Principal Investigators: Eric E. Sabelman, PhD and Jonathan Katz, MD Project Staff: S. Ward, RN; L. Goldschmidt, PhD; Ruth Yap, MS; David L. Jaffe, MS; and James H. Anderson, JEM Project Category: Spinal Cord Injury - 2001 Objective: We propose to test whether a wearable motion analysis and pressure feedback system will help prevent skin breakdown in typically elderly individuals with sensorimotor deficits such as spinal cord injury (SCI), stroke, diabetic neuropathy, prolonged post-surgical immobilization and extreme frailty, who are at risk for the deleterious effects of skin breakdown (i.e. pressure sores). Research Plan: Past Merit Review projects (E601) have led to the creation of a computerized wearable motion analysis system ("WAMAS") with wide potential as a diagnostic and therapeutic device in elder care. The new WAMAS is able to interact with wireless measurement devices, allow individuals to self-monitor pressure changes, provide real-time sensory feedback (visual, tactile, auditory) to the user when pressure limits have been exceeded, communicate patient status to a remote clinician, and recognize when it is unused or incorrectly used if the patient is not complying with pressure-relief instructions. Field testing is being done with subjects in three categories having somewhat different skin care needs: (a) SCI patients referred by VAPAHCS Spinal Cord Injury Center, (b) frail elderly nursing facility residents (from VAPA Long-Term Care), and (c) peripheral neuropathy patients (from VAPA Neurology Service). 12 patients in each of the three categories are to be recruited. Work Accomplished: We are assembling additional sets of the 2nd-generation WAMAS (in addition to those resulting from design/development project E2182DA). Wired and wireless pressure input modules are being fabricated for sending either full-resolution data or only threshold-crossing data to the WAMAS by RF link A stand-alone speech module has been made which is reprogrammable in the field with 32 patient-specific voice messages 4.8 seconds long. We have determined that sensors located in bed and chair cushions yield sufficient data, so that sensors would not have to be attached to the body of non-ambulatory patients. Activity-of-daily-living and pressure relief motion data are being collected using the WAMAS; this has been done for 8 SCI and 5 nursing home subjects to date. The next stage is to establish safe motion/pressure limits, followed by testing to see if assumed limits are exceeded in everyday life. Funding Source: VA RR&D Merit Review Funding Status: Approved
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