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

Abstract

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 selfmanaged 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.

Development of a comprehensive mobile assessment of pressure (CMAP) system for pressure injury prevention for veterans with spinal cord injury

“…Specifically, persons with acquired disabilities (SCI) need a sense of control when using the device. 30 Our findings, supported by the Tung et al 31 review of literature, 31 suggest that the participants in this study, despite their older age and lack of previous exposure to the mobile apps, maintained a high level of interest in this assistive technology because it is intended to help manage their skin health, a very meaningful endeavor to them.…”

A latent structural equation model of risk behaviors and pressure ulcer outcomes among people with spinal cord injury

“…We then will have a better understanding of the influence of health behaviors (both risk and protective) on PrU outcomes in terms of the theoretical risk and prevention model. 24,25 CONCLUSION Our study proposed a valid latent structural model of risk behaviors and PrU outcomes. This study suggests the need to reduce risk behaviors to prevent adverse PrU outcomes, particularly smoking, prescription medication use practices, and use of prescription medication to treat sleep, pain, spasticity and depression/anxiety.…”

“…[14][15][16] Owing to the negative effects of PrU, extensive research has centered on the study of risk factors [17][18][19][20][21] and prevention and treatment of PrU. [22][23][24][25] However, few studies have assessed behavioral risk factors, and they have primarily focused on single observable factors, rather than the impact of multiple risk factors on PrU outcomes.…”

A latent structural equation model of protective behaviors and pressure ulcer outcomes among people living with spinal cord injury

“…A substantial number of systematic reviews have addressed the risk factors 10,11,14,16,17 as well as prevention and treatment of PrU. 13,15,18,19 Several biographic and injury factors have been associated with PrU outcomes, including gender, 6,7,11 race/ethnicity, 4,6,7 age at injury, 10 time since injury [5][6][7]10 and severity of injury. 4,6,7 A recent review by Gelis et al 11 examined PrU risk factors in chronic SCI.…”