Journal of Rehabilitation Research & Development (JRRD)

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Volume 52 Number 2, 2015
   Pages 131 — 146

Abstract — Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: A scoping review

James Y. Tung, PhD;1* Brent Stead, PhD, MBA;2 William Mann, MBA;2 Ba' Pham, PhD;3 Milos R. Popovic, PhD4

1Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Canada;2SensiMAT Systems Inc, Toronto, Canada;3Toronto Health Economics and Technology Assessment Collaborative, University of Toronto, Toronto, Canada;4Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada; and Toronto Rehabilitation Institute, University Health Network, Toronto, Canada

Abstract — Pressure ulcers (PUs) in individuals with spinal cord injury (SCI) present a persistent and costly problem. Continuing effort in developing new technologies that support self-managed care is an important prevention strategy. Specifically, the aims of this scoping review are to review the key concepts and factors related to self-managed prevention of PUs in individuals with SCI and appraise the technologies available to assist patients in self-management of PU prevention practices. There is broad consensus that sustaining long-term adherence to prevention regimens is a major concern. Recent literature highlights the interactions between behavioral and physiological risk factors. We identify four technology categories that support self-management: computer-based educational technologies demonstrated improved short-term gains in knowledge (2 studies), interface pressure mapping technologies demonstrated improved adherence to pressure-relief schedules up to 3 mo (5 studies), electrical stimulation confirmed improvements in tissue tolerance after 8 wk of training (3 studies), and telemedicine programs demonstrated improvements in independence and reduced hospital visits over 6 mo (2 studies). Overall, self-management technologies demonstrated low-to-moderate effectiveness in addressing a subset of risk factors. However, the effectiveness of technologies in preventing PUs is limited due to a lack of incidence reporting. In light of the key findings, we recommend developing integrated technologies that address multiple risk factors.

Key words: assistive technology, integrated technologies, pressure ulcer, pressure ulcer incidence, pressure ulcer prevention, risk factors, SCI, self-managed care, spinal cord injury, wheelchairs.


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This article and any supplementary material should be cited as follows:
Tung JY, Stead B, Mann W, Pham B, Popovic MR. Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: A scoping review. J Rehabil Res Dev. 2015;52(2):131–46.
http://dx.doi.org/10.1682/JRRD.2014.02.0064
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