title: Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: a scoping review.
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.
authors.affiliation: Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Canada;
authors.forename: James Y
authors.initials: JY
authors.lastname: Tung
authors.forename: Brent
authors.initials: B
authors.lastname: Stead
authors.forename: William
authors.initials: W
authors.lastname: Mann
authors.lastname: Ba'Pham
authors.forename: Milos R
authors.initials: MR
authors.lastname: Popovic
mesh_terms: D006801:Humans; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control*; D012648:Self Care; D012656:Self-Help Devices; D013119:Spinal Cord Injuries / Q000150:complications*
keywords: SCI; assistive technology; integrated technologies; pressure ulcer; pressure ulcer incidence; pressure ulcer prevention; risk factors; self-managed care; spinal cord injury; wheelchairs