PUMA

Development of a non-invasive and portable tissue viability measurement and intelligent actuation system for the prevention and early detection of Pressure Ulcer risk at Tetraplegic SCI users

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 Obiettivo del progetto (Objective)

'Wheelchair users (over 5 Million) are prone to develop Pressure Ulcers (PU), especially Tetraplegic Spinal Cord Injury (T-SCI, 114.000) as they do not dispose of the natural mechanisms for prevention. T-SCI lack of pain perception, motor control, reduced tissue viability and alterations on the ANS affecting basal tissue status and response (hyperemia). Suffering a PU affects negatively health, needing additional surgical interventions or longer recovery times, constituting even a deadly threat due infections; derive in social exclusion due to odours and pain; and reduce the time being able to spend sitting limiting independent living, leading all to a reduction of Quality of Life. Treating PUs cost €20 Billions per year to the EU Public Health System. Although, PU prognosis is excellent at early stages being 95% preventable, current solutions are not being effective as they rely on pressure reduction instead of tissue viability, do not consider user state, characteristics and context, and do not optimal combine current strategies. PUMA project aims to develop a novel portable and non-invasive system to prevent and early detect the risk of PU and reverts its onset, based on the control and improvement of tissue viability. Based on Real-time PU risk assessment, a combination of dynamic repositioning systems and Functional Electrical Stimulation will be optimally integrated, preserving tissue viability as well as increasing the resistance to PU development. As a result, the SMEs will strengthen their competitive position facing foreign competition, achieving a cumulative benefits of €24 Million 5 years post-project. PUMA project will count with the collaboration of RTDs on biomechanics, smart textiles and mechatronics; and the support of prescribers, distributors, retailers, T-SCI sufferers and relatives and health care professionals defining needs and requirements as well as product validation, ensuring to fulfil the expectations of end-users and market stakeholders.'

Introduzione (Teaser)

Pressure ulcers (PUs) greatly affect quality of life for wheelchair users. An EU project is developing a prevention system, using fabric-embedded sensors to automatically detect skin condition and initiate corrective action.

Descrizione progetto (Article)

Wheelchair users, particularly quadriplegics, are prone to PUs; users' lack of normal movement and diminished pain sensitivity means constant skin pressure and hence damage. PUs are a serious condition, having social consequences and causing potentially deadly medical complications; in addition, treatment can be difficult and risky.

Nevertheless, found early, PUs usually heal on their own, making detection a priority. Current devices do not work effectively. Thus, the EU-funded http://puma.ibv.org (PUMA) project aims to develop a portable and non-invasive system to prevent and reverse PUs.

A variety of tilting, motion and stimulation devices will be embedded into a smart fabric. The fabric's sensors measure tissue viability and pressure. The proposed system warns the user and automatically initiates optimal corrective action. The PUMA initiative involves eight European organisations, and will conclude after two years in October 2014.

A variety of potential sensors were compared. An impedance spectrometry sensor was selected for a combination of reasons, including reliability, cost and ease of inclusion into a smart textile. Additionally, the project characterised its target users by establishing healthy baselines for impedance and pressure, and characterising the effect of personal factors such as weight.

The consortium also consulted users, carers and professionals concerning scenarios of use. Thus, the system has been designed to incorporate effective movement strategies for each scenario. The user community was similarly consulted about preferences.

PUMA determined component requirements, and conducted various relevant tests on each to establish CE and medical certification. The study team also determined all other system requirements and user interfaces, which will be incorporated into the design.

The project commenced preliminary testing, aiming to duplicate a healthy motion with a combination of different technologies. In addition, the group has made progress towards preliminary algorithms for processing and decision making. PUMA's legacy will be a system for automatically preventing PUs in a multitude of bedridden and wheelchair-bound people. The system will improve patient health, living conditions and social inclusion, while also unburdening public health systems.