Daily Activity Monitoring for Prevention of Pressure Ulcers in Long-Term Wheelchair Users
This paper presents an assistive device for assessment and prevention of pressure ulcers in long-term wheelchair patients. The system consists of several sensors deployed on the wheelchair non-invasively for monitoring pressure changes and tilt usage duri
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Abstract. This paper presents an assistive device for assessment and prevention of pressure ulcers in long-term wheelchair patients. The system consists of several sensors deployed on the wheelchair non-invasively for monitoring pressure changes and tilt usage during daily activities. A pilot study was conducted to evaluate the potential capabilities of the system and the feasibility of implementing alarms based on clinical recommendations. During two weeks, six full-time wheelchair users with severe disability were monitored. Their wheelchairs were electric-powered and equipped with tilt-in-space systems and pressure relief cushions as methods for relieving pressure. Results show that the system is able to capture tilt usage and pressure changes during daily life. Also, it provides relevant information regarding to wheelchair occupancy and activity level. The study shows that most of the subjects spent long hours on the wheelchair without performing pressure relief as often as recommended, confirming the usefulness of a personalized alarm system. Keywords: Activity monitoring Assistive device Caregiver Disability Electric-powered wheelchair Mobile health care Monitoring system Pressure relief Pressure ulcer Tilt-in-space
1 Introduction According to the World Health Organization, around the world there are more than 785 million people with a disabling condition [1]. Currently, people are spending more years of their life with some kind of disability produced to a great extent by the population aging and the increase in chronic diseases [2]. This global scenario challenges researchers to develop new technological solutions to improve quality of life for people living with a disability. People who are unable to walk and need a wheelchair to move independently are estimated at about 10 % of disabled people worldwide [3]. Wheelchair users spend long hours sitting, which can increase the probability of pressure ulcers (PU). PU are injuries on the skin produced by excessive pressure during long periods of time. Excessive pressure, usually over bony prominences, reduces the blood flow producing tissue © Springer International Publishing Switzerland 2015 J. Bravo et al. (Eds.): AmIHEALTH 2015, LNCS 9456, pp. 47–58, 2015. DOI: 10.1007/978-3-319-26508-7_5
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ischemia and death, resulting in an ulcer. Parts of the body in contact with the wheelchair such as the ischial tuberosities, coccyx and pelvis bones are more likely to develop PU. The proper way to avoid PU is to change position regularly. This way, the excessive pressure is relieved and blood can flow through the tissues. Clinicians recommend patients to perform push-ups, side-to-side leans or lean forward over the knees as methods to relieve pressure. However, people who suffer severe mobility impairment cannot relieve pressure by themselves. Usually, they need help from other people, either family members or specialized caregivers, to change positions regularly. In those cases powered wheelchairs equipped with seat functions suc
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