will it help, and how will it help them? This study will help persons with SCI who use manual wheelchairs as their primary means of mobility. What are the potential clinical applications, benefits, and risks? If the trial is successful a commercial partner will bring the Manual Wheelchair Virtual Seating Coach to market to make it available to clinicians and persons with SCI. The manual wheelchair virtual seating coach will provide clinicians and persons with SCI a critical tool to extend interaction and education for the prevention of pressure ulcers, pain management, and quality of life by improving compliance with clinical guidance. What is the projected time it may take to achieve a person-related outcome? We anticipate that the manual wheelchair virtual seating coach will make a positive and lasting difference in compliance with clinical guidance for the prevention of pressure ulcers within 4 weeks. What are the likely contributions of the proposed future clinical study to advancing the field of SCI research, patient care, and/or quality of life? This study if successful will impact SCI research, patient care, and the quality of life of persons with SCI. For research, it will provide data on how people with SCI who use manual wheelchairs actually sit in their wheelchairs and how they move. In addition, this study will provide data on compliance with clinical guidance, and increase knowledge of the impact of machine learning and ecological momentary assessment. Patient care should improve by providing clinicians a tool to help people with SCI take a more active role in their prevention of pressure ulcers. People with SCI should ultimately experience fewer pressure ulcers, less pain, and greater quality of life.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1710620
Entities
People
- Rory A. Cooper
Organizations
- United States Army
- University of Pittsburgh