| 项目编号: | 1603646
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| 项目名称: | A Synergistic Approach to Pressure Ulcer Prevention for Spinal Cord Injured Individuals through Experiments and Modeling |
| 作者: | T. Reid Bush
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| 承担单位: | Michigan State University
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| 批准年: | 2016
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| 开始日期: | 2016-08-01
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| 结束日期: | 2019-07-31
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| 资助金额: | 300774
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| 资助来源: | US-NSF
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| 项目类别: | Standard Grant
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| 国家: | US
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| 语种: | 英语
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| 特色学科分类: | Engineering - Chemical, Bioengineering, Environmental, and Transport Systems
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| 英文关键词: | blood perfusion
; deep tissue
; perfusion
; work
; force
; wheelchair
; thigh
; buttock
; shear load
; individual
; posture
; pressure ulcer
; pu formation
; effect
; seat system
; shear force
; prevention method
; spinal cord injured patient
; pu
; pus
; synergistic approach
; ability
; potential
; spinal cord injury
; interface surface
; rigorous experimental testing
; i.
; experimental testing
; theoretical modeling
; computational modeling
|
| 英文摘要: | Wheelchair users sit in the same seat for the majority of their day and often have limited ability to adjust their position within the wheelchair. This results in significant, highly localized strains yielding critical stress concentrations in the tissue of the buttocks and thighs, leading to reduced blood perfusion (i.e., blood delivery through capillaries), tissue damage, and ultimately the initiation of what is known as a pressure ulcer (PU). PUs are painful, deep wounds that can penetrate to the bone. Their treatment can require hospitalization and, if infected, can lead to death. Current efforts to reduce the formation of PUs are insufficient and there is a critical need for better prevention methods. The design of a wheelchair and its cushion impacts the load distribution, which affects the stresses and strains on the deep tissues, and consequently, the ability of blood to reach these tissues. Specifically, two types of loads need to be considered in the mechanics of seating: normal load (i.e., a force perpendicular to the skin), and shear load (i.e., a sliding force parallel to the skin). Prior work has shown that: 1) seated individuals experience constant shear; 2) loading conditions that include shear forces are more detrimental to blood perfusion than normal forces alone; 3) internal tissue stress concentrations decrease perfusion; and 4) decreased perfusion is a factor that leads to a PU. No work has been done, however, to explore ways to periodically redistribute forces to promote blood perfusion or to quantify the effects of shear loading on deep tissues for wheelchair users. Through a synergistic approach that combines rigorous experimental testing and computational modeling, the PIs will develop a seat system that incorporates an interface surface for reduction of shear loads and an articulating wheelchair that can redistribute forces from one region to another. This seat system will result in increased perfusion in the buttocks and thighs, therefore decreasing the potential for PU formation. The proposed work will have an immediate impact on patients who have a spinal cord injury through the potential for PU reduction, and will have broader impacts for civilian and military populations.
Both blood perfusion and loading play roles in the formation of a Pressure Ulcer (PU), however there is no wheelchair design or cushion design that focuses on promoting blood perfusion or reducing deep tissue stresses caused by shear loads. Moreover, no previous work has focused on quantifying the effect of shear forces on the deep tissues in the buttocks and thighs of spinal cord injured patients. In this project, the PIs will employ a combination of experimental testing and theoretical modeling to: 1) determine the shear forces and blood perfusion on the ischial tuberosity region, as a function of postural changes in seated positions, 2) determine effective stiffnesses in-vivo of the buttocks and thighs, 3) conduct a finite element study to design optimized interface surfaces to minimize deep tissue stresses and strains, and 4) manufacture and test a patient-specific prototype of a cushion/wheelchair system. The ultimate goal of this project is to develop a seat system that includes an interface surface for reduction of shear loads and an articulating wheelchair that can redistribute forces from one region to another. This seat system will lead to decreased internal stresses and increased perfusion, therefore decreasing the potential for PU formation. The work is highly innovative in that it will be the first to relate the effects of posture and shear forces on blood perfusion and the first to model the effects of posture on deep tissue stress distribution. The ability to quantify and define the relationship between force, posture, and perfusion is a significant contribution to the advancement of science related to PU formation and for device design. Understanding the relationship between forces, posture, and perfusion is a necessity for improved modeling of PU formation, advances in seating design, and imperative to the prevention of PUs. The impact of this work will be seen through improved seat designs that are likely to lead to PU reduction. This research will impact all individuals who have an injury or disease causing limited mobility, including patients who are bedridden, elderly, have experienced an accident, stroke, or injuries incurred during military service. |
| 资源类型: | 项目
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| 标识符: | http://119.78.100.158/handle/2HF3EXSE/91484
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| Appears in Collections: | 全球变化的国际研究计划
科学计划与规划
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| Recommended Citation: | |
T. Reid Bush. A Synergistic Approach to Pressure Ulcer Prevention for Spinal Cord Injured Individuals through Experiments and Modeling. 2016-01-01.
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