Biomechanics of Pressure Ulcer in Body Tissues Interacting with External Forces during Locomotion

Mak, Arthur F.T.; Zhang, Ming; Tam, Eric W.

doi:10.1146/annurev-bioeng-070909-105223

Cited by 97 publications

(81 citation statements)

References 140 publications

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“…[10]- [13]). In severe cases when loading conditions cause tissue deformation thresholds to be exceeded (see also [14] on thresholds), painful pressure ulcers may occur [15]; in some reports pressure ulcers have occurred in as high as 55% of subjects with major amputations [16]. However, even mild discomfort may be concerning as it could result in an altered posture and gait, which in turn may cause long term musculoskeletal conditions such as back pain [17].…”

Section: Introductionmentioning

confidence: 99%

Automated and Data-driven Computational Design of Patient-Specific Biomechanical Interfaces

Moerman¹,

Sengeh²,

Herr³

2016

Preprint

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Abstract-Biomechanical interfaces are mechanical structures that form the connection between a device and a tissue region, and, through appropriate load transfer, aim to minimize tissue discomfort and injury. A patient-specific and data-driven computational framework for the automated design of biomechanical interfaces is presented here. Optimization of the design of biomechanical interfaces is complex since it is affected by the interplay of the geometry and mechanical properties of both the tissue and the interface. The proposed framework is presented for the application of transtibial amputee prostheses where the interface is formed by a prosthetic liner and socket. Conventional socket design and manufacturing is largely artisan, non-standard, and insufficiently data-driven, leading to discrepancies between the quality of sockets produced by different prosthetists. Furthermore, current prosthetic liners are often not patient-specific. The proposed framework involves: A) non-invasive imaging to record patient geometry, B) indentation to assess tissue mechanical properties, C) data-driven and automated creation of patientspecific designs, D) patient-specific finite element analysis (FEA) and design evaluation, and finally E) computer aided manufacturing. Uniquely, the FEA procedure controls both the design and mechanical properties of the devices, and simulates, not only the loading during use, but also the pre-load induced by the donning of both the liner and the socket independently. Through FEA evaluation, detailed information on internal and external tissue loading, which are directly responsible for discomfort and injury, are available. Further, these provide quantitative evidence on the implications of design choices, e.g. : 1) alterations in the design can be used to locally enhance or reduce tissue loading, 2) compliant features can aid in relieving local surface pressure. The proposed methods form a patient-specific, data-driven and repeatable design framework for biomechanical interfaces, and by enabling FEA-based optimization reduces the requirement for repeated patient involvement in the currently manual and iterative design process.

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Section: Introductionmentioning

confidence: 99%

Automated and Data-driven Computational Design of Patient-Specific Biomechanical Interfaces

Moerman¹,

Sengeh²,

Herr³

2016

Preprint

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show abstract

“…DTI may occur in soft tissues situated between a bony prominence and a support surface [6][7][8][9][10][11]. In the TTA prostheticuser case, the soft tissues in danger are the gastrocnemius muscle and fat tissues, compressed between the truncated tibia and fibula bones and the hard prosthetic socket.…”

Section: Introductionmentioning

confidence: 99%

Outdoor dynamic subject-specific evaluation of internal stresses in the residual limb: Hydraulic energy-stored prosthetic foot compared to conventional energy-stored prosthetic feet

et al. 2012

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“…Additionally, the available flexible options (e.g. incorporated printed circuit boards) are often still bulky and cannot be used as they create additional pressure spots and skin chafing [1,3,4]. These pressure spots then increase the risk of injury.…”

Section: Introductionmentioning

confidence: 99%

Body-monitoring with photonic textiles: a reflective heartbeat sensor based on polymer optical fibres

Quandt

Braun

Ferrario

et al. 2017

J. R. Soc. Interface.

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Knowledge of an individual's skin condition is important for pressure ulcer prevention. Detecting early changes in skin through perfusion, oxygen saturation values, and pressure on tissue and subsequent therapeutic intervention could increase patients' quality of life drastically. However, most existing sensing options create additional risk of ulcer development due to further pressure on and chafing of the skin. Here, as a first component, we present a flexible, photonic textile-based sensor for the continuous monitoring of the heartbeat and blood flow. Polymer optical fibres (POFs) are melt-spun continuously and characterized optically and mechanically before being embroidered. The resulting sensor shows flexibility when embroidered into a moisture-wicking fabric, and withstands disinfection with hospital-type laundry cycles. Additionally, the new sensor textile shows a lower static coefficient of friction (COF) than conventionally used bedsheets in both dry and sweaty conditions versus a skin model. Finally, we demonstrate the functionality of our sensor by measuring the heartbeat at the forehead in reflection mode and comparing it with commercial finger photoplethysmography for several subjects. Our results will allow the development of flexible, individualized, and fully textileintegrated wearable sensors for sensitive skin conditions and general long-term monitoring of patients with risk for pressure ulcer.

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Biomechanics of Pressure Ulcer in Body Tissues Interacting with External Forces during Locomotion

Cited by 97 publications

References 140 publications

Automated and Data-driven Computational Design of Patient-Specific Biomechanical Interfaces

Automated and Data-driven Computational Design of Patient-Specific Biomechanical Interfaces

Outdoor dynamic subject-specific evaluation of internal stresses in the residual limb: Hydraulic energy-stored prosthetic foot compared to conventional energy-stored prosthetic feet

Body-monitoring with photonic textiles: a reflective heartbeat sensor based on polymer optical fibres

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