Characterising mobility and pressure exposure in community dwelling residents with pressure ulcers using monitoring technology and intelligent algorithm

Abstract

Aim: individuals in the community with reduced mobility are at risk of exposure to prolonged lying and sitting postures, which may cause pressure ulcers. The present study combines continuous pressure monitoring technology and intelligent algorithms to evaluate posture, mobility, and pressure profiles in a cohort of community dwelling patients, who had acquired pressure ulcers.

Materials and methods: this study represents a secondary analysis of the data from the Quality Improvement project ‘Pressure Reduction through COntinuous Monitoring In the community SEtting (PROMISE)’. 22 patients with pressure ulcers were purposely selected from 105 recruited community residents. Data were collected using a commercial continuous pressure monitoring system over a period of 1–4 days, and analysed with an intelligent algorithm using machine learning to determine posture and mobility events. Duration and magnitude of pressure signatures of each static posture and exposure thresholds were identified based on a sigmoid relationship between pressure and time.

Results: patients revealed a wide range of ages (30–95 years), BMI (17.5–47 kg/m2) and a series of co-morbidities, which may have influenced the susceptibility to skin damage. Posture, mobility, and pressure data revealed a high degree of inter-subject variability. Largest duration of static postures ranged between 1.7 and 19.8 h, with 17/22 patients spending at least 60 % of their monitoring period in static postures which lasted >2 h. Data revealed that many patients spent prolonged periods with potentially harmful interface pressure conditions, including pressure gradients >60 mmHg/cm.

Conclusion: this study combined posture, mobility, and pressure data from a commercial pressure monitoring technology through an intelligent algorithm. The community residents who had acquired a pressure ulcer at the time of monitoring exhibited trends which exposed their skin and subdermal tissues to prolonged high pressures during static postures. These indicators need further validation through prospective clinical trials.

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Identifiers

ORCID for Silvia Caggiari: orcid.org/0000-0002-8928-2141

ORCID for Peter R. Worsley: orcid.org/0000-0003-0145-5042

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