Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Jun 9, 2023
Date Accepted: Sep 8, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effects of Real-Time Pressure Map Feedback on Confidence in Pressure Management in Wheelchair Users with Spinal Cord Injury: Pilot Intervention Study
ABSTRACT
Background:
Wheelchair users with a spinal cord injury are at a high risk for developing pressure injuries. Performing weight shifts is a primary method of pressure management for pressure injury prevention; however, individuals with spinal cord injury may lack confidence in their abilities to perform adequate pressure due to their lack of sensation. Real-time seat interface pressure mapping feedback may provide partial substitution for sensory feedback such that an individual’s confidence is improved.
Objective:
To examine how confidence for pressure management by wheelchair users with spinal cord injury was impacted by providing access to real-time, on-demand seat interface pressure mapping feedback.
Methods:
Adults with spinal cord injury (n = 23) completed self-efficacy questions addressing confidence around four factors related to performing weight shifts in this longitudinal, repeated-measures study. We evaluated the impact of providing standard pressure injury prevention education and access to live pressure map feedback on confidence levels for performing weight shifts.
Results:
Access to live pressure map feedback while learning how to perform weight shifts resulted in significantly higher confidence about moving far enough to relieve pressure at high-risk areas. Confidence for adhering to the recommended weight shift frequency and duration was not significantly impacted by in-clinic education or use of pressure map feedback. Confidence that performing weight shifts reduces pressure injury risk increased most following education, with slight additional increase when pressure map feedback was added.
Conclusions:
Access to live pressure mapping feedback improves confidence about performing weight shifts when provided in the clinical setting and demonstrates potential for the same in the home. This preliminary exploration of a smartphone-based pressure mapping intervention highlights the value of access to continuous pressure mapping feedback to improve awareness and confidence for managing pressure. Clinical Trial: ClinicalTrials.gov Identifier: NCT03987243
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