Effects on interface pressure and tissue oxygenation under ischial tuberosities during the application of an alternating cushion.

Pressure ulcers are hazardous to people with diminished sensory and motor functions who remain in the same position for a long time. An important reason for the occurrence of pressure ulcers is the inability of wheelchair users to make postural changes by themselves with no appropriate method of pressure release. In this study, we researched the effects of applying an air cell inflate-deflate alternating sequence cushion prototype to relieve pressure from tissue loaded areas. Moreover, the hypothesis that the alternating sequence could stimulate blood reperfusion in loaded tissues and redistribute interface pressure on support area was also tested. Ten healthy volunteers were recruited to try the prototype cushion for 65 min of continuous loading; 5 min on static mode and 60 min on alternating mode. This study was conducted on healthy people because their sensitivity allowed them to state clearly and in detail, in a feedback questionnaire, any discomfort experienced with the use of our cushion. In order to address our hypothesis, interface pressure, and bilateral ischial oxygenated and deoxygenated hemoglobin were measured. After applying the alternating cushion, the interface pressure was redistributed over a larger contact area. Besides, blood perfusion was improved according to increments in oxygenated hemoglobin and decrements in deoxygenated hemoglobin of ischial regions during loaded condition. Feedback questionnaire showed that the participants did not feel pain or discomfort using the alternating cushion. The overall results showed positive effects on healthy tissue which has encouraged us to design a study involving subjects who use wheelchairs for mobility.

Upper limb orientation assessment as an articulated body chain.

Upper limb orientation estimation based on Magnetic, Angular Rate, and Gravity sensors considering multiple body segments is presented in this work. The proposal allowed assessing the activity of two or more body segments individually and jointly, regardless of their spatial relationship. A custom-made system was developed incorporating a complementary filter and a proportional-integral control for data sensor merging and, noise and instrumentation error reduction. Two controlled tests were carried out to assess the performance of the system. The former evaluated the response of the method in motionless conditions, while the latter assessed the feasibility to follow trajectories in 3D space. Ten volunteers were recruited to evaluate the system performance in three semi-controlled and daily life task tests. The system was evaluated using the common parameters in motion tracking methods and relied on a digital motion processor. The system's outcome presented a root mean square error in the range of 2.65°-3.98° for the semi-controlled tests and 0.48°-1.389° for the daily life task test. The system tests analysis proved that the proposal permitted obtaining the articulated body chain information of multiple segments when three or more MARG sensors are used.

Assessment of the effects of exposure to extremely low-frequency magnetic fields on MDCK epithelial cell lines under a controlled environment.

To assess the effects of exposure to extremely low-frequency magnetic fields (ELF-MFs) on MDCK cell lines, experiments were performed in a chamber under controlled conditions (temperature, humidity and CO2). Therefore, the measured physicochemical and electrical changes in the cells are due solely to the magnetic field exposure and not to external factors. A developed sinusoidal magnetic field generator produced the ELF-MFs with a uniform magnetic field and adjustable intensity and frequency. Three experimental indicators were used: (i) transepithelial electrical impedance (TEEI); (ii) cell migration and proliferation; and (iii) expression of the proteins of the tight junctions, and changes in the area and shape of the cell nuclei. No significant effects on TEEI values were observed when 10 and 50 G 60 Hz magnetic fields were applied to confluent cell monolayers. There were no significant differences in migration and proliferation of the cell monolayer exposed to 60 Hz magnetic fields10 and 50 G , but a contact inhibition factor was observed. The expression of the CLDN-1 protein decreased by 90% compared with the control, while ZO-1 protein expression increased by 120%. No significant effects were observed in the area and shape of the cell nuclei. Experimentation in a controlled environment, under physiological conditions, ensures that the observed effects were strictly due to exposure to magnetic fields. Different exposure conditions are necessary to determine the impact on TEEI and cell migration-proliferation indicators.

Evaluation of suitability of a micro-processing unit of motion analysis for upper limb tracking.

The aim of this study is to assess the suitability of a micro-processing unit of motion analysis (MPUMA), for monitoring, reproducing, and tracking upper limb movements. The MPUMA is based on an inertial measurement unit, a 16-bit digital signal controller and a customized algorithm. To validate the performance of the system, simultaneous recordings of the angular trajectory were performed with a video-based motion analysis system. A test of the flexo-extension of the shoulder joint during the active elevation in a complete range of 120º of the upper limb was carried out in 10 healthy volunteers. Additional tests were carried out to assess MPUMA performance during upper limb tracking. The first, a 3D motion reconstruction of three movements of the shoulder joint (flexo-extension, abduction-adduction, horizontal internal-external rotation), and the second, an upper limb tracking online during the execution of three movements of the shoulder joint followed by a continuous random movement without any restrictions by using a virtual model and a mechatronic device of the shoulder joint. Experimental results demonstrated that the MPUMA measured joint angles that are close to those from a motion-capture system with orientation RMS errors less than 3º.

An alternating pressure sequence proposal for an air-cell cushion for preventing pressure ulcers.

The distribution and release of pressure on ischial regions are two important parameters for evaluating the effectiveness of a cushion; especially the release of pressure over time on ischial tuberosities, which is significant for preventing pressure ulcers. The aim of this work is to evaluate the effect on interface pressure through the application of a proposed alternating pressure sequence for an air-cell cushion. Six healthy volunteers were asked to sit on the air cell cushion, in static and alternating modes, as well as on a typical foam cushion for 12 minutes. Interface pressure was monitored with a matrix sensor system. Interface pressure values on ischial tuberosities, user contact area and pressure distribution were analyzed. Results showed that IP on IT tends to increase in both foam and static cushions, while in alternating cushion IP on IT tends to decrease. User contact area was significantly larger in alternating cushion than in static or foam cushions. Moreover, there is a better pressure re-distribution with alternating cushion than with the other cushions. The goal of the alternating sequence is to redistribute pressure and stimulate the ischial regions in order to promote blood flow and prevent pressure occurring in wheelchair users.

A pressure distribution measurement system for supporting areas of wheelchair users.

Pressure ulcers are skin injuries caused by long term exposition to high pressures on support points that interrupt blood circulation reducing the transport of oxygen and nutrients to the cells. They mainly affect people with poor mobility that stay in seating position for long periods of time. In spite of the diversity of commercial prototypes of cushions, ulcers caused by pressure are still a problem for wheelchair users. This work describes the design of a measurement system of pressure distribution in sedentary position. The aim of the system is to record the pressure concentration in order to obtain specific information about the supporting areas, and with these data used as feedback, eventually to determine an efficient random stimulation sequence to provide, in the future, a system to prevent these referred injuries. The proposed system consists of a 12 air-cell division cushion. Each cell has a pressure sensor and an input for electro valves to inflate and deflate. The recording and control of the valves is carried out through a graphical interface designed in LabVIEW®. A calibration procedure for the designed cushion was made by comparing the greatest load values pressure with a commercial platform, similar results were obtained.