Mobile and Remote Monitoring of Seating Pressure for Wheelchair Users With SCI
Condition: Spinal Cord Injuries
MeSH terms: Spinal Cord Injuries
Study type: Interventional

Summary: 
      This study will examine two interventions to increase weight shifts, overall trunk movement,
      and self-efficacy related to pressure ulcer prevention in wheelchair users with a spinal cord
      injury (SCI).
    

Detailed description: 
      Participants will use a mobile seat interface pressure mapping system that gives them live,
      real-time, visual feedback on the distribution of pressure between them and their seat
      cushion. This type of feedback works as a compensatory strategy for lack of sensation and
      allows the individual to visually observe pressure distribution they are not able to feel.
      Additionally, the participants will be provided with structured pressure ulcer prevention
      education, grounded in the principles of social cognitive theory, regarding pressure ulcer
      risk and use of weight shifts.

      The pressure mapping system, which will be used during training, provides virtual modeling of
      the desired outcome (reduced pressure) and is an important part of the education module.

      The findings of this study will inform clinicians and investigators of whether use of mobile
      seat interface pressure mapping as a compensatory-based intervention has a positive impact on
      trunk movement and self-efficacy for completing weight shifts in wheelchair users who lack
      sensation. Another contribution of this work is an exploration of the relationship between
      self-efficacy and movement in wheelchair users.
    

Intervention name(s): Structured Pressure Ulcer Prevention Education; Mobile Seat Interface Pressure Mapping System (IPM)
Intervention type(s): Behavioral; Other
Intervention description(s): Structured education for performance weight shift maneuvers and pressure ulcer prevention will occur during the initial visit for each subject. The education method used aligns with principles of the social cognitive theory to facilitate learning. The purpose in providing the education is to ensure all of the participants receive uniform instruction in how to perform weight shifts and to facilitate understanding of the importance of completing them as a protective measure against pressure ulcer development. Because each participant will come into the study at varying levels of understanding about pressure ulcer risk and knowledge of how to complete weight shift maneuvers, the education component is critical to ensure all participants are provided with the same information in the same way.; This mobile IPM system was designed to provide visual information about seat interface pressure distribution to compensate for lack of sensation on the sitting surface. This variable will be toggled on and off between the intervention and control phases of the study. The participants will have access to the visual feedback while learning how to complete weight shift maneuvers at the initial visit and then again at home during the intervention phases (weeks 2 and 4). During the control phases (weeks 1 and 3), they will not have access to the visual feedback from the pressure map
Intervention model: Single Group Assignment
Intervention model description: This is a longitudinal, within-subject, repeated (A-B-A-B) measures design. Two interventions will be provided: structured education regarding pressure ulcer prevention through weight shifts at start of study and use of a mobile seat interface pressure map (IPM).
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Spinal Cord Injury; Seating Pressure Mapping; Pressure Injury Prevention; Seating Interface Pressure; Wheelchair User