A novel in-bed body posture monitoring for decubitus ulcer prevention using body pressure distribution mapping.

BACKGROUND: Decubitus ulcers are prevalent among the aging population due to a gradual decline in their overall health, such as nutrition, mental health, and mobility, resulting in injury to the skin and tissue. The most common technique to prevent these ulcers is through frequent repositioning to redistribute body pressures. Therefore, the main goal of this study is to facilitate the timely repositioning of patients through the use of a pressure mat to identify in-bed postures in various sleep environments. Pressure data were collected from 10 healthy participants lying down on a pressure mat in 19 various in-bed postures, correlating to the supine, prone, right-side, and left-side classes. In addition, pressure data were collected from participants sitting at the edge of the bed as well as an empty bed. Each participant was asked to lie in these 19 postures in three distinct testing environments: a hospital bed, a home bed, and a home bed with a foam mattress topper. To categorize each posture into its respective class, the pre-trained 2D ResNet-18 CNN and the pre-trained Inflated 3D CNN algorithms were trained and validated using image and video pressure mapped data, respectively. RESULTS: The ResNet-18 and Inflated 3D CNN algorithms were validated using leave-one-subject-out (LOSO) and leave-one-environment-out (LOEO) cross-validation techniques. LOSO provided an average accuracy of 92.07% ± 5.72% and 82.22% ± 8.50%, for the ResNet-18 and Inflated 3D CNN algorithms, respectively. Contrastingly, LOEO provided a reduced average accuracy of 85.37% ± 14.38% and 77.79% ± 9.76%, for the ResNet-18 and Inflated 3D CNN algorithms, respectively. CONCLUSION: These pilot results indicate that the proposed algorithms can accurately distinguish between in-bed postures, on unseen participant data as well as unseen mattress environment data. The proposed algorithms can establish the basis of a decubitus ulcer prevention platform that can be applied to various sleeping environments. To the best of our knowledge, the impact of mattress stiffness has not been considered in previous studies regarding in-bed posture monitoring.

In-Bed Posture Classification Using Deep Neural Network.

In-bed posture monitoring has become a prevalent area of research to help minimize the risk of pressure sore development and to increase sleep quality. This paper proposed 2D and 3D Convolutional Neural Networks, which are trained on images and videos of an open-access dataset consisting of 13 subjects' body heat maps captured from a pressure mat in 17 positions, respectively. The main goal of this paper is to detect the three main body positions: supine, left, and right. We compare the use of image and video data through 2D and 3D models in our classification. Since the dataset was imbalanced, three strategies were evaluated, i.e., down sampling, over sampling, and class weights. The best 3D model achieved accuracies of 98.90 ± 1.05% and 97.80 ± 2.14% for 5-fold and leave-one-subject-out (LOSO) cross validations, respectively. To compare the 3D model with 2D, four pre-trained 2D models were evaluated, where the best-performing model was the ResNet-18 with accuracies of 99.97 ± 0.03% for 5-fold and 99.62 ± 0.37% for LOSO. The proposed 2D and 3D models provided promising results for in-bed posture recognition and can be used in the future to further distinguish postures into more detailed subclasses. The outcome of this study can be used to remind caregivers at hospitals and long-term care facilitiesto reposition their patients if they do not reposition themselves naturally to prevent pressure ulcers. In addition, the evaluation of body postures and movements during sleep can help caregivers understand sleep quality.

Recent Advances and Applications of Textile Technology in Patient Monitoring.

Sleep monitoring has become a prevalent area of research where body position and physiological data, such as heart rate and respiratory rate, are monitored. Numerous critical health problems are associated with poor sleep, such as pressure sore development, sleep disorders, and low sleep quality, which can lead to an increased risk of falls, cardiovascular diseases, and obesity. Current monitoring systems can be costly, laborious, and taxing on hospital resources. This paper reviews the most recent solutions for contactless textile technology in the form of bed sheets or mats to monitor body positions, vital signs, and sleep, both commercially and in the literature. This paper is organized into four categories: body position and movement monitoring, physiological monitoring, sleep monitoring, and commercial products. A detailed performance evaluation was carried out, considering the detection accuracy as well as the sensor types and algorithms used. The areas that need further research and the challenges for each category are discussed in detail.